Planning Nurse Staffing with a Patient Acuity System

Rebecca Hendren, for HealthLeaders Media , July 27, 2010

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.”

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at

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4 comments on "Planning Nurse Staffing with a Patient Acuity System"

Becky Gaspard (8/19/2015 at 5:38 AM)
Our hospital staff is interested in a acuity [INVALID]em. I would like to know if you can send a sample of a acuity form that will help with our nurse patient ratio on the inpatient oncology health units in our hospital. Thank You, Becky O. Gaspard, RN

Janet Schreiber (4/4/2015 at 6:05 PM)
My hospital is looking at changing to acuity based staffing. Would love to know if you have something for a level 3 NICU. Janet

Sarah (1/1/2015 at 12:22 PM)
I think the acuity based [INVALID]em would drastically improve the PCU I work in. Can you send me a sample? Thanks




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