What’s 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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NAMING WHAT NURSES KNOW
HAPPY NURSES’ WEEK!!!
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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.
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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.
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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.
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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
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NAMING WHAT NURSES KNOW
Retired nursing diagnoses
Retired Diagnostic Label
New Diagnostic Label
Disturbed energy field (00050)
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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)
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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
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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”.
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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
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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
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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
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New Nursing Diagnoses, 2015 – 2017
Domain 12. Comfort
Chronic pain syndrome
Labor pain
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A FOCUS ON CLINICAL
REASONING
Theory /
Nursing
Science
underlying
nursing
concepts
Assessment /
Patient
History
Continual
Re-evaluation
Patient /
Family
Nursing
Diagnosis
Implementation
Evidencebased
Intervention
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Outcome
Identification
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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
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THANK YOU!!!!
T. HEATHER HERDMAN, RN, PHD, FNI
EXECDIR@NANDA.ORG
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