Increased workloads contribute to nurse stress, affect nurse-patient relationships, and can ultimately lead to nurse turnover (O’Connell, Nettleton, Bunting, & Eichar, 2020). Nurse satisfaction can also be influenced by nurse-patient assignments (Allen, 2019). Implementation of a patient acuity tool (PAT) to balance workload and evenly distribute patient acuity in nurse-patient assignments can improve nurse job satisfaction, quality of care, and nurse retention (Firestone-Howard, Gonzalez, Dudjak, & Rader, 2017; Al-Dweik & Ahmad, 2019).

Discussions were held on a 20-bed medical-surgical unit in an acute care hospital with stakeholders that included the nurse manager, charge nurses and bedside nurses at staff meetings and shift huddles regarding the implementation plan of the patient acuity tool (PAT) change project. The PAT was well received and a pilot phase for implementing a PAT was initiated. Pre-PAT survey data was obtained showing the need for a change in the way assignments were given. The PAT was successfully initiated and utilized for 4 weeks in which weekly discussions continued and feedback was obtained from the nurse staff. The implementation phase was abruptly shortened due to the unexpected closure of the unit due to impact of the Coronavirus pandemic. The post-PAT survey data and verbal feedback obtained from stakeholders was enough to identify a marked improvement in nurse satisfaction with nurse-patient assignments post-implementation of the PAT as well as the high frequency of usage of the tool. The results received support the notion that using a PAT for making nurse-patient assignments can positively influence nurse satisfaction. The data surprisingly identified additional unanticipated benefits to the unit including patient safety and quality of care.

Date of publication

Spring 4-19-2020

Document Type

MSN Capstone Project



Persistent identifier



Masters of Science in Nursing