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Checklist: Early detection of deterioration (TOBS)

Observation and escalation when something changes

Use the list when you notice that a citizen seems different from normal – it helps you observe systematically and pass on what is important.

§Observe systematically

  • 01Consciousness level — is the citizen awake alert and oriented as normal?
  • 02Breathing – frequency, and whether it seems strained.
  • 03Pulse.
  • 04Temperature.
  • 05Blood pressure, if included in your local instructions.
  • 06Skin color and moisture.

§Compare with the resident's normal level

  • 01What is different today compared to yesterday?
  • 02Is there sudden loss of function – can she do what she could yesterday?
  • 03Does the citizen seem more sluggish restless or confused than normal?

§Escalate and document.

  • 01Pass the observation on to the nurse or person in charge according to local instructions.
  • 02Document both the observation and the action you took.
  • 03Follow up whether the condition changes after your effort.