Develop and Validate Patient Acuity-based Nursing Assignments Model for Critical Care Units

Abstract

Introduction: This study aims to develop and validate a patient acuity-based nursing assignment model tailored for critical care units. Traditional nurse-to-patient ratio models often fail to address patient complexity, leading to inefficiencies, nurse burnout, and poor patient outcomes. By integrating patient acuity and nurse expertise, the proposed model ensures equitable workload distribution, improves care quality, and enhances staff satisfaction. The study highlights the need for evidence-based, adaptive staffing strategies in intensive care settings.

Methodology: This quantitative study used the Delphi technique to develop and validate a patient acuity-based nursing assignment model for critical care units. Expert opinions from three rounds informed the model. Using Therapeutic Intervention Scoring System 28, checklists, and questionnaires, validated through pilot testing, the model ensures equitable nurse assignments and improved care quality.

Results: The study revealed that most nurses were female with moderate experience and balanced qualifications. Current assignment models were easy but required improvement. Medical intensive care unit and Emergency Medical Surgical Intensive Care Unit had the highest acuity and workload. More nurses led to complications and better outcomes. Expert consensus validated the model, recommending fair nurse distribution per intensive care unit (ICU).

Conclusion: This study developed and validated a patient acuity-based nursing assignment model to address mismatches in traditional ICU staffing. By integrating acuity scores and nurse competencies, the model improved workload balance, care quality, and staff satisfaction. Validation confirmed its reliability and applicability. The study highlights the necessity and feasibility of data-driven, equitable staffing in critical care, offering practical insights for nursing practice, education, administration, and research.