We are often asked if NANDA-I requires or recommends a standardized assessment framework.
We have always said that NANDA-I classification is atheoretical – meaning that you may use the classification with any nursing theory you might choose to use in your practice.
However, perhaps what we haven’t addressed clearly (other than in our book) is our stance on nursing assessment.
NANDA-I favors (and recommends strongly) holistic patient-focused assessment. This doesn’t mean that you need to have hundreds of questions and collect excessive data every time you see a patient. After all, what’s the point of collecting data if we can’t use it?
What it does mean is considering how patient responses affect the entire person.
For example, we might assume that the patient with a mastectomy will have a diagnosis of body image disturbance; however, that’s just not true. Many women do not have issues with changing their bodies from a standpoint of sexuality; however, they may suffer from anxiety or “fear of the unknown” of the cancer diagnosis.
They may be worrying about their families and how their children or partner will respond. This may be something that will cause economic hardship to the family, which may weigh heavily on this woman’s mind. It could be a spiritual dilemma, as well. Likewise, she may worry about (or encounter) infection. She may have postoperative complications. There are a variety of things that can occur in tandem with – or because of – that mastectomy.
Therefore, to simply assume that all people will respond the same makes no sense. But if we had a standardized assessment that could identify trends or patterns in a person’s response, and help us to drill down on those responses to better understand the human experience, we would have the possibility of better understanding what is happening with the “whole person” patient. This assessment would give us greater insights than we would glean from a simple head-to-toe assessment.
It’s important to say that diagnoses identified by a head-to-toe assessment are not wrong (or less important than) those that are identified through a holistic assessment. However, it is a different lens, and it is a lens that often reflects knowledge and focus that is nursing-specific, rather than that of other disciplines.
We are starting to think about how NANDA-I can facilitate the use of an electronic standardized assessment that could support clinical decision-making tools, and improve accuracy and diagnosis. If you’re interested in this, please let us know by emailing firstname.lastname@example.org.