Rehab MATRIX: Content Validity of a Nursing-Led Patient Assignment Algorithm

Abstract

Purpose: The provision of conscientious nursing care is at the forefront of health quality. Unfortunately, a lack of standardization in the assignment of patients to nurses can lead to care inequities. Rehab MATRIX is a nursing-led tool that equitably assigns patients using select acuity variables. Design and Methods: In this initial study, we asked focus groups of 19 registered nurses and 8 patient care assistants to identify medical interventions that increase the effort of nursing care at a 24-bed inpatient rehabilitation facility (IRF). This IRF is affiliated with a comprehensive heart and vascular institute, a level I trauma center, and a The Joint Commission (TJC) Comprehensive Stroke Center. Findings: Thirteen acuity variables were included in the Rehab MATRIX patient assignment grid. High-acuity patients with greater than 6 variables were color-coded “red,” medium-acuity patients with 3 to 5 variables were color-coded “yellow,” and low-acuity patients with less than 3 variables were color-coded “green.” Each registered nurse and patient care assistant were assigned an equitable number of red-, yellow-, and green-coded patients per shift. New admissions were Rehab MATRIX color-coded during nursing report and assigned objectively. Conclusions: Nursing staff at a wide-ranging IRF created Rehab MATRIX, an equitable patient assignment tool, representative of nursing effort needed to provide quality care. Clinical Relevance: Nursing-led patient assignment tools increase autonomy and provide the opportunity for all nursing staff to influence healthcare practice. These factors may lead to increased nursing satisfaction and decreased burnout.

Implementation of the MATRIX Staffing Grid Improves Nurse Satisfaction With Rehabilitation Unit Staffing

“…The implementation of the MSG using a systematic, staged approach with specific implementation strategies resulted in a high rate of adoption and supported this implementation science project. 18,19 The findings confirm and extend previous results from the initial MATRIX study, 14 on an academic hospital-based inpatient rehabilitation unit in Houston, Texas. Improved nurse satisfaction was met with no decrease in patient satisfaction, an important measure of patient-centered outcomes.…”

“…The initial development and content validity of the MSG as a staffing tool for rehabilitation nursing was first described in 2019. 14 As shown in Supplemental Digital Content 1, http://links.lww.com/JNN/A347, this evidence-based objective staffing tool assigns values to key nursing tasks commonly performed in rehabilitation nursing. To provide visual cues, higher acuity patients are color-coded red, moderate-acuity patients are color-coded yellow, and the patients who require the least amount of direct nursing care are coded green.…”

“…In a previous study, the MSG was validated to provide patient assignment equity representative of the nursing effort needed for high-quality care. 14 Our primary hypothesis was that, compared with the current subjective patient assignment process, systematic implementation of the MSG will be associated with a 10% or greater increase in nursing assignment satisfaction. Our secondary hypotheses are the MSG will not reduce patient satisfaction and may result in decreased patient falls.…”

“…The purpose of this study was to evaluate nursing satisfaction with daily patient care assignments following the adoption of the MATRIX Staffing Grid (MSG) at an academic-hospital–based IRF. The initial development and content validity of the MSG as a staffing tool for rehabilitation nursing was first described in 2019 14. As shown in Supplemental Digital Content 1, http://links.lww.com/JNN/A347, this evidence-based objective staffing tool assigns values to key nursing tasks commonly performed in rehabilitation nursing.…”

Review on Comfort Nursing Interventions for Patients Undergoing Neurosurgery and General Surgery

“…Neurology is a secondary discipline within clinical neurology. There are many diseases that are treated in its department, and the majority of patients are elderly [ 1 ]. It is common that elderly patients in neurology, due to the influence of illness or age, will suffer from different degrees of hemiplegia, aphasia, confusion, etc.…”