Italy - NANDA

Implementing Diagnosis-centered Standardized Nursing Language in Italy Through Research Collaboration

The International Nursing Knowledge Association (INKA), formerly NANDA® International, has established an active research collaboration with OPI Rome, the Italian Nursing Council of Rome, to support the implementation of diagnosis-centered standardized nursing language within electronic health record (EHR) systems in the Lazio region of Italy.

This collaboration reflects a shared commitment to strengthening nursing documentation, advancing clinical reasoning, and generating high-quality nursing data that can support both professional practice and scientific research. Integrating standardized nursing language into electronic health record (EHR) environments creates the foundation for consistent nursing documentation, improved visibility of nursing clinical judgment, and research-informed classification development. Implementation in digital systems also supports the generation of high-quality nursing data to strengthen practice, education, and outcomes evaluation internationally.

Collaboration with OPI Rome in the Lazio Region

An active collaboration agreement is currently in place between INKA and OPI Rome (Ordine delle Professioni Infermieristiche di Roma), effective 2025.

OPI Rome is the official professional nursing body responsible for supporting and regulating the nursing profession in Rome and surrounding areas. The organization provides institutional leadership, professional standards, and resources for nurses within the Italian healthcare system.

The purpose of this agreement is the implementation of the INKA’s diagnosis-centered standardized nursing language within EHR systems in the Lazio region, one of Italy’s major healthcare jurisdictions.

Embedding standardized nursing language content into electronic documentation supports:

Consistent recording of nursing clinical judgment
Improved interdisciplinary communication across care teams
Comparable nursing diagnosis data across settings and populations
Stronger infrastructure for nursing-sensitive outcomes evaluation

This type of regional implementation is essential for ensuring that nursing knowledge is represented accurately within digital health systems.

Using EHR Nursing Data to Support Terminology Research and Validation

A key component of this collaboration is that INKA provides free usage of its digital system in exchange for access to a limited data set for research relevant to INKA terms. This enables the scientific development, validation, and refinement of nursing language based on real-world nursing practice.

Implementation-based research collaborations such as this contribute to:

Strengthening the evidence base for nursing diagnoses
Evaluating diagnostic indicators in diverse clinical contexts
Supporting the refinement and ongoing development of classification structures
Advancing research on the impact of nursing care within digital systems

High-quality nursing documentation data is critical for demonstrating nursing contribution to patient care and ensuring that nursing diagnoses remain clinically meaningful and scientifically robust.

Agreement Timeline and Next Phase

The collaboration agreement was formally signed in spring 2025, marking an important milestone in INKA’s continued international research and implementation collaborations.

The implementation phase is expected to begin in spring 2026, with planning focused on the integration of INKA’s diagnosis-centered standardized nursing language into EHR workflows within the Lazio region.

Successful EHR terminology implementation requires careful attention to:

Clinical usability for nurses
Alignment with regional documentation standards
Professional training and governance structures
Ethical and responsible use of clinical data for research

This agreement represents an important step toward strengthening nursing’s digital and scientific infrastructure in Italy.

The OPI – Roma has agreed to provide INKA with a limited data set (LDS) as requested, based on research approved by an approved Institutional Review Board (IRB), within two months of the request, and in compliance with European privacy regulations. The IRB must be identified by the primary investigator or INKA and included in the request for data. This provides researchers with interest in the NANDA classification of nursing diagnosis to access patient data to strengthen the validity of the classification.

Additionally, INKA will receive records to identify usage patterns of the diagnoses and their component phrases annually, in April (to reflect the previous year). These data are to be provided to the INKA CEO by April 30 of each year of the contracted period, to enable an understanding of the most frequently used nursing diagnoses and which diagnostic indicator components (phrases) are most selected by the nurses using them.

Connecting to the Future of Nursing Classification and Clinical Reasoning

As healthcare becomes increasingly data-driven and interoperable, nursing must be supported by structured knowledge frameworks that reflect nursing-specific assessment and decision-making.

INKA’s broader development work includes NANDA 360, an expanded classification and clinical reasoning framework designed to unify diagnoses, outcomes, and nursing actions within a web-based clinical reasoning environment. Italian partners have expressed strong interest in the evidence-based NANDA 360 linkages between nursing diagnoses, patient goals and outcomes, and nursing actions.

NANDA 360 builds on decades of diagnosis-centered scholarship and aims to strengthen linkages between assessment findings, nursing diagnoses, patient goals, and nursing interventions.

Research collaborations such as the collaboration with OPI Rome provide essential implementation evidence to ensure nursing language remains internationally applicable, scientifically validated, and clinically relevant.

Advancing Nursing Collaborations

Through collaborations around the world, INKA supports nurses, educators, informaticians, researchers, and health leaders working to ensure that nursing knowledge is accurately represented within clinical systems.

The collaboration with OPI Rome reflects INKA’s commitment to advancing nursing language research through real-world digital implementation across international health systems.

This work strengthens the scientific development of nursing language while supporting the future of nursing practice through evidence-based classification and clinical reasoning frameworks.

team of medical professionals talking around a whiteboard

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