Priority-Setting Frameworks

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Airway

-A client who is experiencing a compromised airway requires immediate intervention to prevent both illness and death. -airway obstruction can be partial or complete. -can be caused by a variety of factors, including depression of the central nervous system, blockages created by blood or vomit, edema and inflammation of the upper airway, facial trauma, or foreign objects inside the airway.

What is the top-level need of Maslow's Hierarchy?

Self-actualization which is considered a growth need. Maslow's theory assumes that the most basic needs-- those categorized as physiological-- must be met before the client can attempt to fulfill physiological needs; likewise, phycological needs must be met before self-actualization needs can be fulfilled.

Priority setting

is defined as the delivery of nursing care based on the urgency or importance of client needs. In a health care facility, the nurse uses priority setting when determining which needs to address first for an individual client as well as when caring for a group of clients and identifying which client to care for first.

ABCDE Priority Framework

A: Airway B: Breathing C: Circulation D: Disability E: Exposure

What does ABCDE priority stand for?

Airway, breathing, circulation, disability, exposure.

Starting from the bottom of Maslow's hierarchy triangle, what are the levels?

1. physiological needs 2. safety needs 3. love needs 4. esteem needs 5. Self-actualization

When can nurses use priority-setting frameworks to make decisions?

1. An individual client, such as when a client is deteriorating 2. on a group of clients, such as when the nurse organizes care for multiple clients at the change-of-shift report.

Self- Actualization

A need for achievement and mastery. -Reaching one's greatest potential, whatever that may be. It is the desire to be whatever it is that one wants to be, and to achieve the most that one can achieve. After all deficiency needs are met, individuals then strive to reach their fullest potential; they may experience restlessness and unhappiness until they achieve that goal. Very few people are able to reach the state of self-actualization. 5th level- highest

Love needs

A need to give love and receive love. -Once both physiological and safety needs have been met, the individual's attention turns to meeting social needs. 3rd level

Esteem needs

A need to have a high self-image. Two factors motivate the need for self-esteem: the desire to feel good about oneself and having the respect of others. Feeling good about oneself (that is, having a high sense of self-esteem) is achieved by having confidence in one's abilities and achievements, as well as by gaining recognition, appreciation, and respect from others. o When individuals do not meet their self-esteem needs, they develop a sense of uselessness leading to feelings of inferiority. 4th level

Maslow's Hierarchy of Needs

A theory that suggests there are five categories of needs that motivate human beings. The five categories are psychological, safety, love and belonging, esteem, self-actualization.

What is the ABCDE priority framework?

ABCDE priority framework is an algorithm used in prioritizing care for individuals or groups of clients. The purpose of the ABCDE framework is to recognize and stabilize the client's most critical issues first, and then move to the next vital system with the goal of improving the client's outcome and providing time to develop a diagnosis.

What levels of the Maslow's Hierarchy are considered deficiency needs?

Deficiency needs include security and safety, physiological, belonging and love, and self-esteem needs. If those basic needs are not fulfilled, the client experiences this deprivation as discomfort, which motivates the individual to meet those unmet needs.

How can a nurse use the ABCDE framework during the initial client physical assessment?

During the initial client physical assessment, the nurse can use the ABCDE approach to consider which physical assessments to be performed first, which findings are critical and should be addressed, and which interventions should be implemented immediately to manage a potentially life-threatening situation.

When do nurses demonstrate their ability to establish priorities?

Nurses demonstrate their ability to establish priorities when they choose interventions for multiple clients, prioritize individual care for a client, evaluate a client's plan of care, and revise the plan of care as necessary.

Physiological needs

The most basic human needs for air, water, food, housing, sleep, and sexual activity. these basic needs represent the body's attempt to maintain homeostasis. Ex: Id the client is thirsty, it is hard for them to focus on anything besides acquiring water. In this situation, the nurse should first satisfy the client's need for water before moving on to the next level of needs. 1st level

Safety needs

The need for a secure environment in which one can live, work and play. -once all physiological needs have been met, individuals turn their attention toward meeting their safety and security needs. 2nd level

What must the nurse know in order to apply the ABCDE framework?

To apply the ABCDE framework, the nurse must be aware of both expected and unexpected findings for each system. Failure to follow a systematic approach could result in the client experiencing a less than optimal outcome, including admission to the critical care unit or even death.


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