A Review of the Use of Nursing Diagnosis in U.S. Nurse Practice Acts

PURPOSE. To determine how many state nurse practice acts include the term or concept of “nursing diagnosis” and describe their similarities and differences.

METHODS. Investigators independently divided the practice acts of the 50 states and the District of Columbia into those that did or did not include the term “nursing diagnosis” or the word “diagnosis” within a nursing context. To describe other differences, the investigators operationally defined and independently categorized each act as trendsetting, contemporary, or traditional.

FINDINGS. Thirty-three of the 51 practice acts used the term “diagnosis” within nursing context. Of these 33, 13 were identified as trendsetters and 20 as contemporary. Seven trendsetting and 5 contemporary practice acts used the NANDA-based language or “response” when describing the “what” of nursing diagnosis. None of the trendsetting practice acts, but 8 of the contemporary acts, used the NANDA-based “individual, family or community” when describing the “who” of nursing diagnosis.

CONCLUSIONS. The language of nursing is changing. The majority of practice acts now define the practice of professional nursing as including the diagnostic act, although the manner in which they use the term varies.