Nurses perspective of patient acuity on geriatric assessment units.

Abstract

The purpose of this study was to explore how nurses on geriatric assessment inpatient units perceived patient acuity. Three questions were developed and included: what variables do nurses use to define acuity; does variation exist between and among groups of nurses; and are there nursing activities taken for granted or overlooked that can contribute to the perception of acuity? The purposive sample included all the full time and part time nurses (11 RNs, 16 LPNs) working on the units. Focus groups were used to facilitate the data gathering for this qualitative study. Five themes were identified from the data and the program NUD*IST was used to visualize the relationships between the individual items and themes. Patient acuity was defined differently by the RNs and LPNs and is based on their reality and the realm of their mandated practice. A large category of indirect non patient related activities was found to contribute greatly to the nurses' perception of acuity. Two benefits of the study were: 1) provision of a breakdown of items nurses incorporate into their definition of acuity; 2) a list of categories to guide decision making when determining which category of staff is required to best meet the needs of the patients.