Patient acuity: a concept analysis

J Adv Nurs. 2009 May;65(5):1114-26. doi: 10.1111/j.1365-2648.2008.04920.x. Epub 2009 Feb 18.


Aim: This paper is a report of a concept analysis of patient acuity.

Background: Patient acuity is a widely-used term in the health sciences literature, but often without specification of its exact meaning. Concept clarification is therefore needed to delineate the meaning of patient acuity.

Data sources: A review of the Pubmed, CINAHL, MEDLINE and PsychInfo databases for the keyword 'acuity' in the title or abstract of papers in English language journals, as well as searches for the term 'acuity' and 'acute' in the Merriam-Webster and Oxford English Dictionaries were the data sources for this concept analysis. Papers were excluded if 'acuity' was not present in the title or abstract. Publication dates of the literature included in the review ranged from 1974 to 2008.

Findings: The attributes of acuity are severity, intensity and the pairing of acuity measurements with another concept. These attributes were organized according to Holzemer's Outcomes Model for Health Care Research as patient-, provider- or system-related. The sub-categories of attributes identified were physical, psychological, nursing care needs, workload, complexity, case-mix, patient classification systems, urgency/triage scales and other uses.

Conclusion: Researchers are encouraged to specify which attribute of acuity they are studying and to develop measurement tools specific to that attribute, in order to move the science towards standardization of the concept of acuity and its measurement.

Publication types

  • Review

MeSH terms

  • Health Services Research*
  • Humans
  • Patient Satisfaction
  • Terminology as Topic*