Taxonomy of Nursing Diagnoses

The NANDA International Taxonomy

Focus of Nursing
y Health of human beings
y Health-related phenomena are complex because they involve human experiences y Nursings goal is to identify peoples experiences or responses in order to support

them.

y Significant overlap of cues to diagnoses y Contextual factors such as culture can change the perspective of

what is the diagnosis? y Many studies have verified that interpretations of clinical cases have the potential to be less accurate than indicated by the data
(Lunney, 2007).

Nursing Diagnosis: NANDA-I Definition

y Adapted from a national, Delphi study by Dr.

Joyce Shoemaker (1984)

y A clinical judgment about individual, family, or community

responses to actual or potential health problems/life processes. Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable (1997).

The Diagnoses
y 206 NANDA-approved nursing diagnoses as of 2008 y Level of Evidence (LOE) Criteria Established for All

New and Revised Diagnoses y Entry into the Taxonomy requires various levels of clinical evidence

Taxonomy
Oxford English Dictionary
y /taksonnmi/ y noun chiefly Biology
y 1 the branch of science

American Nurses Association

y Classification according to

concerned with classification. y 2 a scheme of classification.

y ORIGIN from Greek

presumed natural relationships among types and their subtypes

y

ANA, 1999

taxis -nomia

arrangement + distribution

Definitions for Classification of Nursing Diagnoses

y Classification y Systematic arrangement of related phenomena in groups or

classes based on characteristics that objects have in common y Nomenclature y A system of designations (terms) elaborated according to pre-established rules
(ANA, 1999)

Definitions for Classification of Nursing Diagnoses

y Domain y A sphere of activity, concern, or function; a field: the domain

of history y Class y A set, collection, group, or configuration containing members regarded as having certain attributes or traits in common; a kind or category.
o (http://www.thefreedictionary.com/domain)

History of NANDA-I Taxonomy II

History of NANDA-I Taxonomy II

Structure of Taxonomy II

Code Structure
y NANDA-I uses a 32-bit integer (or a 5-digit code) to

enable growth & development of the taxonomy without having to change codes repeatedly to accommodate those changes y Code structure is compliant with the National Library of Medicines (USA) Unified Medical Language System (UMLS) concerning healthcare terminology codes

Structure of Taxonomy II yRegistered with Health Level 7 (HL7) yModeled into SNOMED-CT yCompliant with ISO terminology model for a nursing diagnosis yWorking collaboratively with ICNP

Multiaxial System
y 7 axes within NANDA-I Taxonomy y Axis y A dimension of the human response that is

considered in the diagnostic process y Allows for flexibility of the nomenclature y Allows for easy additions and modifications

NANDA-I Axes

Required

Optional

The NANDA-I Model of a Nursing Diagnosis

Diagnostic concept (Axis 1) Judgment (Axis 3) Status of Diagnosis (Axis 7) Time (Axis 6)

Location (Axis 4)

Subject of Diagnosis (Axis 2)

Age (Axis 5)

A NANDA-I Nursing Diagnosis Model: (Individual) Ineffective Coping

Coping (Axis 1) Ineffective (Axis 3) [Actual] (Axis 7) N/A (Axis 4) [Individual] (Axis 2)
N/A (Axis 5)

N/A (Axis 6)

A NANDA-I Nursing Diagnosis Model: Compromised Family Coping

Coping (Axis I)
Compromised (Axis 3) Risk for (Axis 7) N/A (Axis 4) Family (Axis 2) N/A (Axis 6)

A NANDA-I Nursing Diagnosis Model: Readiness for Enhanced Family Coping

Coping (Axis 1) Enhanced (Axis 3) Readiness for (Axis 7) N/A (Axis 4) Family (Axis 2) N/A (Axis 5) N/A (Axis 6)

NANDA-I Taxonomy II: 2008

Taxonomy: Opportunities
y The Diagnosis Development, Taxonomy, and Informatics

Committees have identified the following priorities for diagnosis development y Domain 2: Nutrition
y Class 2: Digestion

y Domain 1: Health Promotion y Class 1: Health Awareness y Domain 2: Nutrition y Class 3: Absorption

Future Development
y Clinicians can easily identify opportunities for new

diagnoses by reviewing the domains/classes with few or no diagnoses present y Construction of new diagnoses, along with submission to NANDA-I, enables the taxonomy to continue to be strengthened y NANDA-Is Diagnosis Development Committee is eager to partner with you to develop new diagnoses, and revise current diagnoses