There has been much discussion among nursing leaders about the need for a reliable and valid tool to measure patient acuity in perinatal units and for use in planning nurse-staffing resources and related budgets. Guidelines for Professional Registered Nurse Staffing for Perinatal Units (Association of Women's Health, Obstetric and Neonatal Nurses [AWHONN], 2010) provide information to construct this type of tool. Using the recommended nurse-to-patient ratios for each type of clinical situation and patient condition, an acuity grid can be created (Table 1). The types of patients and clinical situations listed are offered as examples; of course there are many more. Nurse-staffing needs are dynamic, constantly changing as patients present for care, are admitted, give birth, develop complications, are discharged, and the like. The most useful acuity tool must be able to be sensitive to those changes in real time.
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