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Acuity Scale in Mental Health Mandy Cabrera Walden University
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Healthcare is a varied profession with a wide scope, it has many different aspects to it, and all need taken care of for the population to be in optimum health. All are equally important in the overall scheme of things, however there are still an order in which these needs should be taken care of. This order is called triage. “To date, there are three reliable 5-level triage scales.” (Goransson, Ehrenberg, Marklund & Ehnfors, 2005), the main one being the Canadian Triage and Acuity Scale (CTAS). These triage scales are used to assess the acuity of patients and the order in which they should be seen and taken care of. These acuity scales can also be tweaked to rate the acuity of patients on a unit to evenly balance out a patient load for nurses. When these acuity scales are objective and measurable, with set numbers for certain objects, the patient load is even, and all patients get the needed care, however when they are subjective to nurses’ discretion and opinion they can become skewed and patients can get neglected due to acuity of other patients. On an 18-bed unit for psychiatric health, acuity scales are just as important. Not only is psychiatric health important in these cases, but medical health needs to be taken into consideration as well. With that many beds and only a few nurses, acuity becomes important so that a nurses’ time can be evenly distributed. According to Brown and Clarke, (2013) there are a variety of presentations for mental health including acute anxiety, psychotic and aggressive patients, and patients that are actively suicidal or have attempted suicide; put into the mix these patients’ medical diagnoses and these patients may take a good deal of time from the nurse taking care of them. It is imperative that the balance of acuity be separated and evenly divided between the nurses working in order for the patients to get the best care possible. Without doing so, one nurse may become overburdened with too many acute patients and not have enough time in their twelve-hour shift to take care of patients the way they should be. This could incur incidents on the unit such as aggression, patients harming themselves or others, or suicidal attempts on the unit. Therefore, an
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objective and measurable acuity tool is needed to separate patient load and make the unit as safe as it can be. Patient acuity is something that is looked at in healthcare everywhere, however it is difficult to find acuity scales in psychiatric health that are not subjective. According to the APNA position statement, (2012), “there is a “thin” amount of work in psychiatric inpatient care and nursing”. There is a direct correlation between nurse staffing/patient acuity and hospital quality/safety, unfortunately there is a difficulty in linking this with psychiatric health due to the amount of research in the area. According to the APNA there are several factors that influence staff, acuity is among them.
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  • Spring '18
  • Nursing, Psychiatry, Clarke, Emergency Department, Psychiatric and mental health nursing, Journal of Psychiatric & Mental Health Nursing.

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