Development of a community health intensity rating scale

The purpose of this study was to develop and validate a patient classification method for community health that would enable the categorization of patients based on their nursing care requirements. The Community Health Intensity Rating Scale (CHIRS) was developed by integrating nursing theory with nursing practice. Groups of nurse experts in community health developed prototype definitions for 15 community health parameters that incorporated both patient characteristics and critical indicators of care as descriptors of nursing care requirements. The tool was then pilot tested using staff nurses from three home health agencies. Validation of the tool was accomplished by a retrospective rating of 560 charts from two home health agencies. By quantifying the CHIRS score using nursing visits as a measure of resource consumption, it was possible to show that nursing resource consumption increased with each increasing level of CHIRS rating. Reliability and validity were established for the tool.