Meeting the criteria of a nursing diagnosis classification: Evaluation of ICNP®, ICF, NANDA and ZEFP

Background Few studies described nursing diagnosis classification criteria and how classifications meet these criteria. Objectives The purpose was to identify criteria for nursing diagnosis classifications and to assess how these criteria are met by different classifications. Design/methods First, a literature review was conducted (N=50) to identify criteria for nursing diagnoses classifications and to evaluate how these criteria are met by the International Classification of Nursing Practice (ICNP®), the International Classification of Functioning, Disability and Health (ICF), the International Nursing Diagnoses Classification (NANDA), and the Nursing Diagnostic System of the Centre for Nursing Development and Research (ZEFP). Using literature review based general and specific criteria, the principal investigator evaluated each classification, applying a matrix. Second, a convenience sample of 20 nursing experts from different Swiss care institutions answered standardized interview forms, querying current national and international classification state and use. Results The first general criterion is that a diagnosis classification should describe the knowledge base and subject matter for which the nursing profession is responsible. ICNP® and NANDA meet this goal. The second general criterion is that each class fits within a central concept. The ICF and NANDA are the only two classifications built on conceptually driven classes. The third general classification criterion is that each diagnosis possesses a description, diagnostic criteria, and related etiologies. Although ICF and ICNP® describe diagnostic terms, only NANDA fulfils this criterion. The analysis indicated that NANDA fulfilled most of the specific classification criteria in the matrix. The nursing experts considered NANDA to be the best-researched and most widely implemented classification in Switzerland and internationally. Conclusions The international literature and the opinion of Swiss expert nurses indicate that—from the perspective of classifying comprehensive nursing diagnoses—NANDA should be recommended for nursing practice and electronic nursing documentation. Study limitations and future research needs are discussed.