NANDA International (NANDA-I) NANDA-I
Latest version of terminology standard available through UMLS 2002 Original Publication 1973
Collaboration at the 1973 National Conference Group task force resulted in the creation of NANDA (North American Nursing Diagnosis Association) in 1982. In 2002, NANDA became NANDA International (NANDA-I) to reflect the worldwide use of the terminology. The initial NANDA terminology was developed to allow nursing to identify and classify health problems within the domain of nursing (Jones, Lunney, Keenan, & Moorhead, 2010). Today, NANDA includes more than 216 nursing diagnoses, published by NANDA-I. NANDA-I’s mission is to:
Facilitate the development, refinement, dissemination and use of standardized nursing diagnostic terminology by providing the world’s leading evidence-based nursing diagnoses for use in practice and to determine interventions and outcomes.
Contribute to patient safety through the integration of evidence-based terminology into clinical practice.
Fund research through the NANDA foundation. Support a global network of nurses who are committed to the good quality of nursing care and
improvement of patient safety through evidence-based practice.
NANDA–I maintains that a standardized language representing any profession should provide, at a minimum an evidence-based definition; a list of defining characteristics (signs/symptoms) and related factors (etiologic factors); risk diagnoses that should include an evidence-based definition; and a list of risk factors (International, n.d.).
NANDA-I is commonly used with Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC), referred to as NANDA/NIC/NOC (NNN), as a means of providing comprehensive, research-based, standardized classifications of nursing diagnoses, nursing interventions and nursing- sensitive patient outcomes. These classifications provide a set of terms to describe nursing judgments, treatments and nursing-sensitive patient outcomes (NANDA-I NIC NOC for Safe Patient Care, n.d.). NANDA-I was previously mapped to SNOMED CT, but the mapping is now outdated.
Process for Updating/Publishing Standard The Diagnosis Development Committee (DDC) formulates and conducts review processes of proposed diagnoses and revisions of diagnoses. DDC reviews the literature/submission and has a stringent process to ensure that new terminology is reflective of correct standards of care. The standard is revised every three years.
Usage/Activity Interviewees noted that NANDA-I is widely used across all care settings, published in multiple countries and has been translated into 18 languages; it is in use worldwide. The electronic version of NANDA-I is available through licensure. An exact number regarding usage is difficult to obtain because license information does not accurately reflect the number of sites using NANDA-I. In addition, because
Identifying Challenges and Opportunities within Standard Nursing Terminologies 15
NANDA-I is also published in a text format, it is estimated that more than 40percent of all NANDA-I use is done without a license to use the electronic version (Interview, 2016). Even though NANDA-I reports a high percentage of illegal use, it also claim that it attempts to enforce its licensor agreement vigorously. A licensor agreement is meant to ensure consistent use of the terminology.
Challenges NIC and NOC have a separate licensure from NANDA-I, though NNN is frequently proposed to be used together in a terminology framework for use in EHRs. NANDA-I is less expensive for a licensee, which sometimes leads to smaller health care organizations implementing NANDA-I without NIC or NOC. Software developers, in turn, package their products to allow customization resulting in a partial use of a terminology, deteriorating the quality of the standard. Such a practice directly leads to a lack of consistent use of NANDA-I since each user might not be getting the same content.
Opportunities Many nurses are familiar with NANDA–I due to the widespread use of NANDA-I in nursing education programs.