pt acuity scale

[suni, BSN, RN]

I work a med surg floor and am interested in an acuity scale for staffing purposes if anyone has one they can share it would be most appreciated.

[HouTx, BSN, MSN, EdD]

Commercial acuity scales are proprietary information & cannot be 'shared' unless you purchase a contract the the vendor. Home-grown scales are basically worthless unless they are based on analysis of time & motion studies in the setting in which they will be used.

There are literally decades of nursing research on this subject, so I am sure you can find an enormous number of examples in the literature. If you want to adapt one of them for use in your organization, you will still have to validate the hours of care with local data. Even the most sophisticated scale for ranking patients does not account for two very important variables... so make sure that your scheme accounts for the following:

1) Admissions, discharges & transfers consume a huge amount of nursing time but this is seldom accounted for in any staffing system

2) Differences in nursing skill levels - not all staff are equally productive. New Grads simply cannot work as fast as experienced staff. Levels of staff (RN, CNA, LV/PN) should be specified within each acuity. This can get tricky, so the system should be able to differentiate "high acuity" due to workload (needs can be met with CNA) versus "high intensity" needs that would require an RN (new diagnosis, labile status etc)

Although acuity scales are helpful, they can also be a trap - micromanaging nursing staffing without any ability to adjust when needed. They also require at least annual re-validation with time and motion analysis.