How to determine patient acuity - page 2
Does anyone know of any guidelines for determining patient acuity? I'm sure we can all pretty much do it in our heads, but I'm actually looking for documented recommendations. Without some kind of... Read More
Nov 6, '08 by BookwormRNOf course, acuity systems also fail to account for the ADT 'noise' (admissions, discharges & transfers) that are very time consuming. We all know you can start & end the shift with 4 patients, but the ones you ended up with are not the ones you started with!
Actually, our acuity system (MESH) does take into account admissions, discharges and transfers on the unit. We do get "points" for these things. Sometimes, I agree the points are a true indication of the time spent, but at least it does boost the acuity!
Nov 6, '08 by PudnluvSafe staffing has to start somewhere. It has to be more than just the numbers. I think a laundry list of tasks for determining acuity is a good place to start. It gets away from the number nurse to patient ratio system. And it can be tweaked and upgraded depending on the needs of the unit. I truly appreciate everyones feedback on the issue. Some of us from my unit are really trying to change the system.
Nov 6, '08 by momofdandmWe have a 1-2-3 acuity sheet that each shift fills out. The charge nurse then uses it to determine the assignment for the oncoming shift.
A 1 is for an easy pt. A&Ox3, ambulatory, not a lot of meds, hardly on the call light.
A 3 is for q2h turns, drsg changes, lots of meds, on the call light constantly, incontinent.
A 2 is anywhere in the middle
There are numerous times where we put that a pt is 1-2. That is, they are an easy pt, but they have a little more going on that would make them closer to a 2 as well, but not quite a 2.
Our acuity boards have things like drsg changes, discharges, accuchecks, we also write in if they are q2turns, have foleys, lot of prn pain meds, etc. It's a great system and all charge nurses use it wisely, for the most part, when making assignments.