The concept of a nursing diagnosis has been around for more than 40 years. This is not the formally recognised advanced nurse practitioner managing and diagnosing independently, but rather the nurse’s insight, knowledge and experience being used to holistically treat and manage the patient, separately from a medical diagnosis. The 2018-2020 eleventh edition, Nursing Diagnoses: Definitions and Classification, continues the evidence base and ratification process for existing and new nursing diagnoses, with 17 new definitions being added to this edition.
The diagnoses and classifications range from health promotion, nutrition and levels of activity, to physical manifestations such as impaired balance and acute confusion. Each diagnosis has an individual code, definition, and defining characteristics, along with associated medical conditions. The editors do recognise that some areas require more evidence and are in need of revision. There is also the issue of varying rules and regulations in differing countries regarding what the nursing role can and cannot undertake. One of the aims of the NANDA-I is to standardise nursing diagnoses terminology worldwide in order to increase the evidence base for each diagnosis, and therefore standardise the international nursing diagnosis acceptance and formality.
As the nursing profession appears to be becoming more technical, medicalised and increasingly taking on more of the previously deemed ‘doctor only’ duties, the classification system of recognised nursing only diagnoses is vital, although the line drawn between a nursing diagnosis and an advanced nurse practitioner diagnosis is unclear to many.
The eleventh edition 2018-2020 nursing diagnoses and classification by NANDA international is a very useful guide and educational tool, albeit in need of a more robust evidence base and a wider promotion amongst the nursing profession.
Lee Hough MBE, Queen’s Nurse, White Rose Surgery, Pontefract, Yorkshire
