News and Updates T. Heather Herdman, PhD; RN Executive Director NANDA International

New Management Structure No longer associated with a management company to be responsible for the work of NANDA-I Executive Director position oversees all contracted work (marketing, book and journal publication and editing, finance, legal) More responsive More knowledgeable More cost effective for NANDA-I

NANDA-I Organization NANDA-I Members NANDA-I Networks NANDA-I Board of Directors Executive Director Journal EditorMarketing/PRBookkeeper

NANDA-I Networks Brasil Columbia Ecuador German-speaking countries Honduras Nigeria Peru Venezuela

NANDA-I Networks NANDA-I Membership Network Groups foster collaboration among NANDA-I members in many ways: Development and revision of nursing diagnoses Regional conferences hosted by the Network Group Support from experienced colleagues with questions about nursing diagnosis use, teaching methods, translation issues, etc. Connection with the resources and global reach of NANDA International, including assistance with the study and application of nursing diagnosis in your region.

NANDA-I Network Group Structure NANDA-I Membership Network Groups provide a framework for NANDA-I members to foster the work of NANDA–I and promote membership within a country, region, language or specialty Each Network Group designates a Coordinator who is a Regular Member of NANDA – I, & serves as a member of the NANDA-I Membership and External Relations Committee NANDA-I Membership Network Groups are recognized as part of the greater organization. As such, Network Groups operate according to NANDA-I Bylaws and Membership Network Group policies. All members of NANDA-I Membership Network Groups must become active members of NANDA International within 3 months of the group receiving Board approval. The Board reserves the right to dissolve a NANDA-I Membership Network Group that does not function in accordance with the aims and objectives of the organization and its bylaws.

Increasing our International Base: NANDA-I Networks Provide a voice within a major NANDA-I Committee for network coordinators Provide ease of communication for a group of nurses sharing the same language, same specialty or same country – within themselves and between these groups and NANDA-I Board of Directors Improves our ability to ensure the diagnoses under review are culturally and geographically sensitive, and that translation issues can be dealt with prior to publication

Pricing Structure for Memberships Members are charged lower fees for membership, based on the WHO Classification of Countries $105 USD Per Year: Class I Country (Argentina, USA) $ 55 USD Per Year: Class II Country (Brasil, Columbia, Ecuador, Honduras, Peru, Venezuela) $ 40 USD Per Year: Class III Country (Afghanistan) Enables more members from all over the world Provides all benefits of membership, including discounted purchases and conference registration

2009 Initiatives New NANDA-I Website Goals 1. Increase NANDA ‐ I membership 2. Generate non ‐ dues revenue 3. Create greater organizational efficiency 4. Distribute information about / provide expert assistance on nursing diagnoses 5. Promote the NANDA ‐ I book 6. Promote the NANDA ‐ I conference 7. Provide opportunity for international inclusiveness 8. Build online community among members

Members Only Area Membership discounts on affiliate programs NANDA-I Publications Lexicomp Career center NANDA-I General store purchases Amazon.com

Increased Communication Quarterly newsletters via (sign-up on the NANDA-I website) E-blasts to members with information of interest Updated website content Direct communication to President, Executive Director and Chairs of Informatics, Education & Research, and Diagnosis Development Committees

Increased Transparency Board meeting minutes are posted immediately after the meeting concludes – no waiting! President’s Priorities are posted at website NANDA-I Position Statements are available for downloading

The Definition of Nursing Diagnosis Is the current definition of nursing diagnosis relevant today for : All practice settings? All professional nursing roles? All countries?

A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable. NANDA, 1990 The Definition of Nursing Diagnosis

Accountability Is the nurse truly accountable for outcomes? Is this really interdisciplinary accountability? Where is the patient’s / family’s accountability? Scope Is the scope of this definition too broad or too narrow? The Definition of Nursing Diagnosis

Proposed Change to the Definition A nursing diagnosis is a clinical judgment that nurses make about individual, family, and community responses to conditions/life processes. Based on that judgment, the nurse is responsible for monitoring of client responses, decision-making culminating in a plan of care, and implementing interventions, including interdisciplinary collaboration and referral as needed. The nurse is wholly or partially accountable for the achievement of the desired outcomes. Proposal to NANDA International, 2008

Potential Implications Does changing from “… for which the nurse is accountable” TO “The nurse is wholly or partially accountable…” weaken nursing practice? Is accountability a benchmark of autonomous, professional practice? Is international nursing practice consistent enough to enable a definition that meets all of our needs?

A call for simplicity Questions we should ask regarding nursing diagnosis definition Does the current definition exclude: Any practice setting Any professional nursing role Any country’s nurse practice act/regulation? Can we simplify the definition without impacting any of the above? What does changing the definition give us?

A call to refocus Primary importance is to identify, define and conceptualize the domain of nursing science and nursing practice Gaps exist in our taxonomy that require development and refinement of nursing diagnoses Incomplete taxonomy threatens applicability of nursing diagnoses to international nursing practice

A call to refocus Nurses internationally need to claim their scope of practice by identifying and developing nursing diagnoses Acceptance into the NANDA-I taxonomy enables validation and refinement of diagnoses across practice setting and country Enables standardized terminology for use in electronic health records – ensuring the visibility of nursing for today and into the future

Inclusiveness of Taxonomy How do we ensure that the taxonomy represents: All languages (translation concerns) All cultures All practice settings

Evidence-Base of the Taxonomy NANDA-I is the only nursing diagnostic taxonomy that: Requires an evidence / research base to justify term, definition, defining characteristics, related and/or risk factors Has a peer review process requiring review of relevant literature Is updated annually and permits feedback based on published literature from nurses across the world

Evidence-Base of the Taxonomy Our processes – although important – can slow down inclusion of new and/or revised diagnoses Difficulty with non-English based literature (requires additional time and support from non-English speaking NANDA-I members) Submission process can be intimidating – resources available now, but only in English – require translation into all major languages

New NANDA-I Website Expertise / Assistance in Nursing Diagnosis Development Diagnosis Submission Handbook Free PDF Download New Online Diagnosis Submission Form

Nursing Diagnosis Member Discussion Forum Discuss Nursing Diagnosis Resources, New & revised diagnoses being reviewed by DDC, education issues, Electronic Medical Record issues, Translation concerns, OR set up your own work group to develop or revise nursing diagnoses!

New Publications Nursing Diagnoses: Definitions and classification Critical thinking to achieve positive health outcomes

2010 NANDA-I / AENTDE Conference First conference for NANDA-I held outside of the United States