The Criteria of Critical

Association-LogosThe American Association of Critical Care Nurses (AACN) conducts continuous, comprehensive research on all aspects of delivering skilled nursing care to the most vulnerable patients in the hospital.  For years, this premier organization along with other professional associations like the Emergency Nurses Association, the Association of PeriOperative Registered Nurses,  Association of Women’s Health, Obstetric and NeoNatal Nurses  and many more have worked in the best interests of patients by meticulously developing evidence-based guidelines like the one below.

Unfortunately, hospitals can – and  do – arbitrarily ignore science because they are simply not required to meet any minimum standards of care.  Too frequently in today’s ICUs across the United States, nurses share stories of a hospital putting patients at risk by turning its back on professional guidelines.

Don’t you want your hospital to meet professional standards?  Please help advance the movement for Safe Patient Standards in Minnesota.


Criteria for 24-Hour 1:1 Nursing Care   (retrieved from the website of the American Association of Critical Care Nurses)

 

Stability Level I
  • Patients with unstable cardiac rhythms that cause hemodynamic compromise and necessitate frequent assessments, pharmacological interventions, and/or mechanical termination of the rhythm and patients who require external cardiac pacing and/or placement of a transvenous pacemaker
  • Patients who experience hypertensive or hypotensive crisis and require rapid stabilization of blood pressure
  • Patients with symptomatic cardiac tamponade who require immediate intervention on the unit including drainage and stabilization
  • Patients who experience inadequate myocardial perfusion who exhibit ongoing symptoms of chest discomfort resulting in decreased cardiac output and severe hemodynamic instability
  • Patients who develop symptomatic bleeding and require immediate intervention
  • Patients who experience cardiac arrest and remain severely compromised requiring ventilatory and pharmacological support with continuous adjustments
  • Patients who exhibit symptoms of extreme dyspnea, acute anxiety, orthopnea, and diffuse pulmonary congestion who are highly complex and vulnerable in the acute phase of their illness
  • Patients who require insertion of an intracranial pressure monitoring device (ventricular drain or camino) and demand continuous intracranial pressure monitoring with frequent assessment and interventions
  • Patients with an acute change in neurological status who require continuous nursing assessment and interventions
  • Nonventilated patients exhibiting life-threatening airway compromise who require frequent treatments and continuous observation
  • Patients in metabolic crisis with multisystem compromise who require continuous monitoring, assessment, and interventions
  • Patients who must leave the critical care area for a procedure or test and require continuous nursing assessment and monitoring for the duration of the test
Highly Complex Level I
  • Patients assigned to a research protocol who require initiation into the study that necessitates documentation every 15 minutes or more often
  • Patients who require a diagnostic or therapeutic intervention in conjunction with conscious sedation and recovery
  • Patients who are potential organ donors who require immediate, extensive preparation and/or management
  • Patients who are severely compromised and require continuous arteriovenous hemofiltration
  • Patients who require pressure control ventilation in the acute stage of acute respiratory distress or ventilated patients in the critical stage of acute lung injury with high-PEEP and high oxygen requirements
Vulnerability Level I
  • Patients whose families require frequent interventions including complex teaching and help resolving ethical concerns; for example, families who require counseling because they are considering terminating life support measures and/or donating organs for transplantation
  • Patients exhibiting emotional trauma who require intensive care, collaboration, and coordination with other support services, including but not limited to victims of sexual assault
Resiliency Level I
  • Patients in the acute phase of their illness who exhibit signs of confusion, sensory overload, or psychosis and require continuous assessment and immediate pharmacological interventions
  • Patients who require continuous intravenous sedation and/or neuromuscular blockade for control of anxiety in the acute phase of their illness and those who exhibit withdrawal symptoms as they are weaned from long-term sedation.

 

Patient Story

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