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What Is High-Acuity Nursing?

High acuity patients need more dedicated care, nurses provide much of that care

Acuity levels help nurse managers set appropriate staffing levels in acute care, long-term care and other treatment and rehabilitation settings. Without this system, patients may not receive the amount of care their health status demands. This is particularly important when working with limited staff. Patients who are severely ill receive higher acuity ratings, while patients with better health receive lower ratings. In practice, this means stable patients with more predictable outcomes receive less frequent or less intensive nursing care.

High-acuity patients often present challenging medical conditions, and they often have significant, unpredictable needs. In response, high-acuity nurses provide compassionate, knowledgeable care that is both prompt and professional. Understanding what acuity means and how to treat high-acuity patients is key to managing multiple patients with different acuity ratings.

Acuity and Nurses

High-acuity patients need frequent observation to ensure that they improve or remain stable. Since these patients can decline quickly, nurses must check on them regularly. As a result, high-acuity units and facilities must maintain higher staffing levels. Nurse managers often use acuity scales to decide how many nurses they need for particular shifts.

A particularly high-acuity patient may need a nurse dedicated solely to their care, while low acuity patients may share their nurses with many other patients. In other words, nurse staffing ratios can change dramatically depending on the level of care each patient needs. Patients with complex care requiring attention from an RN will create different staffing needs than patients who need only the attention of nursing assistants, for example.

Understanding Acuity

There is no universal acuity scale, so many facilities and departments develop their own. Different patient health characteristics can influence acuity levels, such as pain management needs, oxygen therapy, blood pressure issues, condition stability, family issues and other characteristics. Mental health and overall patient health also play key roles.

In general, patients requiring a greater degree of observation and intervention from nurses receive a higher acuity rating. While high-acuity patients are typically sicker, other factors can change a patient’s acuity ranking. Even medically stable patients can receive a higher acuity rating if special circumstances are present, such as difficult family visitors, significant mental health condition, or other challenges.

High-Acuity Nursing

Prioritizing patients based on medical need gets each patient the attention they require. Nurse managers use a variety of different scales and strategies to measure these needs. The use of these scales started in medical-surgical settings, but later on, the acuity scale concept moved to other types of treatment and rehabilitation facilities.

As patients’ conditions stabilize, worsen or otherwise change, nurses can change their acuity levels accordingly. It is important to rate patients accurately to ensure they receive the care they need. When used properly, these ratings can help maximize nursing resources.

High-acuity nursing is an essential aspect of acute healthcare. As a nurse, you need to learn how your facility or department uses acuity scales and how to care for high-acuity patients. Most high-acuity patients are seriously ill, but other significant issues may affect their acuity ratings. While high-acuity care can be very stressful, the reward is significant.

Learn more about the A-State online RN to BSN program.


NCBI — Patient Safety and Quality: An Evidence-Based Handbook for Nurses

American Nurse Today– Measuring Acuity on a Medical-Surgical Unit

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