acuity assessment tools

[jeanne1n10]

are there any current acuity assessment tools in practice where you work specifically related to psychaitric patient population?

We're trying to quantify the acuity of our unit to collect data supporiting staffing needs. We're a 30 bed crisis stabilization unit in central Florida, part of a community hospital.

Thanks for any help

[Meraki]

I would be interested in how one "makes it work" with 35 pt - psych pts- and 2 techs. who facillitates activities? what kind of daily schedule do you employ for the pts treatment? what's the mix of Axis I, II, IV?

I'm a bit confused if you are asking this in relation to acuity scales or just asking ingeneral questions about programming on psych units?

We don't do the acuity scale everyday as it isn't used to drive daily patient assignments or individual daily programming. It is more of an outcomes measures that can be used to look at acuity of the unit, areas of acuity of our patient population and staffing and programming based on those acuity levels.

[aloevera]

we do assess acuity in order to staff properly....or try to....the supervisor does this at beginning of shift and will pull from another unit if possible....

[jeanne1n10]

The Charge nurse assesses need/staffing before the beginning of each shift for the upcoming shift.

The Orignial thread asked for a published acuity scale in use at your facillity relative to psychiatric patient acute behavioral needs.

Thanks.

[beepeadoo]

Gonna bump this to the top, as it fits my needs, rather that start a new thread.

I too am looking for a subjective assessment tool/program/system to assess psychiatric acuity in our Emergency Department.

As it now stands we have a tool for MEDICAL acuity that is very cut-and-dried, assessing intervention needs, and then evaluating vitals, to give a Green to Red rating. Consequently the acuity rating drives standards of care. I'm sure this is not foreign to any of you.

So I'm wondering if there is a similar system out there for our psych patients? E.g., evaluating GAF, co-morbidity, HTS/HTO, etc., to give a rating that would then drive standard of care, as well as transition to the floor, when necessary.

Any thoughts would be great.

Have a good one!

]..[

[Meraki]

I too am looking for a subjective assessment tool/program/system to assess psychiatric acuity in our Emergency Department.]..[

I work in pediatric but this one could probably be adapted for adults. The same company may actually have one for adults. I've attached the manual - the scoring sheet is at the end. You can then create algorithms from them - e.g. a 3 on items 1,2 or 4 indicates admission etc...

http://ibhas.in.gov/Documents/CANS-CAT%20Indiana%20.pdf

[PsychRnbc]

i've scanned through the responses to your expressed need -that you've eloquently stated -for a current acuity assessment tool(s), and was hoping to get a helpful response because our unit is in deep need of the same tool. i've googled and googled to no avail for the same thing, and to no avail. nothing - "you can google that." it appears like psychiatric acute inpatient units - "wins the orphan department again." you need it more than we, because we take only voluntary patients, and at most we can have 21 patients; we can definitely identify with all of your other expressions. (i think if one person could get the right team together - there would be million$ to be made per sell of such tool, and ,or a consulting business.) most everyone is looking at staffing hoping to cut unecessary things due to the recession, and i trust most doing so have safety at top of their list.

when we go to budget we need to argue for more budgeted hours per day, i.e. "we need more hours - and why." our administration in the hospital doesn't profess to know much about psych staffing. currently we go by a census based daily staffing - the hours per pt on the unit that we can have. our hospital is all about standards and safety!. but we need more staff to do the job. to see what systems others are using would be of help if standards are higher in those places - that sort of fyi is helpful. but a published well accepted acuity tool for acute inpt psych - would be the perfect answer to your original thread. i'm googled up and googled out!!! praying for a break-through here...

[beepeadoo]

I work in pediatric but this one could probably be adapted for adults. The same company may actually have one for adults. I've attached the manual - the scoring sheet is at the end. You can then create algorithms from them - e.g. a 3 on items 1,2 or 4 indicates admission etc...

http://ibhas.in.gov/Documents/CANS-CAT%20Indiana%20.pdf

I'm actually in peds, so that works for me. Actually that's pretty good -- a bit long but really along the lines of what I was looking for. I shall keep looking as well. Thanks!

[SweetLemon]

We also use a 1-4 system....... On nights everyone must be checked Q15min regardless of their acuity (unless they are already on an established 1:1 basis then they are constantly monitored).

During day/evening shifts it the scale is:

1: patient has contracted for safety with staff and needs little redirection from staff and require hourly checks.

2: Patient has contracted for safety but needs moderate redirection from staff. We still are required to check on them hourly but always keep a much closer eye then that and encourage these clients to spend time in the common areas interacting with staff and peers.

3: Patient has contracted for safety but needs a lot of watching over, monitoring and redirecting, depending on the doctor we probably have these patients on Q15min checks throughout the day.

4: Patient will not contract for safety and depending on the severity of their illness and desire to hurt themselves or others we have them on a 1:1 with staff or if they really need the extra support, 2:1.

To be completely honest, our staffing rarely ever reflects the acuity of our patients. We have so many days where the acuity is low and we have double the staff needed to comfortably run the unit, then on days where acuities are through the roof I find don't have enough staff to simply allow people off the unit for a 15min break. Grrrr... makes me a bit batty! :bugeyes:

[IMustBeCrazy]

Acuity tools on inpatient psych are very misleading IMO. Acuity is supposed to be a numeric measure of the TIME spend with a patient or on their care (med rec, getting orders, completing admit paperwork etc.), based on their condition. So, theoretically a "1" is someone with few needs (INCLUDING few needs of your support staff), stable, very few or no meds, all discharge completed and waiting to leave. We rarely have a "1" on our unit.

In addition, acuities are flexible and can change during a shift. If you are not willing or unable to dynamically update and reassess the state of unit acuities during your shift, then they are useless.

[blondnursey]

the state of minnesota has good psych hospitals.

try contacting them, they have pretty good ratios and acuity tools etc.