Measuring Acuity and Pediatric Critical Care Nursing Workload by Using ICU CAMEO III

BACKGROUND

The Intensive Care Unit Complexity Assessment and Monitoring to Ensure Optimal Outcomes (ICU CAMEO III) acuity tool measures patient acuity in terms of the complexity of nursing cognitive workload.

OBJECTIVE

To validate the ICU CAMEO III acuity tool in US children's hospitals.

METHODS

Using a convenience sample, 9 sites enrolled children admitted to pediatric intensive care units (ICUs). Descriptive statistics were used to summarize patient, nursing, and unit characteristics. Concurrent validity was evaluated by correlating the ICU CAMEO III with the Therapeutic Intervention Scoring System-Children (TISS-C) and the Pediatric Risk of Mortality III (PRISM III).

RESULTS

Patients (N = 840) were enrolled from 15 units (7 cardiac and 8 mixed pediatric ICUs). The mean number of ICU beds was 23 (range, 12-34). Among the patients, 512 (61%) were diagnosed with cardiac and 328 (39%) with noncardiac conditions; 463 patients (55.1%) were admitted for medical reasons, and 377 patients (44.9%) were surgical. The ICU CAMEO III median score was 99 (range, 59-163). The ICU CAMEO complexity classification was determined for all 840 patients: 60 (7.1%) with level I complexity; 183 (21.8%) with level II; 201 (23.9%), level III; 267 (31.8%), level IV; and 129 (15.4%), level V. Strong correlation was found between ICU CAMEO III and both TISS-C (ρ = .822, P < .001) and PRISM III (ρ = .607, P < .001) scores, and between the CAMEO complexity classifications and the PRISM III categories (ρ = .575, P = .001).

CONCLUSION

The ICU CAMEO III acuity tool and CAMEO complexity classifications are valid measures of patient acuity and nursing cognitive workload compared with PRISM III and TISS-C in academic children's hospitals.

Enhanced transmission and reflection of few-cycle pulses by a single slit

We show that a physical mechanism responsible for the enhanced transmission and reflection of ultrashort (few-cycle) pulses by a single subwavelength slit in a thick metallic film is the Fabry-Perot-like resonant excitation of stationary, quasistationary, and nonstationary waves inside the slit, which leads to the field enhancement inside and around the slit. The mechanism is universal for any pulse-scatter system, which supports the stationary resonances. We point out that there is a pulse duration limit below which the slit does not support the intraslit resonance.