Indices of acuity and patient placement

Abstract

Appropriate use of intensive care units is imperative. The purpose of the study was to describe severity of illness and nursing intervention scores of ICU patients at admission, discharge, and readmission, and to investigate whether severity of illness and nursing care needs influenced ICU discharge. Retrospective chart reviews were conducted at a Level I University affiliated medical center. Severity of illness (APACHE II) and nursing care needs (NIS score) were determined for ICU admission and discharge. Of the 123 subjects studied, 11 died; 10 subjects were readmitted. APACHE II and NIS scores decreased significantly between admission and discharge. The ICU survivors demonstrated a wide range of APACHE II and NIS scores. It was concluded that discharge appeared to be based an some recovery rather than recovery to a certain level. Development of objective tools to assess physiologic status and nursing care needs would assist in the appropriate admission and discharge of patients.