Defining Patient Acuity for Nursing Assistants and its Correlation to Patient and Staff Satisfaction

Document Type


Publication Date


Publication Title

MedSurg Nursing


To achieve the best outcomes for patients, healthcare leaders need a continued focus on having nurses work to the best of their abilities and knowledge. The Institute of Medicine (IOM) (2001) recommended continuous organizational improvement through optimizing operations by working on ways to streamline care delivery and eliminate waste. Research findings suggest patients’ needs are met best by using planned skill mixes and acknowledging registered nurses (RNs) are knowledge workers. To support the clinical nurse in providing high-quality care, healthcare leaders need to consider the appropriate care delivery model. Nursing assistants (NAs) are fundamental in assisting the RN with providing appropriate care to patients. Rudisill and coauthors found assigning RNs and NAs to fit patient acuity for a group of patients wasted less time than patient allocation assignments. Excessive workloads may be attributed to nurse burnout, with similar findings likely the same for NAs. While several studies have been conducted about the use of an acuity-based staffing model for the RN, Thomasos and colleagues suggested literature related to the use of a standardized measurement tool for NA workload is lacking. These authors found NA assignments most often were based only on patients’ geographical location rather than patient acuity. They developed the TEAMS Acuity Rating System, which enabled assignments to be made according to patient acuity rather than location. Following implementation of this system, a survey of clinical partners (n=26) found 92% agreed patients benefited from assignment by acuity and 88% agreed patients received better care when assigned by acuity. Using an acuity rating tool rather than patient room location to determine NA assignment would provide a more equitable assignment. By improving efficiency among NAs, RNs then may be used more effectively in completing tasks NAs cannot perform.





First Page


Last Page