Level 5: One-to-One Care

Site:	OpenLearn Create
Course:	Welsh Levels of Care E-Learning Program
Book:	Level 5: One-to-One Care

Printed by:	Guest user
Date:	Monday, 9 February 2026, 4:56 AM

Description

The patient requires at least one to one continuous nursing supervision and observation for 24 hours a day.

The patient requires at least one-to-one continuous nursing supervision and observation for 24 hours a day
The patient is highly unstable, unpredictable, in immediate risk of harm, or in serious clinical deterioration
There may not be a clearly identified primary problem and the patient’s condition, the care plan, observations, clinical review, decision making and the work to deliver care, may include a combination of any or all of the factors described in the lower levels of care

Requires a similar level of nursing care as a patient within a typical intensive care environment
Highly unpredictable condition
Rapid or irreversible deterioration from an unknown cause
Requires emergency intervention and highly intensive levels of nursing care on at least a one-to-one basis for 24 hours a day
Imminent risk of harm, requiring constant monitoring, for example: awaiting transfer to intensive care unit

Requires one-to-one nursing care constantly over a 24 hour period
Requires monitoring and supportive therapy for compromise, or collapse of, two or more organs or systems
Requires close and constant monitoring for a life threatening condition, or an immediate risk to life
Requires constant observations due to their highly unstable and unpredictable condition

Respiratory or CNS depression, or compromise, requiring mechanical or invasive ventilation
Emergency, or temporary, tracheostomy requiring constant monitoring and one-to-one care
Complicated airway requiring constant monitoring and frequent intervention
Monitoring and interventions in immediate post cardiac or respiratory arrest
Patients needing advanced respiratory and therapeutic support of multiple organs

Totally dependent for all activities of daily living as unable to participate in own care
Requires constant intervention on a one-to-one basis

Violent and aggressive patient at immediate and significant risk of serious harm to self and/or others, requiring constant supervision from one or more staff for 24 hours a day
Continuous monitoring of neurological deficit due to risk of rapid deterioration
Significant risk, which is further compromised by, inability to initiate any communication
Significant mental health problems, highly unpredictable and requiring constant supervision on a one-to-one basis

Invasive monitoring
Vasoactive drugs
Treatment of hypovolaemia, haemorrhage, sepsis, or neuro protection in a patient receiving constant intervention