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Taxonomy of Nursing Diagnoses. The NANDA International Taxonomy. Focus of Nursing. “Health” of “human beings” Health-related phenomena are complex because they involve human experiences Nursing’s goal is to identify people’s experiences or responses in order to support them.

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Taxonomy of nursing diagnoses l.jpg

Taxonomy of Nursing Diagnoses

The NANDA International

Taxonomy


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Focus of Nursing

  • “Health” of “human beings”

    • Health-related phenomena are complex because they involve human experiences

    • Nursing’s goal is to identify people’s experiences or responses in order to support them.

  • Significant overlap of cues to diagnoses

  • Contextual factors such as culture can change the perspective of “what is the diagnosis?”

  • Many studies have verified that interpretations of clinical cases have the potential to be less accurate than indicated by the data

    (Lunney, 2007).


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Nursing Diagnosis: NANDA-I Definition

  • Adapted from a national, Delphi study by Dr. Joyce Shoemaker (1984)

    • 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).


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The Diagnoses

  • 206 NANDA-approved nursing diagnoses as of 2008

  • Level of Evidence (LOE) Criteria Established for All New and Revised Diagnoses

    • Entry into the Taxonomy requires various levels of clinical evidence


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Taxonomy

Oxford English Dictionary

American Nurses Association

/taksonnmi/

  • noun chiefly Biology

1 the branch of science concerned with classification.

2 a scheme of classification.

ORIGIN from Greek taxis ‘arrangement’ + -nomia ‘distribution’

Classification according to presumed natural relationships among types and their subtypes

ANA, 1999


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Definitions for Classification of Nursing Diagnoses

  • Classification

    • Systematic arrangement of related phenomena in groups or classes based on characteristics that objects have in common

  • Nomenclature

    • A system of designations (terms) elaborated according to pre-established rules

      (ANA, 1999)


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Definitions for Classification of Nursing Diagnoses

  • Domain

    • A sphere of activity, concern, or function; a field: the domain of history

  • Class

    • A set, collection, group, or configuration containing members regarded as having certain attributes or traits in common; a kind or category.

      • (http://www.thefreedictionary.com/domain)





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Code Structure

  • 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

  • Code structure is compliant with the National Library of Medicine’s (USA) Unified Medical Language System (UMLS) concerning healthcare terminology codes


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Structure of Taxonomy II

  • Registered with Health Level 7 (HL7)

  • Modeled into SNOMED-CT

  • Compliant with ISO terminology model for a nursing diagnosis

  • Working collaboratively with ICNP


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Multiaxial System

  • 7 axes within NANDA-I Taxonomy

  • Axis

    • A dimension of the human response that is considered in the diagnostic process

  • Allows for flexibility of the nomenclature

  • Allows for easy additions and modifications


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NANDA-I Axes

Required

Optional


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Diagnostic concept

(Axis 1)

Judgment

(Axis 3)

The NANDA-I Model of a Nursing Diagnosis

Status of

Diagnosis

(Axis 7)

Time

(Axis 6)

Location

(Axis 4)

Subject of Diagnosis

(Axis 2)

Age

(Axis 5)


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Ineffective

(Axis 3)

Coping

(Axis 1)

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

N/A

(Axis 6)

[Actual]

(Axis 7)

N/A

(Axis 4)

[Individual]

(Axis 2)

N/A

(Axis 5)


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A NANDA-I Nursing Diagnosis Model:Compromised Family Coping

Coping

(Axis I)

Compromised

(Axis 3)

Risk for

(Axis 7)

N/A

(Axis 6)

N/A

(Axis 4)

Family

(Axis 2)


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Enhanced

(Axis 3)

Coping

(Axis 1)

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

Readiness for

(Axis 7)

N/A

(Axis 6)

N/A

(Axis 4)

Family

(Axis 2)

N/A

(Axis 5)


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1998 – Gordon’s Functional Health Patterns were adapted to create Taxonomy II

NANDA-I Taxonomy II: 2008


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Taxonomy: Opportunities to create Taxonomy II

  • The Diagnosis Development, Taxonomy, and Informatics Committees have identified the following priorities for diagnosis development

    • Domain 2:  Nutrition

      • Class 2:  Digestion

    • Domain 1:  Health Promotion

      • Class 1:  Health Awareness

    • Domain 2:  Nutrition

      • Class 3:  Absorption


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Future Development to create Taxonomy II

  • Clinicians can easily identify opportunities for new diagnoses by reviewing the domains/classes with few – or no – diagnoses present

  • Construction of new diagnoses, along with submission to NANDA-I, enables the taxonomy to continue to be strengthened

  • NANDA-I’s Diagnosis Development Committee is eager to partner with you to develop new diagnoses, and revise current diagnoses


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