What is the top 5 tool in nursing?

What Is the TOP 5 Tool in Nursing?

For nurses working with individuals who have cognitive disabilities, understanding each person’s unique needs is essential—especially in a hospital setting where stress and unfamiliar environments can amplify communication challenges. That’s where the TOP 5 tool comes in.

Originally developed in Australia, TOP 5 stands for “Things that are Important to the Person – Top 5.” It’s not a medical device or software, but a simple, person-centered framework used to capture the most important aspects of an individual’s life and care. The tool lists five key things that help healthcare staff provide respectful, effective, and compassionate support.

These five items typically include the person’s communication style (for example, whether they use gestures, pictures, or limited speech), known triggers or stressors, preferred routines, favorite activities, and how best to assist them during personal care. This information travels with the person, often via a small card or digital file, ensuring consistency across different care settings.

In nursing, TOP 5 bridges the gap between clinical care and personal identity. When a patient arrives at a hospital, staff can quickly review the TOP 5 list to understand not just their medical needs, but who they are as a person. This helps reduce anxiety, avoid misunderstandings, and build trust.

The tool is especially valuable for people with intellectual disabilities, autism, or dementia, who may struggle to express themselves in traditional ways. By focusing on dignity and individuality, TOP 5 reinforces a growing shift in healthcare—toward care that’s not only safe and efficient, but deeply human.