Priority Setting Frameworks

Maslow's Hierarchy of Needs

1. Physiological 2. Safety and Security 3. Love and Belonging 4. Self-esteem 5. Self-actualization

Survival Potential

Survival potential is based on the chance a client has for survival during a mass casualty event when resources are limited. Appropriate use of human and physical resources that will save the greatest number of lives is the goal. In order of highest to lowest priority are Class 1/Emergent, Class 2/Urgent, Class 3/Nonurgent, and Class 4/Expectant.

Unstable vs Stable

In the unstable vs stable client priority-setting framework, unstable clients are given priority because they have needs that pose a threat to the client's survival. Oftentimes, the client need that is life-threatening involves his or her airway, breathing, and/or circulatory status. Clients whose vital signs or laboratory values indicate a client may be at risk for becoming unstable should also be considered a higher priority than clients who are stable.

Urgent vs Nonurgent

In the urgent vs nonurgent needs priority-setting framework, urgent needs are usually given priority because they pose more of a threat to the client. Some needs fall into the urgent category because they relate to an intervention that needs to be done within a prescribed time frame. The urgent vs nonurgent needs priority-setting framework is also applicable when the nurse is caring for a group of clients, and a determination must be made in regard to which client has the most urgent need and should be attended to first.

Nursing Process

Assessment/data collection Analysis Planning Implementation Evaulation

Acute vs. Chronic

In the acute vs chronic alterations in health priority-setting framework, acute needs are usually given priority as they may pose more of a threat to the client. Chronic needs usually develop over a period of time giving the body the opportunity to adjust to the alteration in health. Thus chronic alterations - unless a complication is being experienced - are usually considered to be a lower priority.

Least Restrictive/ Least Invasive

The least restrictive, least invasive priority-setting framework assigns priority to nursing interventions that are least restrictive and least invasive to the client. The least restrictive priority-setting framework is used when caring for a client who is exhibiting behaviors that could result in harm to either the client or the client's caregivers, or an intervention that will compromise the natural barriers between the client and the environment that is being considered. When selecting an intervention using this framework, however, you must also ensure that the nursing intervention selected will not put the client at risk for harm or injury.

Safety and Risk Reduction

The safety and risk reduction priority-setting framework assigns priority to the factor or situation that poses the greatest safety risk to the client. It also assigns priority to the factor or situation that poses the greatest risk to the client's physical and or psychological well-being. When a client is facing several risks, the one that poses the greatest threat to the client as compared to the other risks is the one that is deemed the highest priority.