NANDA-I Diagnosis Submission
DDC Preliminary Steps

Proposed diagnoses and revisions of diagnoses undergo systematic review to determine consistency with the established criteria for a nursing diagnosis. All submissions are subsequently staged according to evidence supporting either the level of development or validation.

Diagnoses may be submitted at various levels of development (e.g., label and definition; label, definition, defining characteristics or risk factors, and related factors). All submissions must include supporting references. Indicate if no nursing literature is available. Related research from other disciplines is also appropriate to include.

Articles used for the submssion are to be catalogued in the reference section of the submission form.

NANDA-l Guidelines for Nursing Diagnosis Submission are available on the NANDA-I Web site (www.nanda.org) and the NLINKS Web site (www.nlinks.org; click on "diagnostic review"). Diagnoses may be submitted electronically using the form available on the NANDA-I Web site. Submissions not submitted electronically should be sent as an e-mail attachment to info@nanda.org, using the format provided on the NANDA-I Web site.

On receipt, the diagnosis will be assigned to a primary reviewer from the Diagnosis Development Committee (DDC). This person will work with the submitter as the DDC reviews the submission. At this point, the submission will also be identified on the NANDA-I Web site as a submission in review.

Full Review Process
New diagnoses go through a full review process, which includes the following steps:

1. Posting on the NANDA-I Web site

2. Review of submission by the primary reviewer

3. Primary reviewer works with submitter to address changes that need to be made

4. Submission is forwarded to full DDC for review.

5. DDC recommends one of the following:
  a. Approve with no recommendations
  b. Approve pending follow-through with recommendations (most frequent
   DDC decision)
  c. Disapprove

6. The primary reviewer forwards the DDC recommendations to the submitter and works with the submitter to make the recommended changes.

7. Submissions approved by the DDC are presented and discussed at the biennial conference in order to invite extended member input. Recommendations from the forums are reviewed with the submitter and by the DDC.

8. The submission is then forwarded to the NANDA International Board of Directors for final approval. Diagnoses accepted at the 2.1 level of development will be incorporated into both the NANDA-I Taxonomy II and the NNN Taxonomy of Nursing Practice, and published in the next edition of NANDA-I Nursing Diagnoses: Definitions & Classification.

New Diagnosis Submission Process
To submit a new diagnosis for consideration by the DDC, follow these steps:

1. Obtain the most recent edition of NANDA-I Nursing Diagnoses: Definitions and Classification and review related diagnoses in the book. Refer to the NANDA-I Diagnosis Submission Guidelines on the NANDA-I Web site (www.nanda.org) and the NLINKS Web site (www.nlinks.org; click on "diagnostic review"). Follow the guidelines on the Web in case they have been updated since publication of the most recent edition of the NANDA-I book.

2. Contact Leann Scroggins (scroggins.leann@mayo.edu), Chair of the DDC, for more specific instructions, guidelines regarding format, criteria for assigning level of evidence, and protocol for submission.

3. Review "Glossary of Terms" in the most recent edition of NANDA-I Nursing Diagnoses: Definitions and Classification.

4. Decide whether your diagnosis is an actual diagnosis, risk diagnosis, wellness diagnosis or health-promotion diagnosis.

5. Provide a label for the diagnosis.

6. Provide a definition for the diagnosis that is supported by references. Identify the references.

7. Identify the defining characteristics or risk factors for the diagnosis. Actual diagnoses and wellness diagnoses have defining characteristics; risk diagnoses have risk factors. To facilitate coding, each defining characteristic and risk factor must contain a single concept rather than multiple concepts. For example, rather than listing "nausea & vomiting" as a single defining characteristic or risk factor, each one needs to be listed separately. References (articles, not books) to back up each defining characteristic or risk factor are required and must be identified. The references should be research-based, if possible. If no research-based references or nursing references are available, indicate this in your submission.

8. Identify related factors for actual diagnoses. To facilitate coding, related factors must be single concepts, not multiple concepts. Risk diagnoses and wellness diagnoses do not have related factors. References are required for each related factor and must be identified.

9. Develop a bibliography, including all the articles referenced. Number the references and link the reference to the component(s) of your submission the reference supports. In addition, boldface or place an asterisk by the three key references you want to be included in the next edition of NANDA-I Nursing Diagnoses: Definitions and Classification when your submission is accepted.

10. Provide examples of appropriate nursing interventions (may be NIC or other nursing interventions) and nursing outcomes (may be NOC or other nursing outcomes) for the diagnosis.

11. Use the electronic submission process available on the NANDA-I Web site or e-mail your submission to info@nanda.org.

12. You will be notified when your work has been received and will be given an estimate of the time it will take before you can expect to receive a response from the DDC. Most submissions need some additional work for refinement. You will be assigned a mentor from the DDC to assist you through the process.

Diagnosis Revision Process
To submit a revision of a current diagnosis for consideration by the DDC, the following steps are recommended:

1. Obtain the most recent edition of NANDA-I Nursing Diagnoses: Definitions and Classification and review related diagnoses in the book. Refer to the NANDA-I Diagnosis Submission Guidelines on the NANDA-I Web site (www.nanda.org) and the NLINKS Web site (www.nlinks.org; click on "diagnostic review"). Follow the guidelines on the Web in case they have been updated since publication of the most recent edition of the NANDA-I book.

2. Contact Leann Scroggins (scroggins.leann@mayo.edu), Chair DDC, for more specific instructions, guidelines regarding format, criteria for assigning level of evidence, and protocol for submission.

3. Review "Glossary of Terms" in the most recent edition of NANDA-I Nursing Diagnoses: Definitions and Classification.

4. Identify if the label of the diagnosis needs revision.

5. Review the definition of the diagnosis to determine if revision is necessary; revise if appropriate. The revision must be supported by references and the references must be identified.

6. Review the defining characteristics or risk factors for the diagnosis. Actual diagnoses, wellness diagnoses and health promotion diagnoses have defining characteristics; risk diagnoses have risk factors. To facilitate coding, each defining characteristic and risk factor must contain a single concept rather than multiple concepts. For example, rather than listing "nausea & vomiting" as a single defining characteristic or risk factor, each one should be listed separately. Identify the appropriate changes in the defining characteristics or risk factors and support each change with references. References (articles, not books) to back up each defining characteristic or risk factor are required and must be identified. The references should be research-based, if possible. If no research-based references or nursing references are available, indicate this in your submission.

7. Review the related factors for the actual diagnosis. To facilitate coding, related factors must be single concepts, not multiple concepts. Risk diagnoses, wellness diagnoses and health promotion diagnoses do not have related factors. References are required for each related factor and must be identified.

8. Develop a bibliography, including all articles referenced. Number the references and link the reference to the component(s) of your submission the reference supports. In addition, boldface or place an asterisk by the three key references you want to be included in NANDA-I Nursing Diagnoses: Definitions and Classification when your submission is accepted.

9. If the revision is changing the original intent of the diagnosis, provide examples of appropriate nursing interventions (may be NIC or other nursing interventions) and nursing outcomes (may be NOC or other nursing outcomes) for the diagnosis.

10. Use the electronic submission process available on the NANDA International Web or e-mail your submission to info@nanda.org.

11. You will be notified when your work has been received and given an estimate of the time it will take before you can expect to receive a response from the DDC. Revised diagnoses may undergo a full review process or an expedited review process, depending on the extent of revisions being proposed. The DDC will make this decision and tell you which process is needed. Most submissions need some additional work for refinement. You will be assigned a mentor from the DDC to assist you through the process.

Expedited Review Process
An expedited review process (ERP) is appropriate only for proposed revisions of current diagnoses. The ERP is a streamlined process intended to facilitate rapid review of proposed revisions of diagnoses when the proposed revisions are considered by the DDC to be minor in nature and do not alter the original intent of the diagnoses. Examples of such revisions may include:

• Editing and clarification of definition

• Limited addition of defining characteristics or related factors

An ERP includes the following steps:

1. Posting on the NANDA-I Web site

2. Review of submission by the primary reviewer

3. Primary reviewer works with submitter to address needed changes that need to be made

4. Submission is forwarded to the DDC for review.

5. DDC recommends one of the following:
  a. Approve with no recommendations
  b. Approve pending follow-through with recommendations (most frequent
    DDC decision)
  c. Disapprove

6. The primary reviewer forwards the DDC recommendations to the submitter and works with the submitter to make the recommended changes.

7. Submissions approved by the DDC are forwarded to the NANDA-I Board of Directors for approval. Approval of the proposed revision is posted on the NANDA-I Web site.

NANDA-I Diagnosis Submission Guidelines

NANDA-I Diagnosis Submission Form - Online

NANDA-I Diagnosis Submission Form (Word.doc - 94K)

Procedure to Appeal a DRC Decision on Diagnosis Review