In-patient acuity measurement instrument

Loray · Apr 12, 2003

Hi MHN.

Where I work we have a system of patient dependency levels.

1. self care .......routine supervision only.

2.self care encouraged but requires increased supervision

eg daily activities monitored.....rountine obs

all patients being discharged that day.

3.general nursing care.

constant supervision with daily activties

specific obs eg neuro

newly admitted patients for first 24hrs regardless of condition (except if they rate 4or5.

ect.

4.full nursing care

patient confined to bed

close visual obs.

5. special required..nurse will remain with the patient in eye contact at all times.

Hope this gives you some feedback'

best wishes loray

MoJoeRN,C · Apr 22, 2003

The acuity systems I have worked with were usually slanted toward justifying staffing from the management standpoint. Just to see what happened, I figured the acuity with 7 clients needing 1:1 supervision on suicide or homicidal precautions and it came out 1 staff to 3 patients. I showed this to my Director of nurses (who designed the acuity system) Her remark was that the acuity system was an accurate measurement instrument to justify staffing ratios, and that what I proposed would never happen. Well I have been in a position on night shift with 3 people on detox needing hourly vitals, and doing 3 admissions with only one aid, the supervisor was observed taking smoke breaks during the night while we worked our butts off and declined to help or get extra help because the acuity did not indicate it. So you see acuity's can work whichever way administration wants them to work.

esselmulen · Apr 26, 2003

We used to have an equation called the AMIS that was done before each shift in which, the acuities of individual patients were collectivized and through a mathematical process the charge nurse would arrive at the optimum staffing number. For several years this worked very well until the acuities went up and the staffing fell. When management realized that we were chronically understaffed, they did what any manager would do. They eliminated the AMIS from the charge nurses duties, I'm sure it's still being done by someone but for sure it's not being done by the people who do the work.

esselmulen · Apr 26, 2003

We used to have an equation called the AMIS that was done before each shift in which, the acuities of individual patients were collectivized and through a mathematical process the charge nurse would arrive at the optimum staffing number. For several years this worked very well until the acuities went up and the staffing fell. When management realized that we were chronically understaffed, they did what any manager would do. They eliminated the AMIS from the charge nurses duties, I'm sure it's still being done by someone but for sure it's not being done by the people who do the work.