Diagnosing

Diagnosing is the second phase of the nursing process. In this phase, nurses use critical-thinking skills to interpret assessment data and identify client strengths and problems. Diagnosing is a pivotal step in the nursing process. Activities preceding this phase are directed towards formulating the nursing diagnoses; the care-planning activities following this phase are based on the nursing diagnoses (see Figure 12.1). The identification and development of nursing diagnoses began formally in 1973, when two faculty members of Saint Louis University, Kristine Gebbie and Mary Ann Lavin, perceived a need to identify nurses' roles in an ambulatory care setting. The First National Conference to identify nursing diagnoses was sponsored by the Saint Louis University School of Nursing and Allied Health Professions in 1973. Subsequent national conferences occurred in 1975, in 1980, and every two years thereafter. International recognition came with the First Canadian Conference in Toronto in 1977 and the International Nursing Conference in May 1987 in Calgary, Alberta, Canada. In 1982, the conference group accepted the name North American Nursing Diagnosis Association (NANDA), recognising the participation and contributions of nurses in the United States and Canada. In 2002, NANDA became NANDA International (NANDA-l) to reflect increasing worldwide interest in the field of nursing diagnosis terminology. NANDA International has approved more than 200 nursing diagnoses for clinical use, testing and refinement.