Patient Care Classification Patient Care classification using four levels of nursing care intensity

Area of care Eating Category I Feeds self Category II Needs some help in preparing Category III Cannot feed self but is able to chew and swallowing Category IV Cannot feed self any may have difficulty swallowing Completely dependent

Grooming

Almost entirely self sufficient

Need some help in bathing, oral hygiene Needs some help in getting up to bathroom /urinal Needs some help with adjusting position/ bed..

Unable to do much for self

Excretion

Up and to bathroom alone

In bed, needs bedpan / urinal placed; Cannot turn without help, get drink, adjust position of extremities Acute symptoms Any treatment more than twice /shift

Completely dependent

Comfort

Self sufficient

Completely dependent

General health Treatment

Good Simple supervised, simple dressing

Mild symptoms Any Treatment more than once per shift, foley catheter care, I&O.

Critically ill Any elaborate/ delicate procedure requiring two nurses, vital signs more often than every two hours.. Teaching of resistive patients,

Health education and teaching

Routine follow up teaching

Initial teaching of care of ostomies; new diabetics; patients with mild adverse reactions to their illness

More intensive items; teaching of apprehensive/ mildly resistive patients.

Calculating Staffing Needs

The following are the hours of nursing care needed for each level patient per shift:

Category I NCHPPD for Day shift NCHPPD for P.M (Evening) shift NCHPPD for night shift 2.3

Category II 2.9

Category III 3.4

Category IV 4.6

2.0

2.3

2.8

3.4

0.5

1.0

2.0

2.8

Bibliography
1. B.T Basavanthappa. Nursing administration. New Delhi, Jaypee Brothers. 2nd edition. Pp 539-561. 2. Russell C. Swansburg, Rcihard J. Swansburg. Introduction to management and leadership for nurse for nurse managers; Jones and Barlett Publications. 3rd edition. Pp97-110 3. B.M. Sarkhar. Principles of hospital administration and planning. New Delhi. Jaypee brothers. 1st edition. Pp 85-88 4. Bessie marquis. Leadership and management ; Elsevier publication: 2nd edition .Pp.346-567.

Journals
1. Jennifer neisner , brian raymond. nurse staffing and care delivery models: a review of the evidence; march 2003, institute of health policy,Oakland. 2. McGillis Hall, L., Doran, D., & Pink, G. H. (2004)Nurse staffing model influences cost of nursing services. Nursing staffing mix models, nursing hours and patient safety outcomes. JONA, 34(1), 41-45. 3. Jean Ann Seago, Nurse Staffing, Models of Care Delivery, and Interventions; University of
California, San Francisco School of Nursing

4. Indian Nursing council. Notification; All Nursing colleges, march 2008.