The study wants to know the staffing implications for progressive care and intensive care. But first thing's first. It's important for you, as a nurse, to be clear on the difference between progressive care and intensive care before we dive into staffing.

There are multiple levels of care in hospital care. Critical care, intermediate, acute (medical/surgical) and observation are a few of the many levels of care in the hospital.

ICU is critical care and PCU, or progressive care, is considered an intermediate level of care based on the Centers for Medicare and Medicare Services definitions. Telemetry is a technology, not a level of care

Telemetry could include any level of the patient for a variety of reasons it does not classify a patient at a higher level of care just because a provider ordered it. Telemetry services are typically built within the room-and-board charge.

Many private insurances do not allow cardiac monitoring to be billed separately as the technology is seen as a fixed asset of the facility, used multiple times by multiple patients. The Centers for Medicare & Medicaid Services (CMS) coupled with your state health department determine and enforce levels of care.

Organizations like The Joint Commission and DNV are accredited bodies, and they have "deemed" status granted by CMS. This means that they are accredited bodies, they can survey healthcare organizations on behalf of and instead of CMS.

The CMS definition of critical care includes the direct delivery of medical care by a physician for a critically ill or critically injured patient. A critical illness or injury acutely impairs one or more vital organ systems such as there is a high probability of imminent or life threatening deterioration in the patient's condition.   

Differences in billing to consider

To Evaluate the physician's clinical documentation to determine which level of care the patient meets and he or she should be reviewing and documenting this daily. To payment, each diagnosis-related group and the hospital's reimbursement for inpatient stay is based on that.

As you can imagine, an ICU in a 900-bed hospital city admits very different patients and has a very different capacity for critical care than an ICU in a 100-bed community hospital.

If you are looking for data that equates higher hospital payment in progressive care unit settings to higher staffing levels, you will not find the needed supporting documentation. What is Means for intermediate staffing, acute, critical level of care or observation is there is not just one answer That for you to take and run w ith ?

The average ICU patient in that 900-bed hospital will be much more complex than the most complex patient of the 100-bed community hospital. The larger hospital has greater resources, including specialists, equipment and so on to care for the most critically ill patients.

Patient acuity goes hand in hand with nurse intensity

What you need to do will be somewhat time intensive at first. It is an absolute must to arrive at the right staffing levels to document the nursing intensity required to take care of an intermediate patient.

As noted in the two different sized hospitals, this will be different in each organization. Nurse staffing needs to be determined locally within each hospital and unit based on a variety of factors.

A staffing committee for each unit should be comprised of bedside nurses with unit managers. Unit level outcomes should be monitored monthly about staffing levels and should be adjusted as needed.

Ultimately, this drives all decisions, patient care, and staffing levels. It is imperative to know the difference in levels of care and to help ensure patients get the outcomes they deserve with the appropriate RN staffing regardless of the level of care.