what is considered high acuity?

[yelnikmcwawa]

Hi everyone, just wanted to know what patient acuity number is typically considered "high acuity". Thanks!!!

[Flo., BSN, RN]

Depends on the floor and the acuity tool that they use. On my floor it goes 1-3, with 3 being the highest acuity.

[yelnikmcwawa]

Okay, so my hospital uses 1-4 I believe (maybe 5, but I've not seen that), and many of our patients score between 3 and 4, so would that be considered high acuity? I am not on an intermediate or ICU floor, but we still have neurologically compromised and cardiac patients so our acuities are much higher than a typical rehab or general med/surg floor. Just deciding whether or not it is fair to say that I work on a high acuity floor. Still learning all of this terminology ;-) Thanks!

[GM2RN]

I work in the ED where we score 1-5 with 1 being the highest.

[yelnikmcwawa]

I work in the ED where we score 1-5 with 1 being the highest.

LOL, okay, so clearly there is no standard acuity consideration

[nfdfiremedic, BSN, RN]

In my ED we use the standard ESI 5 level system (Emergency Severity Index) that is recognized nation wide. 1's are in need of immediate life saving intervention. 5's could have called their doctor Monday morning.

Here's some basic info on this widely used (in ED's anyway) system.

http://www.ahrq.gov/research/esi/esifig3-1a.htm

[BackpackingRN]

yea I have only ever seen that scale used on all of the floors. I would have said 3-4 are not exactly high acuity but perhaps there are different scales, I would be interested to know.

[nfdfiremedic, BSN, RN]

to add on to what I mentioned earlier, in my department levels 1-3 are seen in the ED and level 4's and 5's are seen in fast track.

[yelnikmcwawa]

yea I have only ever seen that scale used on all of the floors. I would have said 3-4 are not exactly high acuity but perhaps there are different scales, I would be interested to know.

Our floor acuity is not like an ED acuity. It just helps us to determine staffing needs and keep our patient ratios down. For us, the higher the number, the higher acuity. So a level 1 or 2 would be a walkie talkie with very little, to no skilled nursing going on throughout the shift. A 3 or 4 would have things like tube feedings, trach or wound care, behavioral intervention, frequent vital or neuro checks, cardio drips, etc. Funny how different this all is!

[Reno1978, BSN, RN]

LOL, okay, so clearly there is no standard acuity consideration

Nope, where I work, it's: green/yellow/red.

[ObtundedRN, BSN, RN]

Where I work, I'm not aware of any unit using a scoreing system. If the patient is appropriate for your unit, then you take them. And the patient:nurse ratio depends on the level of care for that unit. med/surg has 6:1, tele is 4:1, progressive and ICU is 2:1. And there are certain criteria that will not let you below a certain level of care. Our progressive is basically an ICU, you only go to ICU if you are sedated or on titrated pressors. If you require high flow O2, are vented, on non-titrated sedation/pressors, on any other titrated drips, or require BiPAP for any reason other then a pre-existing home use for OSA, then you go to progressive. If you don't need any of that but need some tele monitoring or continous pulseOx then you go to tele. If you don't need any of that, then you go to med/surg.

[Esme12, ASN, BSN, RN]

Staffing sysems differ from facility to facility. What may be low acuity for a Level one trauma Center to have on the floor is a High acuity on the regular floor of a rural hospital......

A critical 1: 1 patient in an ICU that does not do open heart is probably a step down patient in one that does...

It is all a matter of prespective.