Acuity systems

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    Just got my newest Nursing Spectrum and in the cover article, they have some statistics about staffing levels nationwide. The stat that caught my eye was the fact that only 43% of hospitals use some kind of acuity system. So more than half of those surveyed (the actual number wasn't given) DON'T use an acuity system to determine staffing. I'm curious as to what acuity systems are in use in hospitals and how they work. For those in hospitals with acuity systems, do you feel the system is effective? If not, why not? And for those whose hospitals don't use any kind of acuity system, how does your facility determine nursing staffing? If it is by a staffing "grid" (or matrix, or whatever term is used), is the grid available for staff to see?

    I know I've thrown out quite a few questions to you all. Hope everyone is having a good week! :-)

    Laurie

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  2. 5 Comments...

  3. 0
    Hi Laurie. Tomorrow is my last day working at my present job. They don't have accuity ratings but a grid which we are not allowed to see lest we realize that we are understaffed. Why is tomorrow my last day? I walked on to 11 patients each and handed in my two weeks notice! I am going to work for a staffing agency and make the big bucks. I figure if I am going to be prostituted I may as well make some money at it.
  4. 0
    Hi~
    The hospital I work for uses an acuity tool, but not for staffing. I have no idea what they use it for. Our acuity does not effect how many nurses are on the floor. Our staffing is based on unit and hospital census. The tool is completed once a week and turned in to the nursing office, never to be seen again. It does make you wonder what they do with it.
    At my previous job we used a similar tool. The hospital was sold, the system that sold it went bankrupt. We, the sold hospital, had to continue to fill the forms out daily as part of the settlement deal. No one had a reaason why we had to continue, just that the nurse managers were told we had too.
  5. 0
    Originally posted by bunky:
    Hi Laurie. Tomorrow is my last day working at my present job. They don't have accuity ratings but a grid which we are not allowed to see lest we realize that we are understaffed. Why is tomorrow my last day? I walked on to 11 patients each and handed in my two weeks notice! I am going to work for a staffing agency and make the big bucks. I figure if I am going to be prostituted I may as well make some money at it.
    So you finally quit Bunky, good luck, I bet you will like agency nursing. It is stressful, however the money is good and you do not get involved in the politics of the individual units. Other problems include lack of support by managment and hostility from permanant staff member, just tell your self, "all the way to the bank".
  6. 0
    Our hospital does not use an acuity system. On the med-surg floors (including oncology and orthopedics), your assignment is simply a block of rooms, regardless of the acuity of the patients in them. This could mean you get 8 patients that are relatively stable (HAH--doubt that!) or 8 barely-making-it patients (or you could have 4 empties and take 4 admissions while other nurses don't take any because their 'block of rooms' was full). In our ICU unit, staff makes the assignments for the oncoming shift and tries to balance it out.

    I know there are systems out there (TISS, APACHE?) but I don't really know of anyone that uses them.
  7. 0
    Our hospital uses "Medicus" its a checkbox tool- we check off if the pt is on the vent with or without restraints, having labs q more often than once a day, unusual (love that one, whats unusual) emotional needs (ie hystrionic pt), etc etc. They actually do use the acutiy to determine if we need 4 or 5 RN's, and if the acuity says we get 4, our 5th floats elsewhere. It generally does work, but it is only done q 24 hrs, and I'll bet you have noticed, not many patients tend to stay the same acuity for 24 hrs in a row!


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