I've been casually working to create a tool for objectively measuring and classifying the current and anticipated acuity levels of the patients on my unit. I know that peoples' definitions of what constitutes a high acuity patient may differ vastly based upon numerous factors, and I don't want to create something that reflects only what I consider acuity to entail. I'm interested in hearing what other nurses believe influences a patients acuity, whether it is objective or subjective, or pertaining to the level of skill required, physical demand, knowledge, time consumption, a particular diagnosis, patient condition....whatever springs to mind when YOU think of acuity! It doesn't matter if you have evidence or an explanation to support your ideas, any input would be greatly appreciated.
Just for some background, I work on an inpatient hem/onc unit that includes med surg overflow as well as an increasing number of renal patients. I am well aware that programs exist to aid in this very thing, however, my hospital still uses paper charting, is by no means advanced in the way of electronic information utilization, and I am hoping to develop something to use as a guideline rather than a strictly interpreted system.
Thanks again in advance for any insight!
Mar 2, '11
by Up2nogood RN
Our acuity tool is based on pt acuity but unfortunately not used for the staffing grid. It was explained to me though the other night it needs to be used effectively to justify the ratios we have now or it could be taken away.
I don't have a copy but it is based mainly on nursing interventions. It really isn't difficut to use, it's just a short form.
A pt with an insulin gtt is automatically a high acuity-doesn't matter if they're a walkie talkie. A pt on tele that needs mult interventions, anyone on an amiodarone gtt is rated a high or 3. A new radical neck with trach is a high but a pt with existing trach with lower interventions would be a medium.
I had 2 pts the other night that required hourly dilaudid pushes and I was told they were technically a high acuity according to our tool even though they were independent pts.
A new stable post op is a medium or 2. A walkie talkie but with pca and 2 abx pb's is a medium also.
A walkie talkie who would be discharged and on oral meds is a low or 1 unless they were a nut and consumed the nurses time for ridiculous reasons, than could be rated higher.
When acuity is based on interventions provided and documented it makes it easier to rate correctly and backs up/justifies the nurses.
Last edit by Up2nogood RN on Mar 2, '11