Assigning Acuity level to pt

[gator mom]

I am working on updating our current method for assigning an acuity # to a pt. I work on a PCU-post surgical/ortho floor. Currently we use a 1-2-3 system with 1 being the most acute and 3 being the least. Currently the individual nurse writes the # next to the pt. before change of shift so the teams can be assigned appropriately. It seems that we use #2 too much and reserve #1 for those that tend to be a difficult pt to deal with and very rarely #3. Some nurses will give their pt. a #2 just because they are pleasant and cooperative even though they need blood,multiple meds and have a lot of pain. We used to have a standard to go by but it has fell to the wayside quite a few years ago before I worked there. We get a lot of total joints,abdominal surgerys,chest tubes,isolation pts.fem-pop bypasses.TURPS etc. Any help is appreciated. Thank you.

[imanedrn]

On my unit, nurses are assigned pts based on sequential room numbers, not acuity, but (during out shift) we fill out a form with the acuity level of the patient. Ours is also 1,2,3, but 1 is lest acute and 3 is most acute.

At the bottom of the sheet, criteria for meeting this acuity is listed, i.e., pt must meet 3 criteria in this area to be #2. It's funny, though, because most nurses disregard the official criteria and just slap a number down. I think most nurses want it to look like their patients are more "acute" than they truly are. In reality, some patients aren't necessarily high acuity but are VERY demanding and that causes a nurse to up them from a 1 to a 2.

The fact that we don't staff based on acuity makes the whole process seem useless, and I imagine that's why our nurses don't take it seriously anyway.

[barefootlady, ADN, RN]

I have never worked where staffing was done by acuity. Our acquity is assigned by completed questions. Blood, mult IV and IV meds, assist was ambulation d/t casts and frequent IV pain meds cause a higher acuity to be assigned.