Staff Developed PACU Acuity Scoring Grid.

Abstract

The goal of this project was to design a tool to classify patients in the postanesthesia care unit (PACU) for acuity as defined by nursing interventions. An instrument development and validation approach was used. A PACU acuity scoring grid was developed using the American Society of PeriAnesthesia Nurses (ASPAN) professional guidelines and Rothman Index concepts to help classify patients by acuity and determine PACU acuity class. The appropriate ASPAN nurse-patient ratio was assigned to the classification. PACU staff were educated on use of the PACU acuity scoring grid. Staff piloted the grid on patients in PACU and then refined the grid. Validity and reliability of the grid were also evaluated. Data evaluation showed that 54% of patients fell into classification II, with a ratio of one nurse to two patients. Classification III is the second highest category with 38%, with a ratio of one nurse to one patient. The tool demonstrated validity and the Cronbach alpha measure of reliability for the PACU acuity scoring grid was 0.695 on 73 of the 92 variables on the grid. The PACU acuity scoring grid is a tool that can be used to identify patient acuity by assigning acuity points to nursing interventions in five categories. The acuity points can be used to assign a patient to a PACU class, which can then converted to a nurse-patient ratio to allow for the provision of safe and efficient nursing care.