The
"Nursing
Diagnosis Handbook: An EvidenceBased Guide to Planning Care," 11th Edition
by Betty J. Ackley, Gail B. Ladwig, and Mary Beth Flynn
Makic is a comprehensive resource for nurses, students, and healthcare practitioners focusing on developing effective, individualized nursing care plans. This edition provides in-depth, evidence-based guidance on the nursing diagnosis process, helping healthcare professionals create care plans based on accurate diagnoses and targeted interventions. Each nursing diagnosis is presented with a detailed explanation, clinical indicators, interventions, and expected outcomes, tailored for various patient populations and settings.
Key Sections and Concepts
1.Foundations of Nursing Diagnosis and Care Planning
a.This section introduces the concept of nursing diagnoses and the importance of structured care planning in nursing practice. It provides an overview of the North American Nursing Diagnosis Association (NANDA) classifications, which offer a standardized language for nursing diagnoses.
b.The handbook emphasizes a holistic and patient-centered approach to care planning, highlighting the importance of understanding each patient’s unique needs, cultural background, and preferences. It also discusses legal, ethical, and clinical rationales behind the use of standardized nursing diagnoses.
2.Assessment, Diagnosis, and Evidence-Based Practice
a.This portion explains the foundational steps in the nursing process: assessment, diagnosis, planning, implementation, and evaluation. Ackley, Ladwig, and Makic detail how to use patient data, clinical judgment, and evidence-
based research to identify accurate nursing diagnoses.
b.The authors emphasize the importance of gathering thorough health histories, performing comprehensive physical assessments, and considering psychosocial, environmental, and spiritual factors that impact health. This section also covers the importance of using research and evidence in selecting diagnoses and planning care, including practical methods to access and evaluate evidence.
3.Organization of Nursing Diagnoses by Patient Needs
a.The handbook organizes nursing diagnoses according to functional health patterns, using a framework based on common health concerns and patient needs. These patterns include areas such as health perception and management, nutritional-metabolic balance, elimination, activity-exercise, and cognitiveperceptual function.
b.Each diagnosis is presented with a specific focus on its defining characteristics, related factors, and risk factors. For instance, a diagnosis related to “Imbalanced Nutrition” might include risk factors like limited access to nutritious foods or certain medical conditions affecting nutrient absorption. This classification allows nurses to quickly identify relevant diagnoses based on patient-specific health issues.
4.Writing and Implementing Effective Care Plans
a.Ackley, Ladwig, and Makic guide nurses on writing clear, measurable goals and outcomes for patient care. They emphasize using SMART goals—Specific, Measurable, Achievable, Relevant, and Time-bound— allowing practitioners to set realistic expectations for patient progress.
b.The handbook provides tips for translating nursing diagnoses into actionable interventions and lists nursing priorities for each diagnosis. It also discusses strategies
for adapting care plans to accommodate changing patient conditions and for involving patients and their families in care planning decisions.
5.Patient Education and Health Promotion
a.This section underscores the role of nurses as educators, emphasizing the importance of promoting health and educating patients about their diagnoses, treatments, and preventive care. The authors discuss how to tailor education based on the patient’s level of understanding, readiness to learn, and cultural background.
b.For each diagnosis, the handbook includes educational tips and strategies that nurses can use to empower patients. Topics like medication management, lifestyle modifications, and self-care practices are included, which are crucial for long-term health maintenance and recovery.
Detailed Chapter Summaries
Chapter 1: Introduction to Nursing Diagnosis
• This introductory chapter provides an overview of nursing diagnoses, including their history, purpose, and relevance in clinical practice. It explains the role of NANDA in establishing standardized terminology and discusses how standardized diagnoses help improve communication across healthcare teams, enhance patient safety, and support legal and ethical practice.
Chapter 2: The Nursing Process and Critical Thinking
• This chapter elaborates on the steps of the nursing process assessment, diagnosis, planning, implementation, and evaluation—and explains the importance of critical thinking in nursing practice. It offers guidelines on integrating clinical judgment with evidence-based research and patient preferences in decision-making.
Chapter 3: The Use of Evidence-Based Practice in Care Planning
• Evidence-based practice (EBP) is foundational to developing effective care plans. This chapter covers methods for accessing, evaluating, and applying research in clinical settings, highlighting resources like systematic reviews, clinical guidelines, and research databases. EBP tools and tips are provided to assist nurses in developing care plans that meet the highest standards of clinical practice.
Chapter 4-10: Nursing Diagnoses and Interventions by Functional Health Patterns
• These chapters are organized by functional health patterns, covering various areas of patient care and specific nursing diagnoses associated with each.
o Health Perception and Health Management: Diagnoses here address issues related to patient understanding, lifestyle, and disease management. Examples include diagnoses for “Noncompliance” or “Ineffective Health Maintenance.”
o Nutritional-Metabolic Pattern: This section includes diagnoses for nutritional imbalances, such as “Imbalanced Nutrition: Less than Body Requirements” and “Risk for Deficient Fluid Volume.” Each diagnosis includes possible interventions, such as dietary education and hydration management.
o Elimination Pattern: Covers diagnoses related to bowel and urinary elimination, including “Impaired Urinary Elimination” and “Constipation.” Treatment strategies may include dietary modifications, medications, and patient education.
o Activity-Exercise Pattern: Diagnoses such as “Activity Intolerance” and “Impaired Physical Mobility” focus on physical health and exercise. Interventions may involve physical therapy, mobility aids, and exercise planning.
o Cognitive-Perceptual Pattern: Diagnoses for this pattern involve mental health and sensory perception, such as “Acute
Confusion” or “Chronic Pain.” Interventions include cognitive-behavioral techniques, sensory aids, and pain management.
Chapter 11: Risk Diagnoses and Safety Management
• This chapter focuses on diagnoses that address potential risks, such as “Risk for Falls,” “Risk for Infection,” and “Risk for Aspiration.” The handbook outlines preventive strategies and safety measures tailored to various settings, including hospital, home care, and outpatient facilities.
Chapter 12: Diagnoses for Special Populations
• The handbook recognizes that certain patient populations, including pediatric, geriatric, and obstetric patients, require specialized care plans. This chapter provides guidelines for tailoring diagnoses and interventions to meet the unique needs of these groups, taking into consideration developmental stages, comorbidities, and specific vulnerabilities.
Chapter 13: Documentation and Evaluation
• Accurate documentation is crucial for continuity of care. This chapter provides tips for effectively documenting nursing diagnoses, interventions, and patient outcomes. It also covers how to evaluate patient progress, make necessary adjustments to care plans, and ensure accountability within the healthcare team.
Features and Tools
• Clinical Tips and Rationale for Interventions: Each nursing diagnosis is accompanied by suggested interventions and clinical rationales. This helps nurses understand the purpose of each intervention and apply it effectively.
• Case Studies and Examples: Real-world case studies demonstrate how to use the handbook’s information in clinical practice. These scenarios challenge nurses to think critically and adapt their approach to different patient cases.
• Outcome Identification and Evaluation Criteria: Expected patient outcomes are included with
each diagnosis, helping nurses set measurable and attainable goals for patient improvement. Evaluation criteria offer benchmarks for assessing progress and revising care plans as needed.
• Patient and Family Teaching: Each diagnosis includes specific educational strategies to help patients and families understand their health conditions, treatment options, and self-care techniques.
• Appendices and Reference Materials: The handbook includes appendices with quickreference tools, such as lists of commonly used NANDA diagnoses, laboratory values, and additional resources for evidence-based practice.
The "Nursing Diagnosis Handbook: An EvidenceBased Guide to Planning Care, 11th Edition" serves
as an essential guide for nurses in developing, implementing, and evaluating individualized care plans. By focusing on evidence-based interventions, standardized diagnoses, and patient-centered outcomes, this handbook helps nurses deliver highquality care across a variety of settings. The extensive examples, real-life case studies, and clear, systematic approach make this book invaluable for both students and practicing nurses seeking to enhance their assessment and care planning skills.