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NURSING DIAGNOSIS



                Presented by
                P. Arul valan
            Lecturer, SXCCON
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).
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.
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)
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.
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.
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).
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.
Example of nursing diagnosis
Developing a Nursing Diagnosis
• Critical thinking   • Clustering cues
• Assessing the       • Consulting
  database              NANDA list of
                        nursing diagnoses
• Validating cues
                      • Writing the nursing
• Interpreting cues     diagnostic
                        statement
Types of nursing diagnosis
Actual Diagnoses(Three Part)
Risk Diagnoses(Two Part)
Wellness Diagnoses(One Part)
Prioritizing nursing diagnosis
• Airway
• Breathing
• Circulation
Case study -1
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.
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.
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.
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.
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.
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.
“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”

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Nursing diagnosis

  • 1. NURSING DIAGNOSIS Presented by P. Arul valan Lecturer, SXCCON
  • 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.
  • 9. Example of nursing diagnosis
  • 10. Developing a Nursing Diagnosis • Critical thinking • Clustering cues • Assessing the • Consulting database NANDA list of nursing diagnoses • Validating cues • Writing the nursing • Interpreting cues diagnostic statement
  • 11. Types of nursing diagnosis Actual Diagnoses(Three Part) Risk Diagnoses(Two Part) Wellness Diagnoses(One Part)
  • 12. Prioritizing nursing diagnosis • Airway • Breathing • Circulation
  • 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”