Patient classification systems (PCS) are used to determine nursing staffing needs based on the amount of care patients require. A PCS groups patients into categories based on their care needs and calculates the nursing hours required for each category. Implementing a PCS helps ensure quality care by matching nursing resources to patient needs, improves patient and staff satisfaction, and allows for monitoring care standards. Common PCS categories include levels of independent care, assistance needed, and intensive care. PCS are an important tool for healthcare administrators and nurses to determine appropriate staffing levels.

1. Presented by
Mr. Chetan R Sangati
IInd year MSc (N)

2. PATIENT SYSTEM OF CLASSIFICATION
 Patient classification system which quantifies the
quality of the nursing care ,is essential to staffing
nursing units of hospitals and nursing homes. In
selecting or implementing a pcs , a representative
committee of nurse manager can include a
representative of hospital administration.

3.  DEFINITION :
 A patient classification system is a method for grouping
patients According to the amount and complexity of their
nursing care requirements.
 Is a system developed to objectively determine workload
requirement, Staffing needs and work hours.
 It serves as a tool to measure patient needs, care giver
interventions and skills level required to meet this needs
 In most classification systems, patient are grouped
according to their dependency on care givers or the
amount of caretaker time and ability employed in caring for
them.

4.  IMPORTANCE OF PCS:
1.Improve patient satisfaction by providing required time
to the patient according to his or her needs.
2.Enhance staff satisfaction by determining staffing needs
and those decreasing workload.
3.Monitor provision of quality nursing care According to
international standard in safe work environment.

5.  CHARACTERISTICS:
1.Differentiate between intensity of care among definite classes
2.Match nursing resources to patient care requirement relate to
time and effort spend on associated activity
3.Economical and convenient to use .
4.Global
5.Objective
6. Flexible
7. Easy to understand

6.  Purposes of pcs:
1. To provide safe and efficient patient care based on standards of care
and practice
2. Determine the number and category of staff (skill mix) needed for
providing quality of patient care.
3. Provide data on each patient care unite that directs and support
staffing in decision making
4. Assess level and support services required.

7. 5. Enhance staff satisfaction through stress free work environment
6. Categorize patients according their needs and the time and skill needed to
satisfy each category needs.
7. Determine work load and nursing care requirements.
.

8. COMPONENTS
 According to johnson indication there are two methods
of categorizing patients.
 FIRST CATEGORY
In which each patient is rated on independent elements
of care , each element is scored , score are summarized
and patient is placed in a category based on the total
numerical value obtained

9.  Each category addresses activities of daily living
,general health ,teaching and emotional support,
treatment and medications. Data are collected on
average time spent on direct and indirect care.
 SECOND CATEGORY
In which set guidelines describing the way in which
patients will be classified the frequency of
classification and the method of reporting data.

10.  THIRD COMPONENT
In average amount of the required for care of a
patient in each category
 FOURTH COMPONENT
In which nursing care hours will be calculate.

11.  According to sullivan,2005Pcs
Is also known as patient acuity systems and are used to assist
nurse leader to determine workload, requirements and staffing
needs(sullivan,2005)
o There are different kind of pcs available, but according to
Sullivan ,the three most commonly used pcs as following:
1.Descriptive :- The nurse chooses the category that best
describes the patient

12. 2. The check list style : The nurse checks the activity level
for each patient in each category and totals the points for
each patient to determine the level of care
3. Time standard method: Another method in which
incharge nurse assigns time based on various activities
that need to be completed for the patient.

13. Other types of pcs:
 Proto type evaluation system.
 Factor evaluation system

14.  Proto type evaluation system: Describes typical
patient and varying need levels. Characteristics are
listed in five care category as follows:
1.CategoryI:patient with acute non chronic, episodic
disease or disability who will return to the pre illness
level of functioning & the care goal complete elimination
of the existing health problem

15. 2.CategoryII :patient with chronic disease on which is
superimposed on acute episode of illness, who
have the potential to return to the pre episodic level
of functioning and the care goal managing chronic
health problem by patient and family without
ongoing support from agency.
3. Category III : patient with chronic disease or
disability where return pre illness level functioning
in not possible but there is potential to increase the
level of functioning, rehabilitation to maximize level
of functioning through continuing agency support .

16. o Category IV : patient with chronic disease or
disability who cant be maintained at home without
ongoing agency support ,for whom the care goal is
maintenance at home at maximum level of
functioning through ongoing agency support.
o Category V : Patient with end stage illness for whom
the care goal is assurance of comfort and dignity
throughout terminal stage of illness

17. Categories of patient classification systems
 Category1: Self-care requiring from1to2hours per
day .
 Category2: Minimal care requiring from3to4 hours

18. Category3: Intermediate care requiring from 5to6
hours
Category4: Modified intensive care requiring from7to
8 hours .
Category5: Intensive care requiring from10to14
hours

19. PATIENT CARE CLASSIFICATION
1-Eating
2-Grooming
3-Excrecise
4-Toileting
5-Comfort measures
6-Mobility
7-General health
8-Treatment
9-Health education and teaching

20. HOURS OF NURSING CARE NEEDED FOR EACH
LEVEL
 Nursing care hours per patient day (NCHPPD)
FOR DAY SHIFT
 NCHPPD for evening shift
 NCHPPD for night shift

21. WORK LOAD MEASUREMENT TOOLS
NCH /PPD = NURSING HOURS WORKED IN 24
HOURS
PATIENT CENSUS

22. A GUIDE TO STAFFING NURSING SERVICES
I. PROJECTING STAFFING NEEDS.
II. COMPUTING NUMBER OF NURSES REQUIRED ON A YEARLY BASIS
III. COMPUTING NUMBER OF NURSES ASSIGNED ON WEEKLY BASIS
IV. ONE METHOD FOR DETERMINING THE NURSING STAFF OF A HOSPITAL
V. IMPORTANT FACTORS OF STAFFING
1. QUALITY AND QUANTITY
2. UTILIZATION OF PERSONNEL

23. MODIFIED APPROACHES TO NURSING
STAFFING AND SCHEDULING
 MODIFIED WORK WEEK
 THE WEEEND ALTERNATIVES
 OTHER MODIFIED APPROCHES
 PREMIUM DAY WEEKEND
 PREMIUM VACTION NIGHT
 A FLEXIBLE ROLE
 CROSS TRAINING

24. NURSING STAFFING,MODELS OF CARE
DELIVARY,AND INTERVENTIONS
 NURSE TO PATIENT RATIO
 TOTAL NURSING STAFF OR HOURS PER PATIENT DAY
 RN OR LVN FTES PER PATIENT DAY
 NURSING SKILL
 NURSING CARE DELIVARY MODEL
 PATIENT FOCUSED CARE
 PRIMARY OR TOTAL NURSING CARE
 TEAM OR FUNCTIONAL NURSING CARE
 MAGNET HOSPITAL ENVIRONMENT/SHARED GOVENANCE

25.  Thank you