LECTURE NOTES: NANDA, NIC, NOC

1. Introduction
Nursing requires clear, standardized communication among professionals.
Three major standardized languages guide this:

 NANDA (North American Nursing Diagnosis Association)

 NIC (Nursing Interventions Classification)
 NOC (Nursing Outcomes Classification)

These help nurses plan, implement, and evaluate patient care systematically.

2. NANDA - Nursing Diagnoses

NANDA-I provides a standardized list of nursing diagnoses.
A nursing diagnosis identifies a patient’s response to health conditions/life processes or a
vulnerability to that response.

 Examples of NANDA diagnoses:

o Acute Pain
o Risk for Infection
o Impaired Gas Exchange
o Anxiety

Structure of a NANDA Diagnosis:

 Problem (what's wrong)

 Etiology (related factors or cause)
 Symptoms (evidence)

👉 Example:

Acute Pain related to surgical incision as evidenced by verbal reports of pain and guarding
behavior.

3. NIC - Nursing Interventions Classification

NIC provides a standardized list of nursing interventions.
An intervention is any treatment based upon clinical judgment that a nurse performs to enhance
outcomes.

 Examples of NIC interventions:

o Pain Management
o Infection Control
o Anxiety Reduction
o Respiratory Monitoring

NIC allows nurses to choose appropriate evidence-based actions.

Each NIC includes:

 Label (title of intervention)

 Definition
 Set of activities (what the nurse does)

👉 Example:

Intervention: Pain Management

Activities: Assess pain, administer prescribed analgesics, use non-pharmacologic comfort
measures.

4. NOC - Nursing Outcomes Classification

NOC provides a standardized list of outcomes to evaluate the effects of nursing interventions.

 Examples of NOC outcomes:

o Pain Level
o Infection Status
o Anxiety Level
o Respiratory Status

Each NOC includes:

 Outcome label
 Definition
 Indicators to measure progress (scored usually from 1–5)

👉 Example:

Outcome: Pain Level

Indicator: Patient reports pain level ≤3 on a 0–10 scale within 24 hours.
5. How NANDA, NIC, and NOC Work Together
1. Assess the patient.
2. Diagnose with NANDA.
3. Plan and Implement interventions with NIC.
4. Evaluate the results using NOC.

Example Workflow:

 NANDA: Acute Pain

 NIC: Pain Management, Medication Administration
 NOC: Pain Level improved

This forms the backbone of nursing process documentation and evidence-based care.

6. Importance in Nursing Practice

 Improves communication among nurses and the healthcare team
 Standardizes nursing practice globally
 Supports evidence-based practice
 Helps in research, education, and administration
 Enhances patient care quality and safety

7. Quick Summary Table

Category Full Form Purpose Examples
Identify patient
NANDA Nursing Diagnoses Risk for Falls, Acute Pain
problems
Nursing Interventions Specify nursing Pain Management, Anxiety
NIC
Classification actions Reduction
Nursing Outcomes Measure patient Pain Level Improved, Anxiety
NOC
Classification outcomes Reduced

Conclusion
Using NANDA, NIC, and NOC together ensures that nursing care is systematic, measurable,
and focused on patient outcomes.
Mastery of these systems is essential for every professional nurse!

NANDA-I

1. Introduction to NANDA-I
 NANDA-I stands for North American Nursing Diagnosis Association International.
 It is a professional organization that develops, researches, and refines standardized
nursing diagnoses.
 Purpose:
To help nurses identify patient responses to health conditions, guide interventions, and
improve patient care globally.

2. History of NANDA-I
 Founded in 1973 in the United States.
 Originally called NANDA (North American Nursing Diagnosis Association).
 Became NANDA International (NANDA-I) in 2002 to reflect its global reach.
 Published the first official list of nursing diagnoses in 1973.

3. What is a Nursing Diagnosis?

 Definition:
A clinical judgment about a patient's response to actual or potential health conditions/life
processes.
 Difference from Medical Diagnosis:
o Medical Diagnosis identifies disease (e.g., Pneumonia).
o Nursing Diagnosis identifies patient responses (e.g., Impaired Gas Exchange
related to alveolar-capillary membrane changes).
4. Components of a NANDA-I Nursing Diagnosis
Each diagnosis includes:

1. Label (problem title)

2. Definition (clear description)
3. Defining characteristics (signs and symptoms)
4. Related factors (etiology or causes)
5. Risk factors (conditions increasing vulnerability)

Example:

 Label: Acute Pain

 Definition: Unpleasant sensory and emotional experience arising from actual or potential
tissue damage.
 Defining Characteristics: Verbal reports of pain, protective behavior, facial grimaces.
 Related Factors: Surgical incision.

5. Types of Nursing Diagnoses

According to NANDA-I, there are several types:

Type Description Example

Existing problems validated by signs and Acute Pain, Impaired
Actual Diagnosis
symptoms Mobility
Risk for Infection, Risk for
Risk Diagnosis Potential problems patient may develop
Falls
Health Promotion Readiness for Enhanced
Patient desires to improve health behaviors
Diagnosis Nutrition
Cluster of nursing diagnoses predicted to
Syndrome Diagnosis Post-Trauma Syndrome
occur together

6. Format of Nursing Diagnosis Statement

For Actual Diagnoses:

PES format:

 P = Problem (diagnostic label)

 E = Etiology (related to)
 S = Signs/Symptoms (as evidenced by)

👉 Example:

Acute Pain related to surgical trauma as evidenced by grimacing and verbal reports of pain.

For Risk Diagnoses:

 Only Problem and Etiology (no signs/symptoms yet).

👉 Example:

Risk for Infection related to surgical incision.

7. Importance of NANDA-I Diagnoses

 Provides common language for nurses worldwide.
 Improves communication between healthcare team members.
 Forms the basis for care planning.
 Supports clinical decision-making and patient safety.
 Facilitates nursing education, research, and quality improvement.

8. Examples of Common NANDA-I Diagnoses

NANDA-I Diagnosis Definition
Impaired Skin Integrity Altered epidermis/dermis
Risk for Falls Increased susceptibility to falling
Ineffective Airway Clearance Inability to clear secretions or obstructions
Anxiety Vague uneasy feeling of discomfort or dread
Imbalanced Nutrition: Less Than Body Intake of nutrients insufficient to meet metabolic
Requirements needs

9. Updates and Editions

  NANDA-I releases new editions of the approved diagnoses every few years (e.g.,
NANDA-I 2024–2026).
 Diagnoses are updated based on research, clinical practice, and global feedback.
 New diagnoses may be added; outdated ones may be revised or removed.

10. Conclusion
 NANDA-I plays a critical role in making nursing a scientific, evidence-based
profession.
 Mastery of NANDA diagnoses ensures better assessment, individualized care plans,
and optimal patient outcomes.

Nursing Interventions Classification (NIC)

1. Introduction to NIC
 NIC stands for Nursing Interventions Classification.
 It is a comprehensive classification system that categorizes and standardizes the
interventions nurses perform to improve patient outcomes.
 The NIC system is one of the key components in evidence-based nursing practice,
alongside NANDA-I and NOC.

2. History of NIC
 Developed in 1992 by Marilyn M. Parker and colleagues.
 NIC is part of the taxonomy system developed by the University of Iowa College of
Nursing.
 Its goal is to standardize and categorize nursing interventions based on clinical
research and best practices.
3. What is a Nursing Intervention?
 Definition:
A nursing intervention is any action taken by a nurse to improve a patient’s
condition, address a nursing diagnosis, or enhance patient well-being.
 Interventions can be:
o Direct (e.g., administering medication)
o Indirect (e.g., advocating for patient needs, managing the environment)

4. Components of NIC Interventions

Each NIC intervention includes:

 Label: The intervention's name

 Definition: A clear description of the intervention
 Activities: The specific tasks or actions involved in the intervention
 Rationale: Evidence-based reasoning for performing the intervention

5. Structure of NIC
 NIC interventions are organized into 7 domains and 30 classes.
 These domains cover broad aspects of patient care, such as basic care, management of
health conditions, and mental health interventions.

Domains of NIC:

1. Basic Physiological: Activities that promote life-sustaining functions (e.g., airway

management, fluid monitoring)
2. Complex Physiological: Interventions for more complex or acute conditions (e.g.,
cardiopulmonary monitoring)
3. Behavioral: Actions related to mental health, coping strategies (e.g., anxiety reduction,
behavior modification)
4. Safety: Measures to prevent harm or injury (e.g., fall prevention)
5. Family: Involvement of family in patient care (e.g., family support)
6. Health Systems: Interventions related to healthcare delivery (e.g., case management,
patient education)
7. Community: Interventions focusing on population-level health (e.g., health promotion,
community outreach)
6. Example of a NIC Intervention
Intervention
Definition Activities Rationale
Label
1. Assess pain level
using a pain scale.
The process of 2. Administer Evidence supports the effectiveness of
Pain
preventing or prescribed analgesics. both pharmacological and non-
Management
reducing pain. 3. Teach non- pharmacological pain management.
pharmacologic pain
relief strategies.

7. How NIC Works in the Nursing Process

 Assessment: Identify patient needs and nursing diagnoses (using NANDA-I).
 Intervention: Select and perform appropriate NIC interventions based on the patient’s
condition.
 Evaluation: Assess the effectiveness of interventions (usually done using NOC).

Example Workflow:

 NANDA Diagnosis: Acute Pain

 NIC Intervention: Pain Management, Medication Administration
 NOC Outcome: Pain Level Reduced

8. Importance of NIC
 Standardization: Provides a unified language for nurses to communicate interventions
effectively across settings.
 Evidence-Based Practice: Ensures interventions are rooted in the latest research.
 Care Planning: Helps nurses choose interventions that best match patient needs,
optimizing care and improving outcomes.
 Quality Improvement: Standardized interventions enable healthcare facilities to assess
care quality and implement improvements.

9. NIC and Nursing Care Plans

 Nursing care plans integrate NANDA diagnoses, NIC interventions, and NOC
outcomes.
  NIC interventions serve as the action step in care planning and directly link to patient
care goals.

Example of a Care Plan:

Step Content
Assessment Patient reports pain 8/10.
NANDA Diagnosis Acute Pain related to surgical incision.
NIC Intervention Pain Management (assess pain, administer analgesics).
NOC Outcome Pain level will decrease to ≤3/10 in 24 hours.

10. Updates and Editions

 NIC updates regularly to incorporate new interventions based on clinical practice and
research findings.
 New editions improve intervention definitions and classifications, ensuring accuracy and
relevance.

11. Summary
 NIC provides a structured, standardized system for nursing interventions.
 Its adoption enhances communication, quality care, and patient outcomes.
 Nurses can rely on NIC to choose interventions that are effective, evidence-based, and
aligned with their patients' needs.

Quick Summary Table of NIC Domains:

NIC Domain Focus
Basic Physiological Interventions promoting life-sustaining functions
Complex Physiological Interventions for acute or complex conditions
Behavioral Interventions for mental health or coping
Safety Preventing harm or injury
Family Involving family in patient care
Health Systems Enhancing healthcare delivery
Community Population-level health interventions
12. Conclusion
 NIC plays a crucial role in promoting high-quality patient care.
 Nurses use NIC to implement tailored, evidence-based interventions that align with the
nursing process.
 Mastery of NIC improves both clinical skills and patient outcomes, ensuring effective
and consistent care delivery.

Nursing Outcomes Classification (NOC)

1. Introduction to NOC
 NOC stands for Nursing Outcomes Classification.
 It is a standardized classification of patient outcomes influenced by nursing
interventions.
 Developed to measure patient progress and evaluate the effectiveness of nursing care.

2. History of NOC
 Developed in the early 1990s by researchers at the University of Iowa College of
Nursing.
 Published first in 1997 to complement NANDA-I and NIC.
 Part of the effort to make nursing care evidence-based and measurable.

3. What is a Nursing Outcome?

 Definition:
A nursing outcome is a measurable behavior or perception of a patient, family, or
community that is influenced by nursing interventions.
 Outcomes are used to evaluate if nursing interventions (NIC) are successful in
improving patient conditions.

4. Purpose of NOC
 Standardize terminology to describe patient outcomes.
  Enable nurses to measure care effectiveness.
 Assist in the planning, evaluation, and documentation of nursing care.
 Support research, education, and clinical practice.

5. Components of a NOC Outcome

Each outcome in NOC has:

 Outcome Label: Name of the outcome (e.g., Pain Control).

 Definition: Description of what the outcome means.
 Indicators: Specific behaviors or states to measure outcome achievement.
 Measurement Scale: A five-point Likert scale (1 = severely compromised to 5 = not
compromised).
 Supporting References: Evidence supporting the outcome indicators.

6. Structure of NOC
 Organized into 7 Domains and 34 Classes.
 Domains reflect broad areas of health and care needs.

Domain Focus
Functional Health Activities of daily living, self-care
Physiologic Health Physical processes (e.g., nutrition)
Psychosocial Health Mental health, coping, emotions
Health Knowledge & Behavior Patient knowledge and lifestyle
Perceived Health Patient perception of well-being
Family Health Outcomes related to family support
Community Health Public health outcomes

7. Example of a NOC Outcome

Component Example
Outcome Label Pain Control
Definition Severity of pain managed
- Patient reports pain level < 3/10
Indicators
- Patient uses pain relief techniques
Measurement Scale 1 (Severely compromised) to 5 (Not compromised)
8. NOC in the Nursing Process
NOC is used in the Evaluation phase of the Nursing Process:

 Assessment ➔ Gather patient information.

 Diagnosis ➔ Use NANDA-I.
 Planning and Interventions ➔ Choose NIC interventions.
 Evaluation ➔ Measure NOC outcomes to assess if goals are met.

👉 Example:

 NANDA Diagnosis: Acute Pain

 NIC Intervention: Pain Management
 NOC Outcome: Pain Control (Goal: Patient reports pain 2/10 or lower)

9. How to Use NOC in Practice

 Select outcomes that match the patient's nursing diagnosis.
 Use indicators to set measurable goals.
 Monitor and rate patient progress using the 5-point scale.
 Document outcomes achieved to inform further care planning.

10. Importance of NOC

 Provides measurable data on nursing effectiveness.
 Supports quality assurance and care standardization.
 Enhances communication among healthcare team members.
 Helps with research by providing measurable outcomes.

11. Quick Example Table

NANDA Diagnosis NIC Intervention NOC Outcome
Risk for Falls Fall Prevention Fall Prevention Behavior
Ineffective Coping Anxiety Reduction Coping Status
Imbalanced Nutrition Nutrition Management Nutritional Status: Food & Fluid Intake
12. Updates and Editions
 Like NANDA-I and NIC, NOC is regularly updated based on research.
 Each update refines outcomes, indicators, and adds new evidence-based outcomes.

13. Summary
 NOC allows nurses to measure the success of their interventions.
 Outcomes guide evaluation of care effectiveness.
 NOC ensures that nursing care is goal-oriented, standardized, and measurable.

Quick Process Diagram

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NANDA Diagnosis ➔ NIC Interventions ➔ NOC Outcomes ➔ Evaluation

14. Conclusion
 The Nursing Outcomes Classification (NOC) is essential for delivering high-quality,
evidence-based nursing care.
 Mastering NOC improves nursing practice, enhances communication, and ensures better
patient outcomes.

DETAILED LINKAGES BETWEEN

NANDA-I, NIC, AND NOC

1. What are they individually?

Component Purpose Example
NANDA-I Identifies the patient’s health problem Acute Pain related to surgical
(Diagnosis) (nursing diagnosis) incision
 Component Purpose Example
Actions the nurse will perform to treat or Pain Management, Medication
NIC (Interventions)
prevent the problem Administration
Measurable results to evaluate patient Pain Control: Patient reports pain
NOC (Outcomes)
progress < 3/10

2. How they are linked: Step-by-Step

Linked
Step Action
Component
1 Assess the patient’s condition and diagnose using NANDA-I NANDA-I
2 Select appropriate nursing interventions based on the diagnosis NIC
Set measurable outcomes/goals to evaluate effectiveness of
3 NOC
interventions
Implement interventions (NIC), monitor progress towards outcomes Care Plan
4
(NOC), revise care plan if needed Integration

3. Example of Full Linkage

Step Description Classification
Assessment Post-surgical patient reports pain (7/10) -
Diagnosis Acute Pain related to surgical incision NANDA-I
- Administer analgesics
Intervention NIC
- Educate on relaxation techniques
- Patient reports pain less than 3/10 within 24 hours
Outcome - Patient demonstrates non-pharmacological pain management NOC
techniques

4. More Linked Examples (Different Diagnoses)

NANDA-I Diagnosis NIC Interventions NOC Outcomes
Airway Management, Respiratory Status: Airway
Ineffective Airway Clearance
Suctioning, Oxygen Therapy Patency
Fall Prevention, Surveillance: Risk Control, Fall Prevention
Risk for Falls
Safety Monitoring Behavior
Imbalanced Nutrition: Less Than Nutrition Management, Weight Nutritional Status, Weight
Body Requirements Management Gain
Anxiety Reduction, Coping
Anxiety Anxiety Level, Coping Status
Enhancement
Impaired Skin Integrity Wound Care, Pressure Tissue Integrity: Skin and
 NANDA-I Diagnosis NIC Interventions NOC Outcomes
Management Mucous Membranes

5. Important Features of Their Linkages

 NANDA-I gives the "what is wrong".
 NIC gives the "what the nurse will do".
 NOC gives the "how we measure if it’s working".
 They are evidence-based and standardized for global use.
 They enhance quality assurance, nursing documentation, and research.

6. Visual Diagram: How NANDA-I, NIC, and NOC Connect

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Assessment ➔ Diagnosis (NANDA-I) ➔ Plan (Select NIC interventions) ➔ Outcome
(Set NOC goals) ➔ Implementation ➔ Evaluation (Measure NOC outcomes)

Each patient care plan thus has a triangular connection:

👉 NANDA-I Diagnosis → guides → NIC Interventions → leads to → NOC Outcomes →

evaluated back to the Diagnosis.

SUMMARY TABLE: NANDA-I vs NIC vs

NOC
Aspect NANDA-I NIC NOC
Focus Nursing Diagnoses Nursing Interventions Nursing Outcomes
Purpose Identify patient problems Treat patient problems Measure the effectiveness
Language Problem-focused Action-oriented Outcome-focused
Impaired Skin Integrity, Wound Care, Anxiety Tissue Integrity, Anxiety
Examples
Anxiety Reduction Level
In short:
✅ NANDA-I → What's the patient's problem?
✅ NIC → What will the nurse do about it?
✅ NOC → How will we know if it worked?