what's new with nanda international?

Whats new with NANDA International?

T. Heather Herdman, RN,PhD, FNI Chief Executive Officer, NANDA International Assistant Professor, University of Wisconsin

Green Bay

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HAPPY NURSES WEEK!!!

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2012-2014 Definition (9th Edition)


A nursing diagnosis is a clinical judgment about individual, family, or community experiences / responses to actual or potential health problems / life processes. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability.

A nursing diagnosis is a clinical judgment concerning a human response to health conditions / life processes, or a vulnerability for that response, by an individual, family, group or community. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability.

Nursing diagnosis: a new definition

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Change from Actual to Problem-Focused Diagnoses



ACTUAL DIAGNOSIS Describes human responses to health conditions/life processes that exist in an individual, family, group, or community.

PROBLEM-FOCUSED DIAGNOSIS A clinical judgment concerning an undesirable human response to health conditions/life processes that exist in an individual, family, group, or community.


Changes to Health Promotion Diagnosis



A clinical judgment about a persons, familys, groups, or communitys motivation and desire to increase well - being and actualize human health potential as expressed in the readiness to enhance specific health behaviors, and which can be used in any health state.

A clinical judgment concerning motivation and desire to increase well-being and to actualize human health potential. These responses are expressed by a readiness to enhance specific health behaviors, and can be used in any health state. Health promotion responses may exist in an individual, family, group, or community.


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Changes to diagnostic labels

Previous Diagnostic Label New Diagnostic Label Ineffective self-health management

Ineffective health management

Readiness for enhanced self-health management

Readiness for enhanced health management

Ineffective family therapeutic regimen management

Ineffective family health management

Impaired individual resilience Impaired resilience

Risk for compromised resilience

Risk for impaired resilience


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Retired nursing diagnoses Retired Diagnostic Label New Diagnostic Label Disturbed energy field (00050) --

Adult failure to thrive (00101) Frail elderly syndrome

Readiness for enhanced immunization status (00186)

--

Imbalanced nutrition: more than body requirements (00001)

Overweight

Obesity Risk for imbalanced nutrition: more than body requirements (00003)

Risk for overweight

Impaired environmental interpretation syndrome (00127)

--

Delayed growth and development (00111)

--


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Standardization of Diagnostic Indicator Terms Decrease of variation in terms used for defining

characteristics, related factors and risk factors Clarity for clinicians should be improved

Similar but slightly different terms appear in different diagnoses Why cant NANDA-I be more clear?

Many of the e.g.s have been removed, unless needed to clarify intent.

Teaching tips that were present in some parentheses are gone


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Other changes

Defining characteristics are identified as those things that can be observed, which includes what can be seen and heard

We have removed terms such as observed and verbalizes, so that it is no longer necessary to have two terms that relate to the same data. Reports pain /observed evidence of pain Pain

(either observed or reported).

Some of the subcategories of terms have been deleted (e.g., objective/subjective) because they are no longer necessary.

Lists of pharmaceutical agents are now generally categorized under the subcategory of pharmaceutical agents.


Domain 1. Health Promotion

Frail elderly syndrome

Risk for frail elderly syndrome

Domain 2. Nutrition

Risk for overweight

Overweight

Obesity

New Nursing Diagnoses, 2015 2017

Domain 3. Elimination and Exchange Chronic functional constipation Risk for chronic functional constipation Domain 4. Activity / Rest Impaired sitting

Impaired standing

Risk for decreased cardiac output Risk for impaired cardiovascular function



Domain 9. Coping / Stress Tolerance Impaired mood regulation Domain 10. Life Principles Impaired emancipated decision-making Readiness for enhanced emancipated decision- making Risk for impaired emancipated decision- making

Domain 11. Safety/Protection Risk for corneal injury Risk for impaired oral mucous membrane Risk for pressure ulcer Risk for delayed surgical recovery Risk for impaired tissue integrity Risk for urinary tract injury Labile emotional control Risk for hypothermia Risk for perioperative hypothermia


Domain 12. Comfort Chronic pain syndrome

Labor pain



Theory / Nursing Science

underlying nursing

concepts Assessment /

Patient History

Nursing Diagnosis

Outcome Identification

Evidence-based

Intervention

Implementation

Continual Re-evaluation

Patient / Family

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A focus on clinical reasoning

Screening Assessment

Data collection Data analysis Clustering of information

Potential Diagnoses

Consider all possible diagnoses that match information available

In-Depth Assessment

Focused data collection Data analysis Confirming or refuting potential diagnoses

Nursing Diagnoses

Determine priority nursing diagnoses

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THANK YOU!!!!

T. HEATHER HERDMAN, RN, PHD, FNI [email protected]

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