• Jean Anne Connor, Christine LaGrasta, Benjamin Cerrato, Courtney Porter, Kimberly Gauvreau, Diana Morrill, Justine Fortkiewicz, Mallory Mechler, Amy Donnellan, Alexandra Kaduc, Ruby Whalen, Ashlee Shields, Michelle Bruno, Angela Jarden, Anne Dey, and Patricia A Hickey.
• Jean Anne Connor is the director of nursing research, Cardiovascular, Critical Care and Peri-operative, Patient Care Operations, Boston Children's Hospital, Boston, Massachusetts, and an assistant professor of pediatrics, Harvard Medical School, Boston, Massachusetts.
• Am. J. Crit. Care. 2022 Mar 1; 31 (2): 119-126.

BackgroundThe 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.ObjectiveTo validate the ICU CAMEO III acuity tool in US children's hospitals.MethodsUsing 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).ResultsPatients (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).ConclusionThe 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.©2022 American Association of Critical-Care Nurses.

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