Nursing

From the staff development bookshelf: Patient classification systems to coordinate patient care

Staff Development Weekly: Insight on Evidence-Based Practice in Education, April 20, 2012

Patient classification systems (PCS), also known as patient acuity systems, are used to assist a nurse leader to determine workload requirements and staffing needs (Sullivan, 2005). There are different kinds of PCS available, but according to Sullivan, the three most commonly used PCS are:

  • Descriptive: Purely subjective system whereby a nurse selects which category best suits the patient.
  • Checklist: Also a subjective system whereby the acuity level of a patient is assigned as a numerical value based upon the level of activity in the specific categories. The numerical value is added up to give the nurse an overall rating.
  • Time standards: Another method whereby the charge nurse assigns a time value based upon various activities that need to be completed for the patient. The time value is totaled and converted to an acuity level.


Some organizations do not use a PCS system, but train their charge nurses to understand that the less a patient can do for themselves and the more activities that you need to do with a patient, the higher the acuity. Your organization needs to educate your charge nurses on what approach is used and recommended so that there is a consistent practice in decision making, regardless of the charge nurse, shift, and department that they work on.

Whatever PCS is used in your facility, it will be applied to forecasting staffing needs within your department. Charge nurses should be informed of the patient care ratios that are relevant to each department and should understand how to predict staffing needs based upon the PCS utilized.

Book excerpt adapted from
Charge Nurse Program Builder by Tammy L. Berbarie, BA, RN, RN-BC.

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