North American Nursing Diagnosis Association International

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The NANDA International ( NANDA-I , International Classification of nursing diagnoses) is a care scientific organization dedicated to the formulation, development and testing of nursing diagnoses busy. The aim of the organization based in Kaukauna (Wisconsin) is to standardize the terminology of nursing diagnostics , which is accompanied by a simplification of nursing documentation and the recording of the nursing process in practice, as well as better statistical evaluability of nursing-relevant data to support further development in nursing research . NANDA International also publishes the International Journal of Nursing Terminologies and Classifications .

aims

The association aims to develop, improve and promote terminology that accurately reflects clinical decision-making by nurses. The introduction of nursing diagnoses improves all aspects of nursing practice: strengthening professional recognition, ensuring consistent nursing documentation that represents clinical decision-making, and accurate documentation to secure nursing funding. The aim of the association is to establish nursing expertise by further developing the international classification of nursing diagnoses NANDA-I. The focus is not on medical diagnoses, but on a classification of nursing problems and risks as well as the patient's willingness to promote health. The focus is on nursing-relevant, human experiences and reactions of patients to health problems / life processes (NANDA International, 2010). NANDA-I wants to support nurses in the nursing documentation and in the nursing process, professionalize nursing through better knowledge and precise description of the diagnoses, and is developing a computer-friendly language to facilitate nursing research and statistical analyzes.

According to studies, the NANDA-I classification is the most widely used nursing diagnosis classification. The current classification contains 216 nursing diagnoses and has been translated into over 20 languages.

history

NANDA emerged in 1982 from the National Conference Association , a commission of nursing scientists formed in 1973 in St. Louis , Missouri , USA during the First National Conference on the Classification of Nursing Diagnosis . Marjory Gordon was elected as the first president of NANDA , who held the office until 1988. In 1986, the World Health Organization was proposed to adopt the NANDA nursing diagnosis classification as a separate chapter within the International Statistical Classification of Diseases and Related Health Problems (ICD). NANDA was supported by the American Nurses Association .

The first classification, Taxonomy I , also known as the Orange Book , was published in 1987. A year later, the organization stepped up its international efforts to disseminate this taxonomy. However, since it remained relatively incomprehensible for many nurses for a long time, a completely revised version was presented at the 13th NANDA conference in 1998. This new classification was adopted in spring 2000 as so-called Taxonomy II . The interest in nursing diagnoses based on the NANDA model had increased worldwide in the following years, so the organization decided in 2002 to rename it to NANDA International (NANDA-I).

In addition to the further development of the current taxonomy, the association has since been working primarily on the integration of the NANDA nursing diagnoses into an overall system of nursing classifications, which in turn describe various aspects of the nursing process. In particular are the classifications of the Nursing Interventions Classification (NIC, dt. Care measures classification ) and the Nursing Outcomes Classification (NOC, dt. Care result classification ) to name. All three classifications were merged in 2003 to form the NANDA-NIC-NOC taxonomy (NNN taxonomy).

International Journal of Nursing Terminologies and Classifications

The association has been running the International Journal of Nursing Terminologies and Classifications since July 2004 , in which peer-reviewed articles report on the further developments, requirements, studies etc. within nursing diagnostics and international nursing classifications.

NANDA-I nursing diagnoses

According to NANDA International , a nursing diagnosis is defined as follows:

“A nursing diagnosis is the clinical assessment of individual, family or community experiences / reactions to current or potential health problems / life processes. A nursing diagnosis is the basis for the selection of nursing interventions with regard to the achievement of outcomes for which the nurses are responsible (adopted at the ninth NANDA-I conference in 2009) "

- NANDA International, 2013

Structure of the NANDA-I nursing diagnoses

The NANDA-I nursing diagnoses are concepts that are compiled in a precombinatorial manner using a multiaxial system (NANDA 2013: 79ff). This means that a NANDA-I nursing diagnosis from a concept of axis 1 z. B. pain and at least one term of another axis, e.g. B. Axis 2 "acute" are composed. This results in the pre-combined nursing diagnosis title "acute pain" . The following axes are defined in NANDA-I (n = indicates the number of terms available):

  • Axis 1: The diagnostic concept (n = 145)
  • Axis 2: Subject of diagnosis (individual, family, group, community, n = 4)
  • Axis 3: assessment (e.g. impaired, ineffective, n = 27)
  • Axis 4: localization (e.g. bladder, auditory, cerebral, n = 28)
  • Axis 5: Age (e.g. infant, child, adult, n = 9)
  • Axis 6: time (chronic, acute, intermittent, n = 4)
  • Axis 7: Status of the diagnosis (current, risk, health, health promotion, n = 5)

The terms on the first axis are the central diagnostic terms of the nursing diagnosis titles and can be used in combination with elements from other axes to describe nursing diagnoses. The NANDA-I nursing diagnoses, which are already described in precombined form, e.g. B. "Dysfunctional Ventilatory Weaning Response", consist of a term of the first axis (Diagnostic concept) "Ventilatory weaning response" and a term "Dysfunctional" of the sixth axis (Descriptor). This axis structure was first described / developed in 2005. The aim is to conform to the international standard reference model for a nursing diagnosis. 216 NANDA-I nursing diagnoses are defined in the NANDA-I edition 2012-2014. They usually consist of a term from the first axis and one or more terms from axes 2–7. For each pre-combined NANDA-I nursing diagnosis title, a definition of its, as well as determining characteristics, influencing factors or, if it is a risk nursing diagnosis, risk factors were developed. The NANDA-I nursing diagnoses follow the PÄS scheme (the PÄS format or PÄS scheme is recommended to describe a nursing diagnosis, P stands for nursing problem , Ä for etiology / causal relationship , S for symptoms / characteristics), consisting of the diagnostic concept / the nursing problem, the influencing factors (also called etiology) and the determining features (also called clusters of signs and symptoms).

NANDA-I is one of the pre-combinatorial polyhierarchical classification systems . So has z. B. the nursing diagnosis " impaired well-being " is assigned to three classes ( physical well-being; environment-related well-being, social well-being ). The nursing diagnosis titles are classified. Due to the numerous rearrangements of the nursing diagnoses, some polyhierarchical connections in the current version have been broken down. The taxonomy II is hierarchically ordered in domains 13 and 47 classes. The areas are health promotion, nutrition, elimination, activity / rest, perception / cognition, self-perception, role relationships, sexuality, coping behavior and stress tolerance, life principles, security / protection, well-being and growth / development.

The version of the NANDA-I nursing diagnoses 2012–2014 comprises 216 nursing diagnoses. Each nursing diagnosis has a title and a definition. Corresponding indicators and cause formulations have been developed for each nursing diagnosis. These are assigned to the nursing diagnoses.

Example of a NANDA-I nursing diagnosis

Title: Personal Care Self-Sufficiency Deficit

Definition: Impaired ability to independently carry out or complete washing activities

Determining features:
  • Inability to reach the bathroom
  • Inability to dry off the body
  • Inability to get hold of washing utensils
  • Inability to get to the water source
  • Inability to regulate the wash water
  • Inability to wash the body
Influencing factors
  • Cognitive impairment
  • Reduced motivation
  • Obstacles in the area
  • Inability to perceive individual parts of the body
  • Inability to perceive spatial relationships
  • Musculoskeletal Impairments
  • Neuromuscular Impairment
  • Pain
  • Impaired perception
  • Pronounced fear
  • weakness
NANDA 2012–2014, p. 273

Changes in NANDA International 2012–2014

A total of 16 new nursing diagnoses have been added to the NANDA International version 2012–2014, and 11 nursing diagnoses have been revised. A nursing diagnosis was shut down. This is:

"Perception disorder (to be defined in more detail: visual, auditory, kinesthetic, gustatory, tactile, olfactory)"

- NANDA-I 2012-2014, 24

In 2012, NANDA called for a revision of this nursing diagnosis. At the moment there is no way to map the various perceptual disorders in patients, so the appeal is very meaningful.

Validity of the NANDA-I nursing diagnoses

NANDA nursing diagnoses have been examined in large numbers in studies. In 2005, Müller Staub cites a total of 1965 studies. Berger, Simon (nursing scientist) carried out a literature analysis on the NANDA-I validation work in 2005. The aim of the validation study was to obtain and describe an overview of the various methods and the status of the validation work. The results of the literature analysis showed that about 45% (n = 70, of then 154 NANDA-I diagnoses) of the NANDA-I nursing diagnoses had a validation work published. Jankin Janice came to similar results in 1994. She found that in a list published by the NANDA Research Committee, when asked about the period 1950 to 1993 of the research work carried out to date (n = 242), out of the 109 research work carried out by the NANDA for clinical and scientific research Testing approved diagnoses only 55 appear in the bibliography mentioned. Most frequently, content validity studies were carried out, criterion and construct validity studies were rarely found. This result is also confirmed by other authors.In a publication the authors state that in relation to the number of all NANDA-I nursing diagnoses there were few clinical validity studies and also few studies on criterion and construct validity compared to the number of content validation studies . The demand for clinical studies has been increasingly followed up in recent years, as Berger Simon noted in his research work. NANDA-I has a significant number of studies. Numerous applications are also documented through publications. Unfortunately, it remains open in numerous descriptions how NANDA-I is used in practice. There are also some studies examining NANDA-I, NIC and NOC in conjunction. In Park's study, for example, B. the frequency of use of NANDA-I, NIC and NOC in the acute inpatient setting was examined. A total of 272 patient records were analyzed. In the study it was possible to identify the top 10 nursing diagnoses, measures, outcomes and NNN linking. For some care measures, no statements could be made regarding effectiveness. NANDA-I has been translated into numerous languages ​​and there is increasing research activity. On the part of NANDA-I as the organization responsible for the further development of the taxonomy, no information could be found on which studies have been carried out with which methods for the individual nursing diagnoses. It is incomprehensible how the study results influence the further development of the NANDA-I nursing diagnoses, according to a result of Berger Simon's research. To map the nursing process, it is necessary to combine NANDA with other nursing classifications and to establish a nursing diagnostic path.

NANDA and the German translation

In 2008 NANDA-I was translated again. This has resulted in numerous changes to the previous version. To increase the acceptance of the translation and to ensure a 1 to 1 translation, a working group was set up in the following years. This group consists of experts in nursing diagnostics. In this working group, the translation is evaluated and agreed. NANDA is available as a book and as a database for integration into software products.

literature

  • Sabine Bartholomeyczik , Marjory Gordon : Nursing diagnoses. Theoretical foundations. , Urban & Fischer, 2001, ISBN 3-437-26380-3
  • KC Freund: Nursing quality development and performance presentation through the nursing classifications NANDA - NOC - NIC. In: Nursing Science 2008 hpsmedia GmbH, 9 (11), ISSN  1422 to 8629 , pp 601-613.
  • Marjory Gordon: Handbook of Nursing Diagnoses. The book for practice. Urban & Fischer, 4th edition, 2003, ISBN 3-437-26442-7
  • Simon Berger, Holger Mosebach, Pia Wieteck (Eds.): NANDA-I Pflegediagnosen: Definitions & Classification 2007-2008. Recom Verlag, 2008, ISBN 3897521113
  • T. Heather Herdman (Ed.): NANDA international nursing diagnoses: definitions & classification, 2009-2011. John Wiley and Sons, 2009, ISBN 1405187182
  • Margaret Lunney: Nursing Diagnostics Workbook: Nursing Decision Making, Critical Thinking, and Diagnostic Process - Case Studies and Analysis. Hans Huber Verlag, 2007, ISBN 3-456-83840-9 .
  • Maria Müller-Staub, Ian Needham, Matthias Odenbreit, Mary Ann Lavin, Theo van Achterberg: Improved quality of nursing documentation: Results of a nursing diagnoses, interventions and outcomes implementation study. In: International Journal of Nursing Terminologies and Classifications, 2007, 18 (1), ISSN  1541-5147 pp. 5-17.

Individual evidence

  1. ↑ Gail Keenan, Dana Tschannen, Mary Lou Wesley: Standardized nursing terminologies can transform practice. In: Journal of Nursing Administration, 2008, 38 (3), pp. 103-106
  2. ↑ Christine Anderson, Gail Keenan, Josette Jones: Using bibliometrics to support your selection of a nursing terminology set. In: CIN: Computers, Informatics, Nursing, 2009 27 (2), pp. 82-90
  3. Jump up ↑ Maria Müller-Staub, Ian Needham, Matthias Odenbreit, Mary Ann Lavin, Theo van Achterberg: Nursing diagnoses, interventions and outcomes - Application and impact on nursing practice: A systematic literature review. In: Journal of Advanced Nursing, 2006, 56 (5), pp. 514-531.
  4. ↑ NANDA-I: History ( Memento of the original from May 25, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (engl.) @1@ 2Template: Webachiv / IABot / www.nanda.org
  5. ↑ T. Heather Herdman (Ed.): NANDA international nursing diagnoses: definitions & classification, 2009-2011. John Wiley and Sons, 2009, 1405187182, p. 389
  6. ^ NANDA-I: International Journal of Nursing Terminologies and Classifications , Wiley-Blackwell, ISSN  1541-5147
  7. ↑ NANDA-International, ed. (2013: 505). Nursing diagnoses definitions and classification 2012-2014, German edition translated by Holger Mosebach. Kassel, RECOM publishing house
  8. ↑ Georg, J., Ed. (2005: 215). NANDA Nursing Diagnoses Definition and Classification 2005–2006. Bern, Hans Huber Verlag
  9. ↑ Georg, J., Ed. (2005: 236 ff). NANDA Nursing Diagnoses Definition and Classification 2005–2006. Bern, Hans Huber Verlag
  10. ↑ NANDA-International, Ed. (2013: 79). Nursing Diagnoses Definitions and Classification 2012–2014, German edition translated by Holger Mosebach. Kassel, RECOM publishing house
  11. ↑ Gordon, M. and S. Bartholomeyczik (2001). Nursing diagnoses. Theoretical foundations. Munich, Jena, Urban & Fischer
  12. ↑ Brobst, RA, AMC Coughlin, et al. (1997) The nursing process in practice. Bern, Hans Huber publishing house
  13. ↑ Gordon, M. (2001). Manual nursing diagnoses. The book for practice. Munich; Jena, Urban & Fischer Verlag
  14. ↑ NANDA-International, ed. (2013: 470). Nursing Diagnoses Definitions and Classification 2012–2014, German edition translated by Holger Mosebach. Kassel, RECOM publishing house
  15. ↑ NANDA-International, ed. (2013: 51 ff). Nursing Diagnoses Definitions and Classification 2012–2014, German edition translated by Holger Mosebach. Kassel, RECOM publishing house
  16. ^ Herdman, HT, Ed. (2012). NANDA-International Nursing Diagnoses Definitions and Classification 2012–2014. Oxford, Wiley-Blackwell
  17. ↑ Müller Staub, M. (2005). "Choosing a nursing diagnosis classification for an introduction to electronic nursing documentation: ICNP, ICF, NANDA and ZEFP in comparison." PrInterNet 7 (2): 115-122
  18. ↑ Jankin, J. (1994). "Research Validation of Nursing Diagnoses: How Much Progress?" Nursing Diagnosis 5 (1): 4
  19. ↑ Parker, L. and M. Lunney (1999: 523). Moving Beyond Content Validation of Nursing Diagnoses. Classification of Nursing Diagnoses: Proceedings of the Thirteenth Conference. MJ Rantz and P. LeMone. Glendale, Cinahl Information Systems: 522-532
  20. ^ Kautz, DD and ER Van Horn (2008). "An exemplar of the use of NNN language in developing evidence-based practice guidelines." Int J Nurs Terminol Classif 19 (1): 14-19
  21. ^ Park, HJ (2010). NANDA-I, NOC, and NIC linkages in nursing care plans for hospitalized patients with congestive heart failure. A thesis submitted in partial fulfillment of the requirements for the Doctor of Philosophy degree in Nursing in the Granduate College of the University of Iowa. United States, College of the University of Iowa
  22. ^ NANDA International, Ed. (2013). Nursing diagnoses definitions and classification 2012–2014, German edition, translated by Holger Mosebach Kassel, RECOM-Verlag

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