An Objective Patient Needs-Based Acuity Tool for the Stem Cell Transplantation Patient Population

Identifying patient care needs per shift and equally balancing nursing workload increases nurse satisfaction and optimizes resources needed to provide appropriate levels of care on an inpatient stem cell transplantation (SCT) unit.

The goal of this quality improvement project was to develop and implement an objective tool to accurately define patient acuity based on specific care needs for patients undergoing SCT, balance nursing workloads, increase nurse satisfaction, and determine accuracy and reliability of the tool.

Using the DMAIC (Define, Measure, Analyze, Improve, Control) framework, an objective acuity tool was designed to meet the needs of the SCT population based on a literature search and staff input. Each nurse completed one acuity tool per shift and turned it into the charge nurse. The total acuity number for each patient was used to equally balance workload among all nurses.

Implementation of the patient acuity tool was successful, with a 61% increase in accurately grading patient acuity, a 48% increase in balanced nursing workloads, and a 45% increase in satisfaction with patient acuity in nursing assignments. The tool is reliable, with a Cronbach's alpha of 0.93.