acuity assessment tools

[jeanne1n10]

are there any current acuity assessment tools in practice where you work specifically related to psychaitric patient population?

We're trying to quantify the acuity of our unit to collect data supporiting staffing needs. We're a 30 bed crisis stabilization unit in central Florida, part of a community hospital.

Thanks for any help

[aloevera]

I'm not sure exactly what you are asking for...we don't have any quidelines to assess acuity levels at our hospital except:

4...one on ones

3....LOS, suicidal, homocidal, threat......

2....psychotic, hallucinations, MDD, ......

1....close to discharge,

Please clarify what you are looking for????

[jeanne1n10]

What we're looking for is a published tool defining levels of acuity in psychiatric patients. Your list of 1 on 1 obs, SI, HI, AVOT hallucinations, eminent DC all apply at our facility but are not "weighted." We're trying to develop or borrow a tool that will help us define staffing needs (in advance) in order to develop tollerance levels for our crisis intervention unit. We have an eclectic mix of patients with ever changing needs (who doesn't?) Perhaps just a discussion of "what works and what doesn't" as far as staffing your current facility? We operate with RN's, LPN's, MHA's, MHT's, and CNA's. Our unit serves "medically cleared" pts with a variety of stabilized medical conditions, varying levels of mobility, and self care ability. We're a Baker Act receiving and treatment unit for short term care in Florida.

any input would be helpful.

Thanks

Jeanne1n10

[aloevera]

sorry, can't help with that so much,....we are always so understaffed that I doublt our facility adheres to much of an acuity assessment tool anyway....we are lucky to have two RN's, 1 LPN (med nurse) and 2 techs on the floor with up to 35 pts., so as you can see, I doubt they are doing much assessing of that issue...

[felixfelix]

whoa, that's a workload

sorry, can't help with that so much,....we are always so understaffed that I doublt our facility adheres to much of an acuity assessment tool anyway....we are lucky to have two RN's, 1 LPN (med nurse) and 2 techs on the floor with up to 35 pts., so as you can see, I doubt they are doing much assessing of that issue...

[smurfette1953]

I too am looking for a patient acuity rating for a psychiatric State facility. We are an inpatient unit with over 300 in-patients. I have an one that is old and time consuming. This would be for psychiatric attendants and nurses.

[smurfette1953]

I too am looking for a patient acuity rating for a State psychiatric facility. We are an inpatient unit with over 300 in-patients. I have an one that is old and time consuming. I am more interested in one for the attendant staff but would also like one for nurses.

[Meraki]

Hi,

We used a great acuity scale...it was for child/adolescent but could work just the same for adult. It has I think 18 items that you rate on a 0-3 scale based on acuity. It was developed by John Lyons out of Northwestern...hope that helps

[jeanne1n10]

I would be interested in how one "makes it work" with 35 pt - psych pts- and 2 techs. who facillitates activities? what kind of daily schedule do you employ for the pts treatment? what's the mix of Axis I, II, IV?

[aloevera]

I would be interested in how one "makes it work" with 35 pt - psych pts- and 2 techs. who facillitates activities? what kind of daily schedule do you employ for the pts treatment? what's the mix of Axis I, II, IV?

techs do the vitals, q's, shuttle pts. to dr, cafe,, search new admits, etc.

we have therapists also to lead groups, family sessions, etc.

[jeanne1n10]

I don't know. maybe our pts are just more "out of control" and needy. we often have 3-7pts on 1:1 observation for fallrisk/prevention, medical instability (risk for seizure activity,) suicide prevention, "special needs" (blind, MR, ALZ/Dementia), not to mention intrussive borderlines fusing to the nurses' station like lampreys.. They are here to stabilize a crisis. They are IN crisis. We have had up to 5 D/Cs 9 adm in an 8 hr 3-11pm shift (um...like this past Wed) with 3 nurses working and splitting the adms but carrying a pt load. One day recently (week ago?) we had 12 d/c and 15 ADM in 16 hrs. Honey, there ain't no stability in that, LOL I work with some phenomenal people who handle themselves professionally in some very "character building" moments. I am continually inspired to advocate for my pts and care for my brother/sister nurses and we struggle with a system seemingly brutalizes all.

[aloevera]

we may have 2-3 on LOS, 4-5 admits a shift, 5-6 D/C, and all of the above, who said anything about stability??