Level of Evidence Criteria
NANDA-I Diagnosis Submission: Level of Evidence Criteria
The NANDA-I Education and Research Committee has been tasked to review and revise, as appropriate, these criteria to better reflect the state of the science related to evidence-based nursing.
➢ Received for Development (Consultation from DDC)
o Label Only
The label is clear, stated at a basic level, and supported by literature references, and these are identified. The DDC will consult with the submitter and provide education related to diagnostic development through printed guidelines and workshops. At this stage, the label is categorized as “Received for Development” and identified as such on the NANDA-I website.
o Label and Definition
The label is clear and stated at a basic level. The definition is consistent with the label. The label and definition are distinct from other NANDA-I diagnoses and definitions. The definition differs from the defining characteristics and label, and these components are not included in the definition. At this stage, the diagnosis must be consistent with the current NANDA-I definition of nursing diagnosis (see the “Glossary of Terms”). The label and definition are supported by literature references, and these are identified. At this stage, the label and its definition is categorized as “Received for Development” and identified as such on the NANDA-I website.
o Theoretical Level
The definition, defining characteristics and related factors, or risk factors, are provided with theoretical references cited, if available. Expert opinion may be used to substantiate the need for a diagnosis. The intention of diagnoses received at this level is to enable discussion of the concept, testing for clinical usefulness and applicability, and to stimulate research. At this stage, the label and its component parts are categorized as “Received for Development and Clinical Validation”, and identified as such on the NANDA-I website and a separate section in this book.
2.0 Accepted for Publication and Inclusion in the NANDA-I Taxonomy
2.1 Label, Definition, Defining Characteristics and Related Factors, or Risk Factors, and References
References are cited for the definition, each defining characteristic and each related factor, or for each risk factor. In addition, it is required that nursing outcomes and nursing interventions from a standardized nursing terminology (e.g., NOC, NIC) be provided for each diagnosis.
• Concept Analysis
The criteria in 2.1 are met. In addition, a narrative review of relevant literature, culminating in a written concept analysis, is required to demonstrate the existence of a substantive body of knowledge underlying the diagnosis. The literature review/ concept analysis supports the label and definition, and includes discussion and support of the defining characteristics and related factors (for problem-focused diagnoses), risk factors (for risk diagnoses), or defining characteristics (for health-promotion diagnoses).
3. Consensus Studies Related to Diagnosis Using Experts
The criteria in 2.1 are met. Studies include those soliciting expert opinion, Delphi, and similar studies of diagnostic components in which nurses are the subjects.
3. Clinically Supported (Validation and Testing)
3.2. Literature Synthesis
The criteria in 2.2 are met. The synthesis is in the form of an integrated review of the literature. Search terms/MESH terms used in the review are provided to assist future researchers.
3.3. Clinical Studies Related to Diagnosis, but Not Generalizable to the Population
The criteria in 2.2 are met. The narrative includes a description of studies related to the diagnosis, which includes defining characteristics and related factors, or risk factors. Studies may be qualitative in nature, or quantitative studies using nonrandom samples, in which patients are subjects.
3.4. Well-designed Clinical Studies with Small Sample Sizes
The criteria in 2.2 are met. The narrative includes a description of studies related to the diagnosis, which includes defining characteristics or risk factors, and related factors. Random sampling is used in these studies, but the sample size is limited.
3.5. Well-designed Clinical Studies with Random Sample of Sufficient Size to Allow for Generalizability to the Overall Population
The criteria in 2.2 are met. The narrative includes a description of studies related to the diagnosis, which includes defining characteristics and related factors, or risk factors. Random sampling is used in these studies, and the sample size is sufficient to allow for generalizability of results to the overall population.