The Foundational Role of Nursing Diagnosis
Before diving into what are the 3 types of nursing diagnosis, it is crucial to understand its purpose. A nursing diagnosis is a clinical judgment about an individual, family, or community's responses to actual or potential health problems or life processes. This judgment forms the basis for selecting appropriate nursing interventions to achieve desired patient outcomes. While a medical diagnosis identifies a disease, a nursing diagnosis focuses on the human response to that condition, making it a critical component of the nursing process (Assessment, Diagnosis, Planning, Implementation, Evaluation).
The Three Core Types of Nursing Diagnoses
Under the NANDA-I taxonomy, there are four classifications, but three are foundational to understanding the framework. The problem-focused, risk, and health promotion categories serve distinct purposes in clinical practice.
1. Problem-Focused Nursing Diagnosis
This is a clinical judgment concerning an undesirable human response to a health condition or life process that exists in an individual, family, group, or community. It is based on objective and subjective data collected during the nursing assessment. The problem-focused diagnosis is typically written in a three-part statement, known as the PES format:
- P (Problem): The diagnostic label itself (e.g., Impaired Physical Mobility).
- E (Etiology): The related factor or cause of the problem (e.g., related to decreased muscle control).
- S (Signs and Symptoms): The defining characteristics or evidence observed (e.g., as evidenced by inability to ambulate).
Example: Acute Pain related to surgical incision as evidenced by patient's report of a pain score of 8/10, guarding behavior, and grimacing. Nurses use this to plan interventions that address the pain and its cause, directly impacting the patient's immediate comfort and recovery.
2. Risk Nursing Diagnosis
A risk nursing diagnosis is a clinical judgment concerning the vulnerability of an individual, family, group, or community for developing an undesirable human response to a health condition or life process. This diagnosis is used when a problem does not yet exist, but risk factors are present that could predispose the patient to it. It is written as a two-part statement:
- Risk for (Problem): The diagnostic label (e.g., Risk for Infection).
- Related to (Risk Factors): The factors increasing the patient's vulnerability (e.g., related to surgical incision and suppressed inflammatory response).
Example: Risk for Falls related to altered gait and history of dizziness. In this case, the nurse will implement preventive measures like ensuring the environment is free of hazards and providing mobility assistance to prevent a fall from occurring.
3. Health Promotion Nursing Diagnosis
This type of diagnosis, also known as a wellness diagnosis, is a clinical judgment about a patient's motivation and desire to increase their well-being and actualize their human health potential. These diagnoses are based on a patient's expressed readiness to enhance specific health behaviors. They are typically written as a one-part statement.
- Readiness for Enhanced (Behavior): The diagnostic label (e.g., Readiness for Enhanced Nutrition).
Example: Readiness for Enhanced Immunization Status. This indicates the patient is open and motivated to learn about and receive recommended immunizations. The nursing interventions would focus on providing education and facilitating access to immunization services.
A Comparison of Nursing Diagnosis Types
| Feature | Problem-Focused Diagnosis | Risk Diagnosis | Health Promotion Diagnosis |
|---|---|---|---|
| Status | Exists now (Actual) | Potential | Readiness for improvement |
| Statement | Three-part (PES) | Two-part | One-part |
| Components | Problem, Etiology, S/S | Risk for, Risk Factors | Readiness for Enhanced |
| Patient Data | Observable signs, symptoms | Predisposing factors | Expressed desire |
| Intervention Goal | Resolve or manage the existing problem | Prevent the potential problem | Promote higher level of wellness |
The Fourth Category: Syndrome Diagnosis
In addition to the three core types, NANDA-I recognizes a fourth: the syndrome diagnosis. A syndrome diagnosis is a clinical judgment concerning a cluster of problem-focused and/or risk nursing diagnoses that occur in a pattern or can all be addressed with similar nursing interventions. These are also one-part statements. An example includes Frail Elderly Syndrome, which would involve a collection of diagnoses like risk for falls, risk for injury, and impaired physical mobility.
The Importance of NANDA-I
For nurses, using standardized language from NANDA International is essential for clear communication and effective documentation. NANDA-I provides a comprehensive list of approved diagnostic labels that ensure consistency across different healthcare settings. This standardization supports evidence-based practice and helps nurses accurately communicate patient needs to other healthcare professionals. The taxonomy allows for continuous updating and refinement based on nursing research.
Nursing Diagnosis vs. Medical Diagnosis
It's important to differentiate between a nursing diagnosis and a medical diagnosis. A medical diagnosis, made by a physician, identifies a specific disease or pathology (e.g., pneumonia, diabetes). A nursing diagnosis, however, describes the patient's response to that condition, which may include physical, psychological, social, and spiritual aspects. For example, a medical diagnosis might be heart failure, while the associated nursing diagnoses could be Activity Intolerance, Excess Fluid Volume, and Anxiety. Nurses treat the nursing diagnoses, while physicians treat the medical diagnosis.
For more detailed information on specific nursing diagnosis labels and the taxonomy, a reliable resource is provided by NANDA International, Inc. NANDA International, Inc.
Conclusion
Knowing what are the 3 types of nursing diagnosis is vital for all nursing professionals. The ability to correctly identify and articulate a patient's needs through Problem-Focused, Risk, and Health Promotion diagnoses directly impacts the quality of care provided. By assessing a patient's current condition, potential vulnerabilities, and motivation for wellness, nurses can develop comprehensive and effective care plans that lead to the best possible outcomes. Mastering these diagnostic types is a cornerstone of professional nursing practice.
