Implementation and Evaluation of a Patient Acuity Tool in Pediatric Oncology

BackgroundThe complexity of pediatric cancer care, combined with inequitable workload distribution and varying patient acuity, can contribute to dissatisfaction and physical and emotional exhaustion among nurses. In contrast to the traditional methods of assigning patients based on nurse-to-patient ratios, the evidence has collectively emphasized the importance of considering patient acuity levels in staffing decisions. Patient acuity tool (PAT) assignment approach has the potential to boost nurse job satisfaction by ensuring safer patient assignments and providing real-time data on staffing needs for workload planning. This project aims to evaluate the feasibility and effectiveness of implementing a validated PAT adapted for local context in a pediatric oncology unit.MethodThe quality improvement (QI) project utilized a pre-post interventional design. The Plan-Do-Study-Act cycle was used to guide its QI efforts in evaluating the utilization rate of PAT, and the effect of implementing PAT on nursing satisfaction, perceived equity of workload and nursing assignment.ResultsA median weekly compliance rate of 88% over the 24-week implementation period was achieved, demonstrating sustained implementation. There was an overall significant improvement in nurses' perceived workload, <i>F</i>(2, 162) = 12.86, <i>p</i> < .001; perceived equity of assignment, <i>F</i>(2, 162) = 16.08, <i>p</i> < .001; and satisfaction with work environment, <i>F</i>(2, 162) = 6.35, <i>p</i> = .002, scores following PAT implementation.DiscussionThe project demonstrated the feasibility and clinical significance of implementing a PAT assignment approach to enhance the nursing practice environment and nurses' job satisfaction in a pediatric oncology unit.