Administrative decision making: staff-patient ratios (a patient classification system for a psychiatric setting)

In this article, we have described a patient classification system in use at the C.F. Menninger Memorial Hospital. It is a type of factor evaluation, in which we use critical indicators or descriptors of care as units of measurement. Each critical indicator represents a grouping of nursing activities rather than concrete time measurement of each activity. The ten critical indicators of patient care needs and nursing activities which were identified were divided into two major categories: routine and extra. Each category was then subdivided to reflect a range or variation of care levels. This type of patient classification appears to have an advantage over other classification systems when applied to psychiatric nursing. The factor evaluations are broad enough in scope to allow inclusion of patient assessment, documentation, and use of the nursing process, while providing a measurement of psychological and psychosocial needs of the patient which are frequently absent in other classification systems that rely on task measurements or acuity levels alone. Because of its practicality it has been readily accepted by nurses working on psychiatric units, and the nurse administrator's effort to put a classification system in place has been made easier.