In the 2020 to 2023 edition of NANDA-I, there are 13 domains of nursing diagnoses. Each domain has between three and six classes of nursing diagnoses, that are then broken down into individual diagnoses. Here we will list all 13 domains, related classes, and an example nursing diagnosis. Please see NANDA International- Nursing Diagnoses Definitions and Classification, 12th Edition, for the complete list of diagnoses.

In 1958, Ida Jean Orlando started the nursing process that still guides nursing care today. Defined as a systematic approach to care using the fundamental principles of critical thinking, client-centered approaches to treatment, goal-oriented tasks, evidence-based practice (EDP) recommendations, and nursing intuition. Holistic and scientific postulates are integrated to provide the basis for compassionate, quality-based care.[1][2][3]


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The North American Nursing Diagnosis Association (NANDA) provides nurses with an up-to-date list of nursing diagnoses. A nursing diagnosis, according to NANDA, is defined as a clinical judgment about responses to actual or potential health problems on the part of the patient, family, or community.

The North American Nursing Diagnosis Association (NANDA) is a body of professionals that manages an official list of nursing diagnoses. The preliminary group was formed in 1973 after a conference was called for the purpose of classifying a list of nursing diagnoses grouped in alphabetical order. Kristine Gebbie and Mary Ann Lavin invited attendees from the United States and Canada to the meeting in St. Louis, Missouri. There the nurses created three components to begin the launch of an organized set of diagnoses. The National Clearinghouse for Nursing Diagnoses located at St. Louis University, the National Conference Group, and a Nursing Diagnosis Newsletter composed the three structures. NANDA was officially formed in 1982. The organization publishes the NANDA-I Definitions and Classification book that can be purchased by healthcare facilities and individual nurses. The association exists in order to continuously refine the terminology used and to develop and promote the lists in order to foster uniformity among professionals.

The NANDA nursing diagnosis list is an essential and useful tool that promotes patient safety by standardizing evidence-based nursing diagnoses. The process enables nurses to implement interventions with predictable outcomes. The presence of uniform and accurate documentation provided by the utilization of the diagnoses assists in obtaining reimbursement of medical bills. NANDA is comprised of goal-oriented nurses who are committed to continually increasing the quality of patient care while promoting and improving levels of patient safety. The group welcomes suggestions from nurses outside of the association on the creation of new or modification of existing nursing diagnoses. The organization conducts research which is funded by the NANDA Foundation.

NANDA has helped to increase patient safety and continuity of care by the development of its standardized list. Its use has helped to allow better efficiency and more effective patient care using nanda Nursing Diagnosis List.

Additional Key Updates46 new nursing diagnoses and 67 revised diagnosesChanges to 17 nursing diagnosis labels, ensuring they are consistent with current literature and reflect a human responseRefinement of the vast majority of the nursing diagnosis related/risk factorsStandardization of diagnostic indicator terms (defining characteristics, related factors, risk factors) to further aid clarity for students and cliniciansCoding of all terms for those using electronic versions of the terminologyWeb-based resources include reference lists for new and revised diagnosesNew chapter on revised Level of Evidence Criteria for diagnosis submission

In 1973, Kristine Gebbie and Mary Ann Lavin called the First National Conference on the Classification of Nursing Diagnoses (Gebbie & Lavin, 1975). It was held in St. Louis, Missouri. Attendees produced a beginning classification, an alphabetized list of nursing diagnoses. The conference also created three structures: A National Clearinghouse for Nursing Diagnoses, located at Saint Louis University and led by Ann Becker; a Nursing Diagnosis Newsletter, edited by Anne Perry; and a National Conference Group to standardize nursing terminology and led by Marjory Gordon. In 1982 NANDA was formed, and included members from the United States and Canada.

A brief examination of the history of classification will serve as a reference point for nursing classifications. It is sometimes stated that the idea of classification dates back to the book of Genesis. Out of chaos "God divided the light from darkness." Primitive cultures, as well as more advanced societies, have classified health-related ideas important to the culture. In his studies of world cultures Murdock (1980) classified theories of illness into theories of natural causation and theories of supernatural causation. (Information for Murdock's subcategories listed in Table 1 are based on information from pages 8-20 of his book.) The Hippocratic School of ancient Greece explained disease using the concept of "humors" rather than supernatural or magical forces.

An inductive approach was used initially by NANDA to begin to identify classes/categories. This is in contrast to deduction of elements from a nursing theory. Theoretical pluralism prevails and the choice of one theory would negate the others. The 100 participants (staff nurses, clinical specialists, educators, researchers, administrators, theorists, and consultants) at the 1973 conference generated a set of nursing diagnoses, definitions, and defining characteristics from their nursing practice expertise stored in memory. These diagnoses represented 29 conceptual areas with approximately 100 terms which were later condensed. This can be compared to the current classification system that contains 71 conceptual areas and 143 terms (North American Nursing Diagnosis Association, In Press).

Participation of nursing specialty organizations is important. Some organizations have submitted high frequency diagnoses in their specialty that are not already classified (Association of Rehabilitation Nurses, the former ANA Council of Psychiatric-Mental Health Nurses, Holistic Nurses, Association of Operating Room Nurses, etc.). The Association of Rehabilitation Nurses submitted new diagnoses from a research study that involved a national, random sample of members. This Association also funded a study that resulted in publication of 21 rehabilitation nursing diagnoses-intervention-outcome linkages (Rehabilitation Nursing Foundation, 1995).

A classification system can be as simple as an alphabetical listing or as formal as a numerical taxonomy. The ideal classifications of mathematics and logic with mutually exclusive categories are seldom found in other disciplines (Bailey, 1994). Biology struggles to distinguish between the animate and inanimate and medicine finds obesity in its classification of diseases (Webster, 1984). Classification is not a simple task with the complexity of nursing, phenomena of concern.

How did the current North American classification system grow? It was nurtured through the efforts of NANDA Taxonomy Committee chairpersons, Drs. Phyllis Kritek, Joyce Fitzpatrick, and currently Kay Avant. Models and frameworks (Maslow, Abdellah) for organizing nursing diagnoses were suggested by participants at the First National Conference and later (Lunney, 1984; Loomis, 1987) but from 1973 to 1986 diagnoses were arranged in an alphabetical listing. In retrospect this was a wise decision for that time period. NANDA currently classifies nursing diagnoses into Taxonomy I, Revised using the structure of Human Response Patterns, as seen in Table 2. This structure for a classification system was accepted by participants in 1986 at the Seventh Conference.

Between 1977 and 1982 a group of 14 prominent nurse-theorists developed an organizing framework from which the patterns in Table 2 are taken (Roy, 1982a, 1982b). Sister Callista Roy, a member of the National Task Force that preceded NANDA, coordinated the work of this group at national conferences and by mail. It was the first time that these leaders in nursing theory

It is claimed that nursing is invisible in health care delivery because we have not articulated our contribution. Although recognized as incomplete, it is impressive to see a list of nurse-sensitive outcomes and know that this list represents a visible "image" of nursing's contribution to the nation's health.

The architecture of the alpha version is based on classification principles but appears complex (ICN, 1995) in comparison with the alphabetical listing of the first report (ICN, 1993). Key concepts for organizing elements are neutral. The orginal definitions of diagnoses and interventions are concise and are available for all terms at all levels of the classification. The beta version of ICNP is due for publication in the near future. As the ICN has stated the ICNP "provides a vocabulary, a new classification for nursing and a framework into which existing vocabularies and classifications can be cross-mapped to enable comparison of nursing data collected using other recognised nursing vocabularies and classifications. For this reason the ICNP is referred to as A Unifying Framework" (International Council of Nurses, 1996, p.13).

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