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Initial Assessment (part 3) Risk Stratification questions to determine level of care
Initial Assessment (part 3) Risk Stratification questions to determine level of care
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Version One. 25 November 2021. 14
Assess Clinical Risk
The clinical risk profile of an individual is determined by their individual clinical risk and the most vulnerable/at-risk member of their household.
COVID-19 Care 1 if the patients answers no to all of the stratification questions and there are no high-risk household members2 (whether COVID-19 positive or negative).
COVID-19 Care 1
Patients self-monitor symptoms daily and receive alternate day (or as clinically indicated) remote clinical assessment from an appropriate practitioner. This can be a nurse, NP or GP (if this is provided by a nurse, then NP or GP support must be available if required)
COVID-19 Care 2 if they answer yes to any of the stratification questions or there are any high-risk household members (whether COVID-19 positive or negative).
COVID-19 Care 2
Most patients in COVID-19 Care 2 have risk factors putting them at higher clinical risk of deterioration and requiring daily monitoring.
Ask the patient to self-monitor (including pulse oximetry if required) and record observations at least twice daily.
Higher risk patients are reviewed by a suitable clinician daily (including weekends), with additional checks as clinically indicated. Patients should have access to a pulse oximeter if they have personal risk factors for COVID-19 Care 2. A patient with a clinically lower risk may be stratified to COVID-19 Care 2 due to having a high risk household member. Stratification to COVID-19 Care 2 indicates clinical risk of deterioration if the household member becomes COVID-19 positive and therefore a need for awareness of the household.
Arrange a pulse oximeter. Patient Instructions for use can be found here (and will be supplied with the pulse oximeter to the patient)
https://www.healthnavigator.org.nz/health-a-z/p/pulse-oximeter-adult/ Ensure contactless delivery from pharmacies is available if needed.
2 High-risk household members: The patient with COVID-19 can usually identify high-risk household members quickly if asked about the age of household members, whether any are not vaccinated, and if any have medical conditions.
