Nursing diagnosis

The nursing process encompasses patient assessment, nursing diagnosis, planning of patient outcome criteria, implementation of nursing interventions, and evaluation of whether the desired patient outcomes have been achieved. Nursing diagnosis is a critical part of the nursing process wherein a nurse provides a clinical judgment in response to a patient’s actual or possible health issues and communicates it to the patient, family members, and caregivers. Nursing diagnoses can then be used to direct nursing interventions, the actions nurses perform, based on the patient’s specific health condition, to achieve outcomes for which nurses are responsible.

Nursing diagnoses differ from medical diagnoses, which are completed by attending physicians and include notes on a patient’s illness or condition that the doctor can use for research and treatment. Conversely, the nursing diagnosis incorporates the nurse’s clinical judgment regarding the individual’s response to actual or potential health concerns and defines the patient’s physical, sociocultural, psychological, and spiritual response to the health condition. Apart from the pain experienced by the patient, nursing diagnoses also consider other sources of poor health such as anxiety and poor eating habits.

Background

There are several organizations that provide standardized taxonomies for nursing diagnoses, interventions, and outcomes that are recognized by the American Nurses Association (ANA). One of the most well-known is NANDA International (NANDA-I), formerly the North American Nursing Diagnosis Association. NANDA-I is an organization of nurses focused on continuously improving nursing diagnosis to increase the quality of patient care in coordination with the promotion and improvement of patient safety. The group receives and assesses recommendations from nurses outside of the organization. Research is funded by the NANDA International Foundation to create a community-implemented model for executing nursing practices.

NANDA-I has categorized nursing diagnoses into thirteen domains: health promotion, nutrition, elimination and exchange, activity/rest, perception/cognition, self-perception, role relationships, sexuality, coping/stress tolerance, life principles, safety/protection, comfort, and growth/development. These domains encompass 267 NANDA-I nursing diagnoses in the organization’s Nursing Diagnoses: Definitions and Classification 2021–2023, the twelfth edition of its nursing diagnosis guidebook.

NANDA-I also divides the nursing diagnosis into four categories: problem-focused diagnosis, health promotion diagnosis, risk diagnosis, and syndrome diagnosis. Problem-focused diagnosis refers to responses to health conditions or life processes. Health promotion diagnosis has to do with the motivation to improve well-being and health potential. Risk diagnosis is concerned with vulnerabilities for developing adverse responses to health conditions or life processes. Syndrome diagnosis involves a defined grouping of concurrent nursing diagnoses that can be addressed as a group and via similar nursing interventions.

Healthcare facilities that use the NANDA-I classification maintain preprinted forms or electronic access to the standardized NANDA-I nursing diagnosis list in each of their patient care units to allow nursing and clinical staff to have easy access to these forms for implementation and review. Changes in the patient’s health conditions are noted in the diagnosis forms and are added to the patient’s permanent health record or electronic medical record (EMR). Correct collection and completion of the EMR enable clear communication among the clinical staff and permit continuity in patient care.

The Nursing Interventions Classification (NIC) is another empirical, comprehensive classification for the nursing process, similar to that published by NANDA-I. NIC interventions are applicable in all health and wellness settings, although interventions can be approached both directly and indirectly. The 554 interventions listed in the sixth edition of the NIC are categorized into thirty classes and seven domains (basic, complex, behavioral, safety, family, health system, and community). NANDA International Nursing Diagnoses: Definitions and Classification, 2024–2026 (13th edition) taxonomy includes 277 approved nursing diagnoses, with 56 new diagnoses added and 123 diagnoses revised, along with updated defining characteristics, related factors, and risk factors to support evidence-based nursing diagnosis. The NIC is accepted by the ANA and is an addition to the National Library of Medicine’s Unified Medical Language System Metathesaurus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). The NIC has been recognized by the Joint Commission (TJC) as meeting the TJC standard for uniform data, and is also listed in the Health Level Seven International (HL7) and used in the Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT).

The International Council of Nurses is the publisher of the International Classification for Nursing Practice (ICNP), which serves as the standardized global nursing language and is supported by the World Health Organization (WHO). The ICNP was developed in conjunction with ANA-recognized nursing taxonomies, including NANDA-I, NIC, Omaha System, Home Health Care Classification, and the Nursing Outcomes Classification (NOC).

Impact

Healthcare agencies around the world have adopted the NIC, ICNP, and NANDA-I nursing diagnosis methods for standardized and competent nursing evaluation. The NIC and ICNP have been translated into several other languages, such as French, Spanish, Japanese, Korean, and German. Standardized, regulated nursing language allows uniform and comprehensive understanding of the patient’s conditions to efficiently address the patient’s needs, continue the developed course of care, and produce predictable health outcomes. Revisions in NANDA International emphasizes an evidence-based approach to nursing diagnoses, requiring documented research evidence and peer-reviewed proposals for the development and approval of new diagnoses.

Bibliography

Bulechek, G., et al., eds. Nursing Interventions Classification (NIC). 6th ed. Elsevier, 2013.

"Center for Nursing Classification and Clinical Effectiveness." College of Nursing, University of Iowa, nursing.uiowa.edu/center-for-nursing-classification-and-clinical-effectiveness. Accessed 13 Mar. 2026.

Herdman, T. Heater, and Shigemi Kamitsuru, eds.; NANDA International. Nursing Diagnoses: Definitions and Classification: 2015–2017. 10th ed. Wiley, 2014.

Herdman, T. Heater, and Shigemi Kamitsuru, eds. NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023. 12th ed. Thieme Medical Publishers, 2021.

Herdman, T. Heather, and Shigemi Kamitsuru, eds. Nursing Diagnoses: Definitions and Classification 2024–2026. 13th ed., e-book ed., Thieme, 2024.

“NANDA International Nursing Diagnoses: Definitions and Classifications (2024–2026 Edition)” Book Launch. NANDA International, 15 Apr. 2024, https://nanda.org/2024/04/book-launch-nanda-international-nursing-diagnoses-definitions-and-classifications-2024-2026-edition/. Accessed 13 Mar. 2026.

"Nursing Diagnoses: Definitions and Classifications." NANDA International. NANDA-I, 2024. Web. Accessed 13 Mar. 2026.

"The Nursing Process: A Complete Guide to Using This Indispensable Nursing Tool." Nightingale College, 27 Feb. 2022, nightingale.edu/blog/nursing-process.html. Accessed 13 Mar. 2026. 

Warren, Judith J., and Amy Coenen. "International Classification for Nursing Practice (ICNP): Most-Frequently Asked Questions." Journal of American Medical Information Association, vol. 5, no. 4, 1998, pp. 335–36. NCBI. Web. Accessed 13 Mar. 2026.