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  1. Kucera, Patricia MSN, RN
  2. Kingston, Eileen DNP, BSN, RN, MPA
  3. Ferguson, Tysa DNP, RN, CNML
  4. Jenkins, Katie MSN, RN
  5. Fogarty, Melissa MSN, RN
  6. Sayles, Harlan MS
  7. Cohen, Marlene Z. PhD, RN, FAAN


Background: Staff shortages, reduced budgets, and high acuity of violent psychiatric patients can create challenges in psychiatric intensive care units (PICUs).


Local Problem: Staffing of the psychiatric unit was based on patient census rather than evidence-based practices.


Methods: A pre-/postintervention design was used to examine changes in nursing satisfaction and patient outcomes as measured with the National Database of Nursing Quality Indicators (NDNQI) survey results.


Interventions: A psychiatric specific acuity tool was implemented on the PICU of a Veterans Administration hospital.


Results: After an initial decrease related to the COVID-19 pandemic, total acuity and the total number of nurses remained relatively stable while the unit census declined. NDNQI survey results improved with the largest being a 52-percentile increase for the quality-of-care summary measure.


Conclusions: An acuity tool can help standardize practice, determine fair patient assignments among staff, increase nurse satisfaction, and promote best practices for patient safety.