NANDA, NIC, and NOC-An International Review

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May 24th, 2012

By , BSN, RN

NANDA-I is underway here in Houston. In case you have missed it somewhere, NANDA-I stands for North American Nursing Diagnosis Association-International. I know it sounds a little funny but NANDA started here in the U.S. and, as other countries embraced the nursing language that NANDA developed (and no one ever really said that name all the way out), the organization added the “I” to recognize the worldwide scope of nursing language.

This is the 40th Anniversary of NANDA-I and it really is an international event. In fact, the folks manning the registration desk tell me there are more non-U.S. attendees than U.S. citizens (as many as 75 percent foreign, in fact).

In the hours I spent in pre-conference lectures today I met nursing academics and instructors from (in no particular order) Mexico, Canada, Peru, Brazil, Japan, Indonesia, England and Australia. I am told there are attendees from Ecuador and Estonia too. The U.S. is well represented however by some of the finest nursing language and research minds in the country.

Now, I don’t have the audacity to list myself amongst that company. To tell the truth I had to come home after taking in a day's worth of information and really look up some of the topics under discussion. I think, after this review, I will be better set to understand the conversations of the next couple of days. And these are important discussions. The people attending NANDA-I are helping to set the language we use every day in caring for our patients. Having a common language means safer care and better outcomes.

Here are a few of those terms:

  • NANDA-I – The organization is responsible for nursing diagnoses; definitions and classifications. They were established to develop, refine, and promote taxonomy (the process of identifying, arranging and classifying) of nursing diagnostic terminology.
  • NIC – Nursing Intervention Classification as developed by the Iowa Intervention Project. This is taxonomy of nursing interventions that provide a level of standardization to enhance communication across care settings. Extensive nursing research, expert review, and clinical judgment merged to form 486 interventions grouped in 30 classes and seven domains.
  • NOC – Nursing Outcomes Classifications are designed to provide the language for the evaluation step of the nursing process. The NOC project complements the work of NANDA-I and the NIC.

All together they are simply knows as “NNN.” According to NANDA-I, "these classifications provide a set of terms to describe nursing judgments, treatments and nursing-sensitive patient outcomes. Together, NANDA-I, NIC, and NOC (NNN) promote communication about nursing care across settings, sharing data across systems, identifying core nursing concepts that cross setting and clinical specialty, identifying specialty nursing concepts, evaluating outcomes, conducting effectiveness research, measuring nursing productivity, evaluating nursing competencies, facilitating reimbursement, and designing curricula."

Best Practices

As the pre-conference day continued those in attendance took a look at different methods for teaching Nursing Diagnosis. Everyone seems to agree it is a complicated subject that can probably be done better. Improvements or modernization is needed for some of the diagnoses and language, how to use the taxonomy seems to need refining.

The focus of the afternoon was finding new ways to educate nursing faculty in the reasoning behind nursing diagnoses. Experts from Great Britain, Japan, and the US offered information and suggestions for making sense and making strides in the teaching and the understanding of nursing diagnoses.

”We have to help students look at those clues so they can treat the causes, not the symptoms,” said T. Heather Herdman, PhD, RN. “We have to teach our students about nursing concepts and the underlying diagnoses. Symptom management is important but it should not be the primary focus of our care.”

So with a review of terminology under my belt and a better understanding of where nursing should be headed in terms of nursing diagnoses, interventions and outcomes I am ready to get back to the conference. More tomorrow.

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