Here are some basic guidelines for rating acuity. Patients are rated on a scale of 1-4 based on some of the following:
Level 1: VS X 1, A&O,independent care, 1-2 PO meds, saline lock, room air, 1-2 closed incisions OTA, no procedures
Level 2: VS X 1 and Orthostatic BP X 1, Fluid restrictions, 1 PRN med, 3-5 scheduled PO meds, 1-2 schedule SQ/IV meds, PCA, Labs X 1, O2 per NC or simple mask, O2 sats X 1, tele w/o changes, NG/G or J tube, chem strips X 1, simple drsg change<5 min, simple drain, foley care
Level 3: Assess X 3, Neuro checks q 4 hrs. VS X 2, Orthostatic BP X 2, Oral care X 1, 3-4 3 emisis, TPN/Lipids, aspiration precautions, 2 PRN meds, 6-10 scheduled PO meds and/or crushed meds, 3 scheduled SQ and/or IV meds, 2 IV sites, Blood products <2, meds that require assessment before giving (cardiac etc), trach O2/O2 via face mask, O2 titration/O2 sats X 2, Low RR, suctioning X 1-2, trach care X 1, prep for surgery/post procedure checks, freq tele changes with stable pt, chem strips X 2, drsg change 5-10 min, multiple/complex drains/monitor > tubes q 1-3 hrs, Post op bleeding, osotomy care, detox precautions, restraint alternatives, assist with elimination X 3-4, straight cath X 1, ck urine output q 4 hours, specimen collection X 2
Level 4: Assess >/= 4, Neuro cks >/= 4, VS > 2, Orthostatic BP X 3, ADL complete care, emesis >/= 5, oral care X 2, total feed, aspiration precautions, 2 PRN meds, > 10 PO meds, 4 scheduled SQ and or IV meds, 2 IV sites/lines, Meds crushed or per PEG/FT, multiple blood products >/= 2, detox protocol, lab intrerpetation >/= X 2, mech ventilation, cont or intermittant POX/O2 sats > X 2, Suctioning > 2, Trach care > 2, frq tele changes with interventions, chem strips > 2, dressing changes > 15 min or X3 or >/= 2 assist, osotmoy irrigation, freq alarm cks > 2 hrs, DT's, pt wanders, isolation precautions (contact, droplet, neutropenic etc), sitter, assist with elimination >/= 5, insert or poss foley insert, incontinent care X 2, bowel incontinence with freq loose stools, >/= 2 assist with BR, BSC or bedpan, IV insert X 2
These are basic guidelines and can be tweaked for any unit.