The aim of this multi-site prospective cohort study is to utilize the internally validated CAMEO© acuity tool to describe the cognitive workload complexity of pediatric critical care nursing across eight children’s hospitals. The CAMEO defines acuity in terms of nursing cognitive workload complexity, the intellectual processing of information about patients that drives critical thinking, decision-making and the resulting level of surveillance necessary to meet patient needs. For more information about the CAMEO tool, please review our CAMEO publication. This study will seek to enroll 800 (100 patients per site) pediatric patients admitted to intensive care units across participating sites to externally validate the tool.