Acuity tools or fraud???

[lee1]

Do you know what acuity tools are used to plan your staffing at your hospitals?? How are they used?? Do they have a name like GRASP? (that is one that I have read about)

Are they used every shift to determine and validate staffing?? If not, how is your appropriate staffing validated???

[Tweety, BSN, RN]

We staff buy numbers, not acuity, which is wrong sometimes. If you have a heavy patient acutiy on the floor, tough, doesn't mean you'll get extra help.

There is some tool they use in budgeting the floor. Every day/week/or month, I'm not sure, they turn in the acuity's on the floor using a point system, i.e. total cares are equal to a "4". Then supposedly this forms the basis for the budget for the amount of nurses your floor needs.

[nurs4kids]

lol..

we staff by acuity (our's is called RVU's

as long as our staffing is below the projected need, we're cool..and we don't get more staff to bring us up to the "need"..

if we're over, someone gets pulled or sent home..sometimes

[Genista, BSN, RN]

We have an acuity tool that we have to fill out each shift and fax to staffing. I know for a fact it isn't used, because I can tally up some BIG numbers for high acuity, but it won't change our staffing. It won't matter if my patients' numbers equal 22 or 62, we get the same nurse patient ratio. In reality, we are staffed by numbers. The acuity sheets are just a big "show" for Joint Commission.

[Allison S.]

We use Quadramed, but I don't think it is being used to predict staffing on a regular basis. On occasions when we have high acuity, it seems to take demand from the staff nurses to our unit management to increase staffing. Not sure if they then use the acuity numbers to justify expanded staffing, but I think they do.

On the other hand, we work with children, and I don't feel that the tool accurately captures the amount of work needed from staff depending on whether or not parents are available or interested in helping with ADLs, feeding, and keeping the kids out of trouble (e.g. from climbing oob, wandering into eachother's rooms, staff only rooms, etc.)

[Agnus]

Ok we staff by patient to nurse ratio. However, if we agree we have a high acuity or low acuity census we might adjust that. We also take into consideration that it is not always a high acuity that demands more time. Actual acuity can be low and a patient's/family's needs may be high.

We fill out an acuity tool on admission but it is essentially ignored. I don't think it has a name. It certainly does not fit any of the descriptions of tools I have seen in text books or otherwhere.

[lee1]

Do your hospitals have RN forums, where the chief nurse CEO meets with staff quarterly or whatever????

Ask her/him what acuity tool they are using and how it is used?

Sometime the upper management THINKS that middle management is doing it's job properly.

How are your managers given their job reviews?? By whom??