Assessment of Patient Stability

(1) For purposes of implementing 958 CMR 8.04, the Staff Nurse assessing the ICU Patient shall assess the stability of the ICU Patient utilizing: (a) The exercise of sound nursing assessment and judgment within the parameters of the Staff Nurse’s continuing education and experience; and (b) The Acuity Tool developed or selected by the Acute Hospital and certified by the Department, pursuant to 958 CMR 8.00. (2) If the Staff Nurse assessing the ICU Patient determines within the exercise and scope of sound nursing assessment and judgment within the parameters of the Staff Nurse’s continuing education and experience that the ICU Patient’s stability requires a different Staff Nurse-to-patient ratio than that indicated by the Acuity Tool, the Nurse Manager or the Nurse Manager’s designee shall resolve the disagreement between the Acuity Tool and the Staff Nurse’s assessment, in consultation as appropriate with the other Staff Nurses in the ICU and taking into account nursing skill mix and patient census in the ICU and other Critical Environmental Factors, and shall determine the appropriate Patient Assignment. 8.05: continued (3) The Staff Nurse assessing the ICU Patient shall assess the stability of the ICU Patient using the Acuity Tool at a minimum: (a) Upon the ICU Patient’s admission or transfer to the ICU; (b) Once during a Shift; and (c) At other intervals or circumstances as specified in the Acute Hospital’s policies and procedures established pursuant to 958 CMR 8.06(3)(a). (4) Nothing in 958 CMR 8.05 shall limit the application of relevant state or federal law to Registered Nurses, including M.G.L. c. 112, § 80B, 244 CMR 3.00: Registered Nurse and Licensed Practical Nurse, and 244 CMR 9.00: Standards of Conduct.