Patient classification

patient classification

1. Presented by Mr. Chetan R Sangati IInd year MSc (N)

2. PATIENT SYSTEM OF CLASSIFICATION Patient classification system which quantifies the quality of the nursing care ,is essential to staffing nursing units of hospitals and nursing homes. In selecting or implementing a pcs , a representative committee of nurse manager can include a representative of hospital administration.

3. DEFINITION : A patient classification system is a method for grouping patients According to the amount and complexity of their nursing care requirements. Is a system developed to objectively determine workload requirement, Staffing needs and work hours. It serves as a tool to measure patient needs, care giver interventions and skills level required to meet this needs In most classification systems, patient are grouped according to their dependency on care givers or the amount of caretaker time and ability employed in caring for them.

4.   IMPORTANCE OF PCS: 1.Improve patient satisfaction by providing required time to the patient according to his or her needs. 2.Enhance staff satisfaction by determining staffing needs and those decreasing workload. 3.Monitor provision of quality nursing care According to international standard in safe work environment.

5. CHARACTERISTICS: 1.Differentiate between intensity of care among definite classes 2.Match nursing resources to patient care requirement relate to time and effort spend on associated activity 3.Economical and convenient to use . 4.Global 5.Objective 6. Flexible 7. Easy to understand

6. Purposes of pcs : 1. To provide safe and efficient patient care based on standards of care and practice 2. Determine the number and category of staff (skill mix) needed for providing quality of patient care. 3. Provide data on each patient care unite that directs and support staffing in decision making 4. Assess level and support services required.

7. 5. Enhance staff satisfaction through stress free work environment 6. Categorize patients according their needs and the time and skill needed to satisfy each category needs. 7. Determine work load and nursing care requirements. .

8. components According to johnson indication there are two methods of categorizing patients. FIRST CATEGORY In which each patient is rated on independent elements of care , each element is scored , score are summarized and patient is placed in a category based on the total numerical value obtained

9. Each category addresses activities of daily living ,general health ,teaching and emotional support, treatment and medications. Data are collected on average time spent on direct and indirect care. SECOND CATEGORY In which set guidelines describing the way in which patients will be classified the frequency of classification and the method of reporting data.

10. THIRD COMPONENT In average amount of the required for care of a patient in each category FOURTH COMPONENT In which nursing care hours will be calculate.

11. According to sullivan,2005Pcs Is also known as patient acuity systems and are used to assist nurse leader to determine workload, requirements and staffing needs(sullivan,2005) There are different kind of pcs available, but according to Sullivan ,the three most commonly used pcs as following: 1.Descriptive : - The nurse chooses the category that best describes the patient

12. 2. The check list style : The nurse checks the activity level for each patient in each category and totals the points for each patient to determine the level of care 3. Time standard method: Another method in which incharge nurse assigns time based on various activities that need to be completed for the patient.

13. Other types of pcs : Proto type evaluation system. Factor evaluation system

14. Proto type evaluation system: Describes typical patient and varying need levels. Characteristics are listed in five care category as follows: 1.CategoryI :patient with acute non chronic, episodic disease or disability who will return to the pre illness level of functioning & the care goal complete elimination of the existing health problem

15. 2.CategoryII :patient with chronic disease on which is superimposed on acute episode of illness, who have the potential to return to the pre episodic level of functioning and the care goal managing chronic health problem by patient and family without ongoing support from agency. 3. Category III : patient with chronic disease or disability where return pre illness level functioning in not possible but there is potential to increase the level of functioning, rehabilitation to maximize level of functioning through continuing agency support .

16. Category IV : patient with chronic disease or disability who cant be maintained at home without ongoing agency support ,for whom the care goal is maintenance at home at maximum level of functioning through ongoing agency support. Category V : Patient with end stage illness for whom the care goal is assurance of comfort and dignity throughout terminal stage of illness

17. Categories of patient classification systems Category1: Self-care requiring from1to2hours per day . Category2: Minimal care requiring from3to4 hours

18. Category3: Intermediate care requiring from 5to6 hours Category4: Modified intensive care requiring from7to 8 hours . Category5: Intensive care requiring from10to14 hours

19. Patient care classification 1-Eating 2-Grooming 3-Excrecise 4-Toileting 5-Comfort measures 6-Mobility 7-General health 8-Treatment 9-Health education and teaching

20. Hours of nursing care needed for each level Nursing care hours per patient day ( NCHPPD) FOR DAY SHIFT NCHPPD for evening shift NCHPPD for night shift

21. Work load measurement tools NCH /PPD = NURSING HOURS WORKED IN 24 HOURS PATIENT CENSUS

22. A guide to staffing nursing services PROJECTING STAFFING NEEDS. COMPUTING NUMBER OF NURSES REQUIRED ON A YEARLY BASIS COMPUTING NUMBER OF NURSES ASSIGNED ON WEEKLY BASIS ONE METHOD FOR DETERMINING THE NURSING STAFF OF A HOSPITAL IMPORTANT FACTORS OF STAFFING 1. QUALITY AND QUANTITY 2. UTILIZATION OF PERSONNEL

23. MODIFIED APPROACHES TO NURSING STAFFING AND SCHEDULING MODIFIED WORK WEEK THE WEEEND ALTERNATIVES OTHER MODIFIED APPROCHES PREMIUM DAY WEEKEND PREMIUM VACTION NIGHT A FLEXIBLE ROLE CROSS TRAINING

24. NURSING STAFFING,MODELS OF CARE DELIVARY,AND INTERVENTIONS NURSE TO PATIENT RATIO TOTAL NURSING STAFF OR HOURS PER PATIENT DAY RN OR LVN FTES PER PATIENT DAY NURSING SKILL NURSING CARE DELIVARY MODEL PATIENT FOCUSED CARE PRIMARY OR TOTAL NURSING CARE TEAM OR FUNCTIONAL NURSING CARE MAGNET HOSPITAL ENVIRONMENT/SHARED GOVENANCE

25. Thank you