patient acuity system

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Does anyone use a patient acuity system? My nurses feel like the acuity of their patients have increased so much that the normal ratio they are used to now feels unsafe to them... with battleing with the patient flow from the er when we have open beds, its hard to tell the nurses they have to yet take another patient to stop from posting the pt in boarding status in the er. help!!!!

Specializes in psychiatry, orthopaedic trauma.

this sounds interesting - are you able to share your method?

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this sounds interesting - are you able to share your method?

sure. I can email you our template if you like. PM your email and I'll get it to you along with our protocol for using it.

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Specializes in psychiatry, orthopaedic trauma.

no idea how to pm - [email protected] Very much appreciated!!

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Specializes in Psych, Med/Surg.

Childpsych- I am the manager of several units- child psych is one. We are looking to re-vamp our acuity leveling system. Would you share your leveling tool?

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ChildPsych - not to jump on the bandwagon...but

We are also struggling. We are a VERY small unit (6) beds and can't justify the electronic systems...could we also get a copy?

Thanks for considering.

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done. let me know if you have questions.

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Child Psych,

Could you please send the paper to me as well? [email protected]

Thanks so much!

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I can not figure out how to send a PM would you be willing to email your equity tool to me as well. [email protected]

Thanks for considering this!

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Specializes in Tele m/s, new to ED.

This is always a sticky subject. What is safe? Our VIP of clinical practice has a goal of about 5:1. That's 1.5 hours per patient on a med-surg, post-Op floor. Nurse Assistants do all the baths, pass trays, and answer call bells. We have few LPN's left, and when they are on they do the glucose monitoring, and pass some meds. We currently are also using the outdated Charge Nurse sitting at the desk, taking orders, and accomodating the docs (yes, one even makes sure a certain doc has a particular chair.) My day staff, longer tenure, chronologically advanced, believe 4:1 is really pushing the limits. My evening staff and night staff don't say much. They regularly have 6-7:1, call-ins change everything. I have told my outspoken, safe ratios nurses that the ICU has positions available. The are never over 3:1. However. They have no aides, no secretary, and no Charge Nurse waiting on everybody. They also have ventilated patients, and patients on cardiac drips, etc.

I'm a new manager, and I haven't worked a med-surg floor in some time. I recall nurses giving baths, doing all the meds and glucose monitoring, and answering call bells. I was on Telemetry floor, generally 6:1 ratio. It was busy, and very tiring. As a rural hospital the docs know the limitations and put the higher acuity patients in the ICU.

I put determining the acuity/ratio on the Charge Nurse. The Staff Nurses and Charge know the patients best. If someone is more acute, or has more IV meds, Blood Transfusions, recent post-Op complications, then that Nurse should have a "lesser" assignment. I also expect the Charge Nurse to go down the hall and help out (admits, meds, call bells...)

The times are changing. Med-Surg units are more acute, the patients are more complex, nursing has become more technical, and the fiscal expectations are perhaps outragious. Unfortunately, Nursing is being asked to do more and more, with less and less. I stress team work and communication. Ask for help. Document changes in patient presentation, and let the docs know what the patient needs. The Nursing Process. What is the plan, where do we need to change the plan.

I don't know if this helps anybody, but I feel better getting it out of my Sunday morning brain.

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