The structure of pediatric intensive care unit (PICU) nurses’ staffing assignments influences the outcomes of children recovering from congenital heart surgery. Therefore, clinical investigators have tried to develop ways to measure assignment acuity and establish standardized guidelines for PICU staffing models. However, most acuity measures are predominantly derived from patient-related physiological data. Such methods may be predictive of patient outcomes but are of limited use for informing nurse-patient staffing assignments. In response, Jean Connor and colleagues developed the Complexity Assessment and Monitoring to Ensure Optimal Outcomes (CAMEO) acuity tool in 2009. The CAMEO tool expands on traditional methods of measuring patient acuity by capturing other relevant domains that reflect acuity from the nurse’s view (ie, workload complexity, intellectual processing demands, decision-making, and patient surveillance needs). After several iterative and revisionary investigations that provided evidence of the CAMEO’s and CAMEO II’s utility in a single health care system, the present work...

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