Research Collaborations: Brazil, Italy, and the USA
The International Nursing Knowledge Association (INKA), formerly NANDA® International, research collaborations support the advancement of assessment-driven, diagnosis-centered nursing knowledge and structured clinical reasoning across diverse health systems worldwide.
INKA (formerly NANDA® International, NANDA-I) supports international research collaborations focused on the implementation, validation, and ongoing development of diagnosis-centered standardized nursing language.
In Brazil and Italy, emerging work in electronic health record (EHR) integration highlights both the progress and the ongoing needs involved in embedding the nursing process within digital clinical environments.
As nursing documentation becomes increasingly structured and data-driven, collaborations that support diagnosis-centered implementation are essential for ensuring that nursing knowledge remains visible, clinically meaningful, and scientifically robust across diverse healthcare systems.
Progress in INKA Standardized Nursing Language Integration
Recent updates from nursing leaders in Brazil indicate that progress has already been made in integrating the INKA’s diagnosis-centered standardized nursing language into an EHR nursing module of a regional public health system.
This represents an important step in advancing standardized nursing documentation and strengthening the clinical infrastructure needed for consistent diagnostic reasoning.
Work is just beginning on implementation of the NANDA-I nursing diagnosis database into the EHR module within the OPI-Rome health system in Italy.
Structured nursing diagnoses within EHR systems help support:
- Clear nursing clinical judgment at the point of care
- Improved interdisciplinary communication
- Comparable nursing data across populations and settings
- A foundation for nursing-sensitive outcomes research
Embedding standardized nursing language into digital workflows is increasingly recognized as a critical requirement for modern professional nursing practice.
Identified Challenge: Interventions and Outcomes Infrastructure
A key issue has also been identified in the continuation of full nursing process implementation within EHR environments.
While nursing diagnoses have been structured successfully, there is not yet an authorized standardized database of nursing actions or patient goals / outcomes linked by evidence to the nursing diagnoses available for use in the current implementation context which has clear, evidence-based linkages to nursing diagnoses based on individual patient assessment.
This gap affects the ability to fully support the care planning and prescription stage of the nursing process digitally.
As noted in recent updates from our partners in Brazil and Italy:
- Diagnoses are present and structured
- Nursing actions and patient goals / outcomes linked to nursing diagnoses in an evidence-based manner remain a critical missing component
- Standardization and governance are required for the next phase of implementation
This reflects a broader challenge seen internationally: assessment-based, diagnosis-centered standardized nursing language is foundational, but full digital nursing process integration requires aligned infrastructure across assessment, diagnoses, actions, and patient goals / outcomes.
