Refinement of the Intensive Care Unit Complexity Assessment and Monitoring to Ensure Optimal Outcomes III Acuity Tool

• Published in: Dimensions of critical care nursing Vol. 41; no. 3; p. 144
• Main Authors: Connor, Jean A, LaGrasta, Christine, Hickey, Patricia A
• Format: Journal Article
• Language: English
• Published: United States 01.05.2022
• Subjects: Child; Critical Care Nursing; Humans; Intensive Care Units; Intensive Care Units, Pediatric; Nursing Staff, Hospital; Patient Acuity; Personnel Staffing and Scheduling; United States; Workload; United States
• DOI: 10.1097/DCC.0000000000000523

The Intensive Care Unit (ICU) Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO) acuity tool quantifies patient acuity in terms of nursing cognitive workload complexity. The aim of this study was to refine the ICU CAMEO II acuity tool. An expert panel of nursing staff from 4 pediatric ICUs convened to refine the CAMEO II across a large, freestanding children's hospital in the United States. This study used a modified Delphi technique. Through a series of 4 Delphi rounds, the expert panel identified Domains of Care and nursing care items that were suitable to be collapsed or bundled. The number of Domains of Care decreased from 18 to 10. Each of the expert panel members then completed the ICU CAMEO II tool and the newly revised tool, ICU CAMEO III, on 5 to 10 patients. Sixty completed ICU CAMEO II tools, and ICU CAMEO III tools were available for comparison. The average difference of the 2 tools' total scores was 5 points (minimum, 4; maximum, 7). The level of agreement between the 2 tools by CAMEO Complexity Classification level (I-V) was 90%. The ICU CAMEO III acuity tool is a streamlined measure to describe and quantify the acuity of pediatric critical care nursing. Use of this acuity measure will support projection of staffing models, staffing assignments, and benchmarking across pediatric ICUs. Further research is underway to validate the CAMEO III for multisite use.