Taxonomies of nursing diagnoses: a psychologist's view.

Nurses routinely make judgments about the states of their patients and make decisions, choosing among interventions, in the care of their patients. Judgment and decision-making researchers, such as myself, study how these judgments and decisions are made, and when there is a need, we study how the accuracy and efficiency of such judgments and decisions can be improved. From my point of view, a taxonomy of nursing diagnoses is a tool to help nurses make better judgments and decisions. In this editorial I discuss nursing diagnoses as a taxonomic system intended to facilitate cognitive organization of information. I do not take a position, pro or con, on the issue of using nursing diagnoses in practice, but rather my focus is on the qualities that make a taxonomic system useful as aid in learning, memory, and decisionmaking. First, I will present some historical work from cognitive psychology related to clinical judgment and decision-making in order to provide the reader with a sense of my perspective. Second, I will review some research studies that I believe are representative of those conducted in developing the NANDA taxonomy over the years and I will critically evaluate them from the point of view of a cognitive scientist. The selection of studies for evaluation is, admittedly, biased. My intent is not to provide an exhaustive summary of the literature, but to provide examples that serve to illustrate the state of this research. Finally, I will outline an ambitious recommendation for research aimed at quantifying the quality of any nursing diagnoses taxonomy if it is to function as a tool for improving judgment and decision-making. Nursing diagnoses categorize patients’ health problems for which nurses provide solutions through nursing interventions (Müller-Staub et al., 2007). According to the North American Nursing Diagnosis Association, nursing diagnoses are intended to provide nurses with the basis for selecting interventions to achieve outcomes for which the nurse is accountable (NANDA International, 2007). Accurate descriptions of patient problems or needs in the form of