The Patient Classification System

The Patient classification system (PCS), also known as patient acuity system, is a tool used for managing and planning the allocation of nursing staff in accordance with the nursing care needs.  Thus, PCS is used to assist nurse leaders determine workload requirements and staffing needs.  

There are different kinds of PCS available, but the three most commonly used are:

Descriptive -   This is a purely subjective system wherein the nurse selects which category the patient is best suited.

Checklist - Another subjective system, wherein the patient is assigned to a numerical value based on the level of activity in specific categories.  The numerical value is added up to give the nurse an overall rating. 

Time Standards – This is another method where the nurse assigns a time value based on the various activities needed to be completed for the patient.  This time value is sum up and converted to an acuity level.

Among these three, the most commonly used is the descriptive kind of Patient Classification System.  These are subdivided into four classifications namely:

Self-care / Minimal Care.  The first classification of patients who are recovering and normally requires only diagnostic studies, minimal therapy, less frequent observations, and daily care for minor conditions and are awaiting elective surgery.

Moderate care.  The patient in this category is moderately ill or under the recovery stage from a serious illness or operation.  They require nursing supervision or assistance that is related to ambulating and caring for their own hygiene.

Maximum care.   Patient needs close attention and complete care all through the shift. The nurses initiate, supervise and perform most of the patient's activities. 

Intensive care.  The last category or classification, wherein the patients are acutely ill and high level of nurse dependency is required.  Intensive therapy and/or intensive nursing care is needed because of the unstable condition of the patient.  Frequent evaluation, observation, monitoring and adjustment of therapy is also required. Patients in these levels include those in critical conditions or in life and death situations.

But whatever PCS is used, this will be applied to forecast staffing needs within each department. Nurses should be informed of the patient care ratios that are relevant to each department and should understand how to predict the staffing needs.