PATIENT CARE ASSIGNMENT

OPHTHALMOLOGY
OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY WARD

IV ACCESS INTRA JUGULAR (IJ), PERIPHERAL LINE (PL),

PERIPHERALLY INSERTED CENTRAL CATETHER (PICC),
IMPLANTABLE VENOUS ACCESS (PORTA CATH),
UNIT MANAGER: CENTRAL VENOUS PRESSURE LINE (CVP), IVF, HEPLOCK
CHARGE NURSE / SENIOR NURSE: O2 SUPPORT NASAL CANNULA, FACE MASK, BIPAP, T-PIECE,
MECHANICAL VENTILATOR
DATE: FEEDING NGT, PERCUTANEOUS ENDOSCOPIC GASTROSTOMY,
SHIFT: JEJUNOSTOMY

STAFF NURSE BED PATIENT NAME LEVEL ALLERGY WITH IV O2 FEEDING CBG SPECIAL POSSIBLE
OF FC ACCESS SUPPORT ENDORSEMENT PROCEDURE DISCHARGE
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CARE

LEVEL OF CARE DESCRIPTION LEVEL OF CARE DESCRIPTION LEVEL OF CARE DESCRIPTION

1 SELF CARE ASSUMES SELF CARE INDEPENDENTLY 3 - MODERATE SELF CARE IS PERFORMED WITH ASSISTANCE 5 CRITICAL PATIENT IS IN CRISIS AND DEPENDENT IN CONTINUAL
NO CONTRAPTIONS CARE PATIENT IS AT MODERATE SAFETY OR COMPLICATION RISKS CARE CARE BY HEALTH TEAM
UNDERWENT PROCEDURE WITH MODERATE SEDATION ONGOING LIFE SUPPORT IN ANY CRITICAL CARE SETTING
ON OXYGEN SUPPORT OR CASE
2 MINIMAL ASSUMES SELF CARE WITH MINIMAL ASSISTANCE OR SUPERVISION 4 COMPLEX PATIENT IS CAREGIVER-DEPENDENT FOR SELF CARE REQUIRES CONTINUOUS MONITORING
CARE PATIENT IS AT LOW SAFETY OR COMPLICATION RISKS CARE PATIENT IS AT HIGH SAFETY OR COMPLICATION RISKS POST ARREST
WITH 1 -2 IV FLUIDS WITHOUT INCORPORATATION ONGOING LIFE SUPPORT UNDERWENT PROCEDURE WITH GENERAL SEDATION
WITH 1 DRAINAGE WITHIN 24