Inpatient Nursing- ICU

RRM Category: INPATIENT CARE

Overview

The ICU RRM module estimates the number and type of nursing staff and is based on the American Association of Critical Care Nurses’ (AACN) Scope and Standards for Acute and Critical Care Nursing Practice, which states the professional practice of the acute and critical care nurse is characterized by the application of relevant theories, research, and evidence-based guidelines to explain human behavior and related phenomena.

Such application also provides a basis for nursing intervention and evaluation of patient-oriented outcomes. The standards of care for the acute and critical care nurse build upon ANA’s Nursing: Scope and Standards of Practice to delineate expectations in this specialty environment.

Services Description:

Intensive Care Unit nursing staff provides acute care services 24 hours per day, 365 days per year to patients with a high intensity of illness.

AACN has established and developed a staffing criteria for 24-hour 1:1 Nursing Care in using the Synergy Model, which allows the standardization of the delivery of care from one ICU to another while personalizing it according to patient’s needs.

The Synergy Model Patient Classification for Level I are those patients that require 24-hour nursing care and could not safely be assigned to a nurse caring for another patient.

The criteria for 1:1 nursing care consist of 4 categories:

• Stability, Level 1
• Highly Complex, Level 1
• Vulnerability, Level 1
• Resiliency, Level 1

If the patient does not fall into the 1:1 category by meeting these levels, the patient is classified as 1:2 nurse- to-patient ratio.

Reference: American Association of Critical Care Nurses, www.AACN.org Exit Disclaimer: You Are Leaving www.ihs.gov 

Staffing Criteria

4.8 FTEs provides 24-hr coverage

Minimum requirement of 2 nurses per 24-hr coverage

Fixed RN Supervisory Clinical Nurse of 1.0 FTE for each facility with an ICU.

Fixed Registered Nurse – ICU staff of 10 FTE for each facility with a 1:2 nurse-to-patient ratio of 1 to 4 patients, plus 4.8 FTEs Registered Nurse – ICU for every 1 to 2 additional patients and/or for every patient classified 1:1 nurse-to-patient ratio.

Fixed ICU Health Technician/Monitor Technician-ICU staff of 10 FTE for each facility with an ICU.

Fixed Clerical Support- ICU staff for 2.0 FTE for each facility with an ICU.

Staffing Formulae

Driving Variables:

Patient Classification
Detoxification of patients

Personnel Categories:

RN Supervisory Clinical Nurse
Registered Nurses
Clerks
Health Technician/Monitor Tech.
Clerical Support

MINIMUM STAFFING LEVELS:

VARIABLE STAFFING LEVELS: