Measuring Acuity and Pediatric Critical Care Nursing Workload by Using ICU CAMEO III

Area of Science:

• Pediatric critical care medicine
• Nursing workload assessment
• Healthcare quality improvement

Background:

• The Intensive Care Unit Complexity Assessment and Monitoring to Ensure Optimal Outcomes (ICU CAMEO III) tool assesses patient acuity based on nursing cognitive workload.
• Validating acuity tools is crucial for ensuring appropriate resource allocation and patient care in pediatric intensive care units (PICUs).

Purpose of the Study:

• To validate the ICU CAMEO III acuity tool within the context of US children's hospitals.
• To assess the tool's ability to measure nursing cognitive workload and patient acuity in pediatric intensive care settings.

Main Methods:

• A convenience sample of 840 children admitted to 15 pediatric intensive care units across 9 US hospitals was enrolled.
• The ICU CAMEO III tool's concurrent validity was assessed by correlating its scores with the Therapeutic Intervention Scoring System-Children (TISS-C) and the Pediatric Risk of Mortality III (PRISM III) scores.
• Descriptive statistics were used to characterize patient, nursing, and unit data.

Main Results:

• The study included 840 patients from 15 PICU beds, with a median ICU CAMEO III score of 99.
• Strong correlations were observed between ICU CAMEO III scores and both TISS-C (ρ = .822) and PRISM III (ρ = .607) scores, indicating robust concurrent validity.
• The ICU CAMEO complexity classifications also showed significant correlation with PRISM III categories (ρ = .575).

Conclusions:

• The ICU CAMEO III acuity tool and its complexity classifications are validated as reliable measures of patient acuity and nursing cognitive workload in academic children's hospitals.
• The findings support the use of ICU CAMEO III as a comparable measure to established tools like PRISM III and TISS-C for assessing pediatric patient acuity.