What’s new with NANDA International? T. Heather Herdman, RN,PhD, FNI Chief Executive Officer, NANDA International Assistant Professor, University of Wisconsin – Green Bay Pagina successiva NAMING WHAT NURSES KNOW HAPPY NURSES’ WEEK!!! Pagina precedente Pagina successiva Nursing diagnosis: a new definition 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. Pagina precedente 2015-2017 Definition (10th Edition) 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. Pagina successiva Change from Actual to ProblemFocused Diagnoses 2012-2014 Definition (9th Edition) 2015-2017 Definition (10th Edition) ACTUAL DIAGNOSIS PROBLEM-FOCUSED DIAGNOSIS Describes human responses to health conditions/life processes that exist in an individual, family, group, or community. A clinical judgment concerning an undesirable human response to health conditions/life processes that exist in an individual, family, group, or community. Pagina precedente Pagina successiva Changes to Health Promotion Diagnosis 2012-2014 Definition (9th Edition) A clinical judgment about a person’s, family’s, group’s, or community’s 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. Pagina precedente 2015-2017 Definition (10th Edition) 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. Pagina successiva NAMING WHAT NURSES KNOW Changes to diagnostic labels Previous Diagnostic Label New Diagnostic Label Ineffective self-health management Ineffective health management Readiness for enhanced selfhealth 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 Pagina precedente Pagina successiva NAMING WHAT NURSES KNOW 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 Overweight body requirements (00001) Obesity Risk for imbalanced nutrition: Risk for overweight more than body requirements (00003) Impaired environmental -interpretation syndrome (00127) Delayed growth and development (00111) Pagina precedente -- Pagina successiva NAMING WHAT NURSES KNOW 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 can’t 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 Pagina precedente Pagina successiva NAMING WHAT NURSES KNOW 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 (either observed or reported). Pain • 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”. Pagina precedente Pagina successiva New Nursing Diagnoses, 2015 – 2017 Domain 1. Health Promotion Domain 3. Elimination and Exchange • Frail elderly syndrome • Chronic functional constipation • Risk for frail elderly syndrome • Risk for chronic functional constipation Domain 2. Nutrition • Risk for overweight • Overweight • Obesity Domain 4. Activity / Rest • Impaired sitting • Impaired standing • Risk for decreased cardiac output • Risk for impaired cardiovascular function Pagina precedente Pagina successiva New Nursing Diagnoses, 2015 – 2017 Domain 9. Coping / Stress Tolerance • Impaired mood regulation Domain 10. Life Principles • Impaired emancipated decision-making • Readiness for enhanced emancipated decisionmaking • Risk for impaired emancipated decisionmaking Pagina precedente 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 Pagina successiva New Nursing Diagnoses, 2015 – 2017 Domain 12. Comfort Chronic pain syndrome Labor pain Pagina precedente Pagina successiva A FOCUS ON CLINICAL REASONING Theory / Nursing Science underlying nursing concepts Assessment / Patient History Continual Re-evaluation Patient / Family Nursing Diagnosis Implementation Evidencebased Intervention Pagina precedente Outcome Identification Pagina successiva A focus on clinical reasoning • Data collection • Data analysis Screening Assessment • Clustering of information Potential Diagnoses • Consider all possible diagnoses that match information available • Focused data collection • Data analysis In-Depth Assessment • Confirming or refuting potential diagnoses Nursing Diagnoses • Determine priority nursing diagnoses Pagina precedente Pagina successiva THANK YOU!!!! T. HEATHER HERDMAN, RN, PHD, FNI EXECDIR@NANDA.ORG Pagina precedente