Related Experiment Video
Updated: May 30, 2026
06:52
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Patient acuity rating: quantifying clinical judgment regarding inpatient stability
Dana P Edelson1, Elizabeth Retzer, Elizabeth K Weidman
1Department of Medicine, University of Chicago, Illinois, USA. dperes@medicine.bsd.uchicago.edu
Journal of Hospital Medicine
|August 20, 2011
Summary
A new Patient Acuity Rating (PAR) score effectively quantifies clinical judgment of patient deterioration risk. This tool aids in improving patient handoffs and reducing adverse events during care transitions.
Area of Science:
- Healthcare quality improvement
- Clinical risk assessment
- Patient safety
Background:
- Increased patient handoffs due to resident work-hour restrictions pose risks.
- Need for improved accuracy and efficiency in provider sign-outs.
Purpose of the Study:
- Develop and validate a judgment-based scale to predict clinical deterioration risk.
- Assess the utility of the Patient Acuity Rating (PAR) score.
Main Methods:
- Prospective observational study at a university teaching hospital.
- Physicians and midlevel practitioners assigned a 7-point PAR score to patients.
- PAR scores correlated with actual cardiac arrest or ICU transfer within 24 hours.
Main Results:
- 6034 PAR scores collected; 74 patient-days resulted in adverse events.
- Overall AUROC of 0.82 for PAR predicting deterioration.
- PAR score of 4+ showed 82% sensitivity and 68% specificity.
Conclusions:
- Clinical judgment of patient stability can be reliably quantified.
- The PAR score efficiently conveys complex patient assessments during handoffs.
- Potential to improve communication and reduce adverse events in inpatient care.
Related Concept Videos
01:20Assessment of Ventilation I: Respiratory Rate
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:30Guidelines for Nursing Documentation I
Quality documentation and reporting share essential characteristics that ensure they are practical and valuable resources for those who use them. These characteristics are:
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
01:15Nursing Evaluation
The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
Section...
Section...
01:21Planning Nursing Care I
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
01:21Methods of Documentation III: PIE
Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:
01:29Nursing Assessment
The two sources for collecting information are primary and secondary. After gathering information, interpretation and validation help to complete the data. The purpose of assessment is to establish data with the initial information, to interpret data about the patient's perceived needs and health problems, and to respond to these problems identified.
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments and...
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments and...