Planning Nurse Staffing with a Patient Acuity System

Each unit has varying levels of acuity. Harper’s maternal-child unit has seven different levels because it includes women in labor, women in delivery, C-sections, the operating room, and post-partum patients.

Harper says her unit relies on the software to support why they do things. “Charge nurses do acuity assessments every eight hours to examine staffing needs. The program helps them identify what happened on the shift and anticipate what may happen on the next,” she says.

“In my area, someone in early stages of normal labor doesn’t need as much nursing time,” she says. “We put (the) IV in, put them on the monitor, etc. When they get into second stage, they need more time, such as monitoring, pain medications, and emotional support. Then when delivery occurs, we need more people.”

The system tracks patients as they get more or less acute and Harper says it helps to justify staffing. A manager may look at a report that showed eight nurses for 10 patients on one shift, which sounds like a lot, but the acuity report will demonstrate the patients were all high acuity.

Harper says the system is appreciated by nurses because it allows nurses to determine their staffing needs. “It’s the nursing staff that identifies the needs of the patient and what’s going on with the patient,” she says. “It’s their decision. It’s not a higher-up decision. They are the ones who select the patient acuity. Staff nurses put this together—it’s not the managers who decided it.”