INTENSIVE CARE UNIT DAILY GOALS Room: AM PM Shift Date: Nurse Initials:________________ Nurse Initials:________________ sedative for AM Wean off sedation extubation Trial N/A Goal sedation level @ ________________ Pain management w/_________________ PT/OT Consult OOB CV MAP goal if not 60 mmHG:____________ anti-hypertensive Vasopressor IV overnight on AC Rest Ventilator Weaning Vent: Yes No indicated settings   SBT if SBT tolerated PS/TC/CPAP Extubate Continue Wean___________________ GI/Nutrition for next day procedure Diet NPO Tube Feeding at goal NPO for _______ (check insulin use) SLP consult today target to achieve On Renal/fluids I/O Goal for day: goal (I = O) Even by __________ Negative Patient determined Glycemic control None SSI Infusion Long-acting Heme prophylaxis DVT transfusion and goal Hgb Blood Infectious disease antibiotic(s) be discontinued? Can Lines/tubes to be placed Catheter Can a catheter be removed? Can a be removed? Medication review Renal or hepatic adjustment  meds Home reviewed To do Tests/procedures: labs and/or CXR needed? AM meeting or update: Family Code may intubate DNR, Discharge Criteria MS withdrawal of care Possible
INTENSIVE CARE UNIT DAILY GOALS Room: AM PM Shift Date: Nurse Initials:________________ Nurse Initials:________________ Trial off sedation N/A Wean sedative for AM extubation Goal sedation level @ ________________ Pain management w/_________________ PT/OT Consult OOB CV MAP goal if not 60 mmHG:____________ Vasopressor IV anti-hypertensive Ventilator Weaning Vent:  Yes  No SBT indicated Rest overnight on AC settings Extubate if SBT tolerated Continue PS/TC/CPAP Wean___________________ GI/Nutrition Diet NPO for next day procedure Tube Feeding at goal NPO for _______ (check insulin use) SLP consult today Renal/fluids I/O Goal for day: On target to achieve goal Even (I = O) Negative by __________ Patient determined Glycemic control None SSI Infusion Long-acting Heme DVT prophylaxis Blood transfusion and goal Hgb Infectious disease Can antibiotic(s) be discontinued? Lines/tubes Catheter to be placed Can a catheter be removed? Can a be removed? Medication review  Renal or hepatic adjustment Home meds reviewed To do Tests/procedures: AM labs and/or CXR needed? Family meeting or update: Code DNR, may intubate Discharge Criteria MS Possible withdrawal of care