Infusion Center Outpatient Acuity: An Integrative Review of the Literature

Problem: Patient acuity is a concept used in the health care setting and is a driver of nurse staffing and patient scheduling practices, but it is sometimes used without any well-defined understanding of its true meaning. As healthcare transitions to the ambulatory setting, which includes infusion centers, it is imperative that it provides high-quality care that increases patient and provider satisfaction. An integrative literature review was conducted to identify the current state of outpatient acuity and opportunities for classifying patients in the infusion center. Eligibility criteria: Key words included outpatient acuity and nurse satisfaction with workload from peer-reviewed sources in the English language and nursing discipline. Associated MeSH terms were also included in the search.

Sample: Articles from the Cochrane Library, PubMed, Ovid, CINAHL, and SCOPUS databases were used for this analysis.

Results: Forty-five relevant abstracts and 13 were included in the analysis.

Conclusion: There is no systematic way to assign nurse workload in the ambulatory setting. A review of the articles revealed themes of effective resource allocation, satisfaction, and classification and acuity tools, which supports the implementation or use of an acuity system to assign patient workload in the ambulatory setting.

Implications: The lack of research evidence also supports the need for additional research. Leaders must take an active role in researching the evidence and developing evidence-based practice guidelines to ensure that safe and quality care is consistently rendered. Research is needed to test the impact of a patient acuity system for the pediatric ambulatory infusion center on nurse satisfaction.