HNEMR202C AGITATION SCALE 250214 indd - myLink - mylink hnehealth nsw gov 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's family name, given name, and medical record number (MRN) in the designated fields.
3. Fill in the facility name, date of birth (D.O.B.), gender, and address/location/ward as required.
4. Score the patient’s agitation level every hour by placing a '•' in the appropriate scoring area based on observed behaviors.
5. Document any interventions taken at each hour by noting them next to the corresponding time slots.
6. Utilize the reverse side of the form for detailed notes on specific behaviors and interventions implemented.
7. Review and ensure all sections are completed accurately before saving or sharing your document.

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