2. Evolution of nursing process
• Fry (1953) identified that nursing diagnosis is a
tool for individualizing patient care.
• First National Conference for the Classification
of Nursing Diagnoses, (1973).
• American Nurses Association (ANA)
published Standards of Nursing Practice (1973).
• North American Nursing Diagnosis
Association (NANDA), 1982.
• NANDA developed 21 new nursing diagnoses
and revised 37 existing diagnoses (1998).
3. Purpose of nursing process
• Identifies areas that nurses can resolve or enhance.
• Demonstrates professional judgment.
• Organizes decision making as part of the nursing
process.
• Promotes accountability.
• Provides communication among nurses and other
health care personnel.
• Promotes use of standardized language and process.
• A means to individualize care.
• Provides a mechanism for conducting nursing research.
4. Definition of a Nursing Diagnosis
(NANDA, 1996)
A nursing diagnosis is defined as “ a clinical
judgment about an individual, family or
community responses to actual and potential
health problems/life processes. Nursing
diagnosis provide the basis for selection of
nursing interventions to achieve outcomes
for which the nurse is accountable.”
(NANDA, 2009)
5. Comparison of Medical and Nursing
Diagnoses
• Medical diagnosis is the terminology
used for a clinical judgment by the
physician that identifies or
determines a specific
disease, condition, or pathologic
state.
6. Nursing Diagnosis
• Terminology used for a clinical
judgment by the professional nurse that
identifies the client’s
actual, risk, wellness, or syndrome
responses to a health state, problem, or
condition.
7. Components of a Nursing Diagnosis
• The two-part statement
– Problem statement or diagnostic label
– Etiology
• The diagnostic label and etiology are
linked by the term related to (RT).
8. Components of a Nursing Diagnosis
• The three-part statement
– Diagnostic Label
– Etiology
– Defining Characteristics
• Defining characteristics are the signs and
symptoms, subjective and objective data, or clinical
manifestations.
• The phrase, “as evidenced by …” (AEB), is joined
to the first two components.
14. Avoiding Errors in Developing
a Nursing Diagnosis
• Accurate and complete collection of data.
• Use of an organizational framework for
clustering data cues.
• Thorough analysis and validation of data.
• Correct writing of the nursing diagnosis.
15. Limitations of Nursing Diagnosis
• Lack of consensus among nurses regarding
the NANDA-approved nursing diagnosis
list.
• Nurses are overworked and have less time
with clients.
• Care is still organized around the medical
diagnosis.
16. Limitations of Nursing Diagnosis
• Nurses are afraid they may be ridiculed for
using nursing diagnoses.
• The nursing diagnosis list does not always fit
the client situation.
• Nurses may be unable or unwilling to use
nursing diagnoses because of incomplete
knowledge.
• If a nursing diagnosis is inappropriate, and as a
result, the interventions are inappropriate or
lacking, the nurse is liable for these errors in
judgment.
17. Overcoming Barriers to Nursing Diagnosis
• Familiarity of nursing diagnosis language
empowers the nurse to communicate more
effectively.
• Health care agency administrators and
medical staffs need to be more supportive of
the use of nursing diagnoses.
18. Overcoming Barriers to Nursing Diagnosis
• Enhanced communication between clinical
nurses and leaders will increase the
development of nursing diagnoses.
• Most nursing education programs offer
standardized content related to nursing
diagnoses.
• Experienced nurses need opportunities to
review nursing diagnoses.
19. Overcoming Barriers to Nursing Diagnosis
• Every attempt should be made to
describe phenomena that do not fit
into existing nursing diagnosis
language.
• The nurse may be on the threshold
of documenting a new nursing
diagnosis.
20. “At the end of the day
I can truly says I made a difference
in someone’s life today….
And that is why I am
NURSE”
