NANDA-I NURSING DIAGNOSIS RESOURCES Back to Top
NANDA-I Nursing Diagnoses: Definitions and Classification 2009-2011 Print Edition Mobile Device Edition - 30 Day Free Trial Critical Thinking to Achieve Positive Health Outcomes Nursing Case Studies and Analyses NANDA-I Journal Free Sample Issue NANDA-I Nursing Diagnosis Reference Card Two-Sided Laminated Format Includes Nursing Assessment / Diagnosis Summary
NURSING DIAGNOSIS BASICS  Back to Top
What is a nursing diagnosis?
A nursing diagnosis is a clinical judgment about individual, family, or community experiences and responses to actual or potential health problems and life processes.
Why use nursing diagnosis?
A nursing diagnosis is used to determine the appropriate plan of care for the patient. The nursing diagnosis drives interventions and patient outcomes, enabling the nurse to develop the patient care plan. Nursing diagnoses also provide a standard nomenclature for use in the Electronic Health Record, enabling clear communication among care team members and the collection of data for continuous improvement in patient care.
Why doesn’t NANDA International provide a list of its diagnoses on its website?
There is no real use for simply providing a list of terms – to do so defeats the purpose of a standardized language. Unless the definition, defining characteristics, related and/or risk factors are known, the label itself is meaningless. Therefore, we do not believe it is in the interest of patient safety to produce simple lists of terms that could be misunderstood or used inappropriately in a clinical context.
NURSING DIAGNOSIS VS. MEDICAL DIAGNOSIS  Back to Top
What is the difference between a medical diagnosis and a nursing diagnosis?
A medical diagnosis deals with disease or medical condition. A nursing diagnosis deals with human response to actual or potential health problems and life processes.  For example, a medical diagnosis of Cerebrovascular Attack (CVA or Stroke) provides information about the patient’s pathology. The complimentary nursing diagnoses of Impaired verbal communication, risk for falls, interrupted family processes and powerlessness provide a more holistic understanding of the impact of that stroke on this particular patient and his family – they also direct nursing interventions to obtain patient-specific outcomes.
What is the best nursing diagnosis to use for my patient with congestive heart failure (or any other) medical diagnosis?
Using a medical diagnosis alone does not provide enough information to accurately diagnosis a patient from a nursing perspective. A holistic nursing assessment is critical for you to identify the potential nursing diagnoses. A medical diagnosis may be a related (or etiologic) factor for a nursing diagnosis, but you must identify defining characteristics of a nursing diagnosis during your assessment; it is impossible to make an accurate nursing diagnosis strictly from a medical diagnosis.
Does NANDA-I provide a list of nursing diagnoses that go along with the most common medical diagnoses?
There are several books that use this format. However, we believe the individual nursing assessment is critical to the accurate nursing diagnosis for a patient. It can be helpful to consider nursing diagnoses that tend to cluster with a particular medical diagnosis. However, if nurses only use a “list” of nursing diagnoses with a particular medical diagnosis, they are missing the uniqueness of the patient for whom they are providing care – that is the risk of this approach. A nursing diagnosis must always be related to each individual patient’s nursing assessment, or we risk misdiagnosis and inappropriate interventions. Remember that patient safety demands accurate nursing diagnosis!
LEARNING AND USING NURSING DIAGNOSIS  Back to Top
Do I have to use the “Nursing Diagnosis…related to…as evidenced by” statement to write a diagnosis that is considered to be accurate by NANDA-I?
No. While this is a good way of teaching the diagnostic reasoning process, it is not required by NANDA-I. It is sufficient to provide the nursing diagnosis label (e.g., Anxiety), and in fact, many computer systems do not allow the “related to…as evidenced by” model. However, it is important that nurses communicate the assessment data to support the diagnosis they make, so that others caring for the patient know why a diagnosis was selected.
How many diagnoses should my patient have?
Students are often encouraged to come up with a list of every possible diagnosis that a patient might have – this is a learning method. However, in practice, it is important to prioritize nursing diagnoses, as these form the basis for nursing interventions. You should consider which diagnoses are the most critical – from the patient’s perspective as well as from a nursing perspective – and the resources and time available for treatment. Other diagnoses may require referral to other health care providers or settings, e.g. home health care, a different hospital unit, skilled nursing facility, etc.
Can I change a nursing diagnosis after it has been documented in a patient record?
Absolutely! As you continue to assess your patient and collect additional data, you may find that your initial diagnosis wasn’t the best one – or your patient’s condition may have resolved. It is very important to continually evaluate your patient to determine if the diagnosis is still the most accurate for the patient at any particular point in time.
Should Licensed Practical / Vocational Nurses or Nursing Technicians / Assistants be taught to make nursing diagnoses?
The use of nursing diagnosis requires clinical judgment based on a holistic nursing assessment. Because only professional nurses (RN’s in the USA, for example) are licensed to perform nursing assessments, it is not acceptable for a practical / vocational nurse or nursing technician / assistant to make a clinical judgment resulting in a nursing diagnosis. However, these individuals work with professional nurses to provide care to patients, by implementing a plan of care that is developed by the professional nurse. Therefore, it is important they understand the nursing diagnoses just as much as the medical diagnoses, so the rationale is clear for the interventions they are asked to do.
STANDARDIZED NURSING LANGUAGE (SNL) BASICS  Back to Top
What is standardized nursing language?
A commonly-understood set of terms used to describe the clinical judgments involved in assessments(nursing diagnoses), along with the interventions, and outcomes related to the documentation of nursing care.
How many standardized nursing languages are there?
The American Nurses Association recognizes 12 languages for nursing.
What are the differences among standardized nursing languages?
Many nursing languages claim to be standardized; some are simply a list of terms, others provide definitions of those terms. NANDA-I maintains that a standardized language that represents any profession should provide, at a minimum, an evidence-based definition, list of defining characteristics (signs/symptoms) and related factors (etiologic factors); risk diagnoses should include an evidence-based definition, and a list of risk factors. Without these, anyone can define any term in his/her own way which obviously violates the purpose of standardization.
What is the connection between standardized nursing language and patient safety?
Patient safety requires that clinicians quickly grasp the priority needs of a patient. Use of language that requires a written narrative is no longer effective in today’s high acuity environment. Just as the medical discipline uses standardized language to identify patient disease states – so that all caregivers of all professions understand what is meant by a “Myocardial Infarction” (heart attack) – it is also critical that when nurses use terminology such as “activity intolerance, “all health care providers clearly understand what is meant and the appropriate plan of care. Lack of common definitions and defining characteristics (signs and symptoms) for nursing diagnosis language, leads to miscommunication and potentially, to mistreatment of patients. Standardized language ensures consistent communication and clarity - and therefore a better direction for patient care.
EVIDENCE-BASED PRACTICE & TAXOMONY  Back to Top
What is evidence-based nursing practice?
Evidence based practice allows nurses to enrich their clinical training and experience through the utilization of up to date research. With the large amount of research and information that exists in the health care arena, learning the skills of evidence based practice allows nurses to search for, assess, and apply the literature to their clinical situations.*
What is taxonomy?
Taxonomy is the practice and science of categorization and classification. The NANDA-I taxonomy currently includes 206 nursing diagnoses that are grouped (classified) within 13 domains (categories) of nursing practice: Health Promotion; Nutrition; Elimination and Exchange; Activity/Rest; Perception/Cognition; Self-Perception; Role Relationships; Sexuality; Coping/Stress Tolerance; Life Principles; Safety/Protection; Comfort; Growth/Development.
* Kessenich CR, "Teaching nursing students evidence-based nursing." Nurse Educator, Nov/Dec 1997, 22(6): 25-29.