Nurses Knowledge and Perception on Patient Acuity Tool and Their Relationship with Self-assessed Patient Outcomes in Houston, Texas, United States of America

Abstract

This study assessed registered nurses’ knowledge and perceptions of the Patient Acuity Tool (PAT) and examined their relationship with self-assessed patient outcomes in acute care settings in Houston, Texas, United States. A quantitative descriptive-comparative-correlational design was used. The study included 415 registered nurses from four acute care hospitals selected through convenience sampling. Data were collected using a structured questionnaire covering demographic and professional characteristics, PAT knowledge, perceptions of tool use, and self-assessed patient outcomes. The instrument demonstrated acceptable content validity (Aiken’s V = 0.77) and excellent internal consistency (Cronbach’s alpha = 0.940). Data were analysed using frequency, percentage, mean, standard deviation, independent-samples t-test, one-way analysis of variance, and Pearson product-moment correlation, with statistical significance set at p < 0.05. The findings showed limited overall knowledge of PAT use, with an overall knowledge score of 46.1%. Nurses were more accurate in identifying acuity in clear safety-related scenarios than in complex postoperative or specialised clinical situations. Respondents reported a neutral perception of PAT (overall mean = 3.31), while self-assessed patient outcomes were rated favourably (overall mean = 3.41). Significant differences were found according to years of nursing experience, perception of tool use, and self-assessed patient outcomes. Perception of PAT was positively associated with self-assessed patient outcomes, whereas knowledge showed weak negative correlations with perceptions and self-assessed outcomes. The findings indicate the need for targeted training, mentorship, and organisational support to improve consistent and effective use of acuity-based staffing tools.