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Taxonomy of Nursing Diagnoses
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  1. Taxonomy of Nursing Diagnoses The NANDA International Taxonomy

  2. 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).

  3. 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).

  4. 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

  5. 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

  6. 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)

  7. 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)

  8. History of NANDA-I Taxonomy II

  9. History of NANDA-I Taxonomy II

  10. Structure of Taxonomy II

  11. 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

  12. 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

  13. 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

  14. NANDA-I Axes Required Optional

  15. 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)

  16. 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)

  17. 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)

  18. 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)

  19. 1998 – Gordon’s Functional Health Patterns were adapted to create Taxonomy II NANDA-I Taxonomy II: 2008

  20. Taxonomy: Opportunities • 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

  21. Future Development • 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