Using the change process to implement nursing diagnoses

The purpose of this study was to assess the impact of implementing nursing diagnosis in a community hospital where only 32.5% of medical-surgical patients had individualized care plans. Of these care plans, only 13% correctly identified North American Nursing Diagnosis Association (NANDA) nursing diagnoses. Prior to the study, staff lacked commitment toward written care plans and viewed time management as the major clinical barrier to completion. Staff were instructed in nursing process and nursing diagnosis through a mandatory continuing education series. A follow-up survey at 6 months revealed care plans completed according to NANDA standards in 82% of cases. The nursing staff verbalized an increased commitment and appreciation of nursing process and its influence on patient care.