Patient Characteristics and Their Relationship to Perceived Patient Acuity
Nurses working in intensive care units (ICUs) indicated that the majority of their patients functioned at the more-compromised end of each patient characteristic rating scale. Nurses working in non-intensive care units indicated that the majority of their patients functioned at the less-compromised end of each patient characteristic rating scale. Exploration of the qualitative comments regarding the eight patient characteristics suggests that they provide a thorough description of patients.

Nurses caring primarily for ambulatory patients characterized their patients as more stable, less complex, less vulnerable, more predictable, more resilient, and having greater ability to participate in decision making and care, and greater resource availability than did nurses caring primarily for acutely ill patients. In turn, nurses caring primarily for acutely ill patients characterized their patients as functioning at the higher end of the patient characteristic rating scales than did nurses caring primarily for critically ill patients. The data suggest that the eight patient characteristics differentiate the patients of nurses who describe their patient populations as differing in acuity.

There was a strong and significant association between patient acuity scores (derived from nurses’ estimates of the percentage of their patients who could be described as ambulatory care, acute care, and critical care) and six of the eight patient characteristics (i.e., stability, complexity, vulnerability, predictability, resiliency, and participation in care). Nurses who rated their patient population as more acute also rated the patients they had seen in the past month as less stable, more vulnerable, less predictable, less resilient, and less able to participate in care than did nurses who rated their patient populations as less acute.

Relationships Among the Patient Characteristics
Correlations among the patient characteristics ranged from .15 to .68, suggesting modest relationships among the patient characteristics. An exploratory factor analysis was conducted to explore these relationships further. A two-factor solution was obtained for each of the three patient age groups. For nurses of neonatal and pediatric patients, the first factor consisted of stability, complexity, vulnerability, predictability, and resiliency. This factor seems to reflect the intrinsic (e.g., internal, physiological) characteristics of the patient and family. The second factor consisted of participation in decision-making, participation in care, and resource availability and seems to reflect characteristics extrinsic (e.g., external, contextual) to the patient and family. A similar two-factor solution emerged for the adult group, with the exception that predictability loaded with the extrinsic characteristics, rather than the intrinsic characteristics.

The findings from the trend analysis also support the distinction between the intrinsic and extrinsic nurse characteristics: The findings revealed that while all five of the intrinsic characteristics bore a linear relationship with patient acuity scores, only one of the three extrinsic characteristics (participation in care) did so. Thus it appears that the intrinsic characteristics are more closely tied to nurses’ perceptions of the overall acuity of their patients.

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