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what is considered high acuity?

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by yelnikmcwawa yelnikmcwawa (New Member) New Member

6,392 Profile Views; 317 Posts

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

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Flo. has 7 years experience as a BSN, RN and specializes in Developmental Disabilites,.

571 Posts; 8,101 Profile Views

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

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317 Posts; 6,392 Profile Views

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!

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1,840 Posts; 17,818 Profile Views

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

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317 Posts; 6,392 Profile Views

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 :lol2:

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nfdfiremedic has 8 years experience as a BSN, RN and specializes in ED, Neuro, Management, Clinical Educator.

60 Posts; 2,646 Profile Views

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

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BackpackingRN specializes in Emergency.

50 Posts; 1,698 Profile Views

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.

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nfdfiremedic has 8 years experience as a BSN, RN and specializes in ED, Neuro, Management, Clinical Educator.

60 Posts; 2,646 Profile Views

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.

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317 Posts; 6,392 Profile Views

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!

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Reno1978 has 6 years experience as a BSN, RN and specializes in SRNA.

1,133 Posts; 15,236 Profile Views

LOL, okay, so clearly there is no standard acuity consideration :lol2:

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

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ObtundedRN has 6 years experience as a BSN, RN and specializes in Critical Care.

428 Posts; 7,580 Profile Views

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.

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Esme12 is a ASN, BSN, RN and specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

4 Articles; 20,896 Posts; 146,316 Profile Views

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.

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