BestPracticeNurse.com
Person submitting the request.
Person submitting the request
Registered Nurse
Student Nurse
Allied Health Professionals
1. Patient Assessment Data
(Without Identifiers)
Clinical Profile:
Age group: [Pediatric/Adult/Geriatric]
Medical diagnosis (ICD-10 code): [______]
Functional status: [Ambulatory/Assisted/Bedbound]
Key Metrics:
Vital signs trends
Pain score (0-10 scale)
Braden Scale (pressure injury risk)
Fall risk score (Morse Scale)
2. Nursing Diagnoses
(Using NANDA-I Taxonomy)
Prioritized list:
"Impaired Skin Integrity related to immobility..."
"Risk for Infection secondary to surgical incision..."