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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: Friday, 19 April 2024, 7:11 AM

Description

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

Lay Descriptors

  • 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

Clinical Descriptors

  • 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

Nursing Theme 1 - Assessment and Observation

  • 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

Nursing Theme 2 - Respiration

  • 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

Nursing Theme 3 - Personal Care, Nutrition and Hydration

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

Nursing Theme 4 - Cognition and Communication

  • 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

Nursing Theme 5 - Medication

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