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patient classification system


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Patient classification system:

Patient classification system

Patient classification system:

Patient classification system Tool which qualifies the quality of nursing care. The PCS is a scheme that groups the patients according to the amount and complexity of their nursing care requirements. It serves as a tool to measure patient needs, caregivers interventions, and the skill levels required to meet those needs.


PURPOSES OF PCS •Determine the required nursing hours needed to provide safe and efficient patient care based on standards of care and practice. •Determine the number and category of staff (skill mix) needed for providing quality patient care.


CONT… Monitor changes in patient demographics and care needs. Provide data on each patient care unit that directs and supports staffing decision-making. •Ensure that quality nursing care is provided in a safe environment.

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•Assess the level and support services required. •Enhance staff satisfaction through a stress free work environment


USES OF PCS:- The PCS data generated is used to: •Improve patient satisfaction by providing required time to the patient according to his/her needs. Enhance staff satisfaction by determining staffing needs and thus decreasing workload

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•Monitor the provision of quality nursing care according to international standards in a safe work environment


Concepts… The care management team is the focal point. 2. Classification and staffing are separate. 3. Classification is based on professional judgment. 4. The system is self-auditing. 5. Staffing is based on informed professional judgment.


Characteristics Differentiate intensity of care among definite classes Measure and quantify care to develop a management engineering standard Match nursing resources to patient care requirement

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Relate to time and effort spent on the associated activity Economical and convenient to repot and use Open to audit

Types or Styles :

Types or Styles Patient classification systems (PCS), also known as patient acuity systems, are used to assist a nurse leader to determine workload requirements and staffing needs (Sullivan, 2005). There are different kinds of PCS available, but according to Sullivan, the three most commonly used PCS are:

Descriptive PCS:

Descriptive PCS Descriptive: Purely subjective system whereby a nurse selects which category best suits the patient.

Checklist method:

Checklist method Checklist: a subjective system whereby the acuity level of a patient is assigned as a numerical value based upon the level of activity in the specific categories. The numerical value is added up to give the nurse an overall rating.

Time standard method:

Time standard method Time standards: Another method whereby the charge nurse assigns a time value based upon various activities that need to be completed for the patient. The time value is totaled and converted to an acuity level.




PROTOTYPE EVALUATION SYSTEM •In the prototype system, characteristics of patient typical of each care category are listed, and other patients are classified on the basis of their resemblance to a typical patient in the list

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Category I: Patients with acute, non chronic, episodic disease or disability who will return to their pre-illness level of functioning and for whom the care goal is complete elimination of the existing health problems .

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Category II: Patients with chronic disease on which is super imposed an acute episode of illness, who have the potential to return to the pre-episodic level of functioning, and for whom the care goal is management of the chronic health problem by the patient and family with out ongoing support from the agency

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Category III: Patients with chronic disease or disability, where return to pre-illness level of functioning is not possible but there is potential to increase the level of functioning, and for whom the care goal is rehabilitation to a maximum level of functioning through continuing agency support.

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Category IV: Patients with a chronic disease or disability who can't be maintained at home without ongoing agency support, for whom the care goal is maintenance at home at a maximum level of functioning through ongoing agency support

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Category V: Patients with end stage illness for whom the care goal is assurance of comfort and dignity through out the terminal stage of illness


FACTOR EVALUATION SYSTEM In the factor system, a number of critical care descriptors are identified, against each of which the patient’s need for care is measured to yield a sub score. this sub score, when combined with other sub scores, yields a total score that designates the patient’s dependency category


FUNCTIONAL CLASSIFICATION SYSTEM •Most patient classification systems are of the factor type, in which a number of care elements or descriptors are identified, each of these elements is broken down into sub elements, and a standard time is set for accomplishment of each sub element (each of which represents a different level of patient dependency)

Formula for nursing workload:

Formula for nursing workload Standard formula for calculating nursing care hours per patient day- NCHPPD = Nursing hours worked in24 hours Patient Census

Hours of work in each category:

Hours of work in each category shift Category I Category II Category III Category IV NCH/PPD for day shift 2.3 2.9 3.4 4.6 NCH/PPD for evening shift 2 2.3 2.8 3.4 NCH/PPD for night shift 0.5 1 2 2.8

Conclusion :

Conclusion PCS or patient acuity system is introduced in 1960. Measurement tool for nurses workload and quality of care Commonly used type in India are Descriptive, checklist and time standard.

Bibliography :

Bibliography Ann Marriner tomey. Gudie to nursing management and leadership Page no: 395-397 Bessie . L. Marquis, Carol j huston. Leadership roles and management functions in nursing. Page no: 405-408

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D. elakkuvana bhaskara raj. Management of nursing service education. Page No: 63-65 Dee Ann Gillis . Nursing management a system approach. www.google.com

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