Congress Abstracts 2006

101

THE DEVELOPMENT OF A PATIENT CLASSIFICATION TOOL ON AN INPATIENT BLOOD AND MARROW TRANSPLANT UNIT. Marcia Brandert, RN, BSN, OCN^®, Debbie Cline, RN, BSN, Patty Johnston, RN, MHA, OCN^®, Carol Causton, RN, OCN^®, and Amy Meyers, RN, BSN, OCN^®, University of Texas M.D. Anderson Cancer Center, Houston, TX.

In the current health care arena, an increasing focus on rising health care costs, the shortage of nurses, and proposals for safer, mandatory staffing levels have led many hospital administrators to re-evaluate the standards and systems used to classify patients. The use of a Patient Dependency System (PDS) has presented an alternative to the traditional Patient Classification System tool.

The purpose of the PDS is adequate staffing of patient care units without compromising patient care. Rather than focusing solely on the acuity of the patient, this system places a greater emphasis on the patient's dependency on staff to have their needs met and the hours of care required by each patient.

A patient classification tool utilizing the PDS model is currently being developed at our comprehensive cancer center. Each inpatient unit is actively involved in the process of creating a tool specific to their patient population. On the inpatient blood and marrow transplant unit, a committee comprised of nurse management and staff nurses was formed to evaluate our unit's needs. From this committee, nine classification categories have been developed with defined criteria for each. A point system allocates a set number of points for each criteria in a particular category. Patients are then placed in a class level (1-5) based on their total number of points and reevaluated each shift. The second part of this model encompasses workload measurement. This process will assist in determining the hours of care required by each patient and quantifying the work done by the nurse during a particular shift. It will focus on both direct and indirect care activities, as well as routine activities on the unit.

The goals of this project are:
* Optimal staffing levels for all inpatient units
* Appropriate use and allocation of resources
* Maintaining budget compliance
* Greater ease in assigning patients on individual units

As the unit continues with the development of the tool, the importance of objectivity, statistical validity, documentation, and the ability to discriminate between patients in emphasized.