I think the reason depends on many issues. In Brazil, the publication of articles on nursing diagnosis is increasing at present because we have research better now than in past years. An example is a clinical validation process, then if you do good research you can published on the impact journals in Brazil.

Hi Graciele, I think Olga referred to Northamerican and British journals. It is true that Brazilian journals frequently publish articles on the subject. Is it just for the different development of the application of the nursing process or are other factors coming into play?

Best regards.

I agree with Graciele that the reason depends on many issues as for the use of diagnoses in clinical settings http://www.ncbi.nlm.nih.gov/pubmed/21676043 "What factors influence the prevalence and accuracy of nursing diagnoses documentation in clinical practice? A systematic literature review."

Probably a systematic use of nursing diagnoses in clinical settings will determine more research on impact journals.

Hi Colleagues!!

yes José I guess other factors coming into play, as a great example is the nursing documentation with taxonomies or not, or else nursing electronic records or not!

Fabio, great paper, so great pick up about this issues!!! I agree with all the factors presented in this article.

Regards.

Dear colleagues,

One of the issues what may be of influence is that we as researchers have to make an evidence based bridge to the impact of inaccurate and accurate diagnosis documentation on aspects of patient safety and quality and efficiency of care. The effect of accurate nursing diagnosis on nursing sensitive patient outcomes need to be researched in more depth. That may lead to a paradigm shift in thinking (of editors and reviewers) about the importance of nursing documentation in general and of nursing diagnosis as the heart of nursing specifically. I think we as researchers have a lot work a head but ND might be the most wanted issue in high rated journals in the near future...

Dear colleagues,

I totally agree with Wolter Paans' exposition. But I would add that publishers should be also aware of the need for research to validate the available nursing languages​​. Most of the NANDA-I nursing diagnoses need studies to support their validity, the same goes on NOC outcomes and the effectiveness of NIC interventions. I consider it is an absolute priority, the empirical testing of the utility of taxonomies when applied to real care situations. The obstacles that many publications put to accept papers on this issue, hinder the international diffusion of many research projects that would be useful to refine taxonomies, increasing their use.

Couldn't agree more with you, Wolter, Jose and Graciele - I think part of the problem is that the accuracy research is often of the "expert" variety, and journals are looking for strong clinical validation. We need to move into epidemiological methods, case control, cohort studies and even retrospective analysis for Risk diagnoses that enable larger sample sizes - I think Wolter is absolutely correct, that the effect of diagnosis on outcome needs to be explored but we also need to really conduct international, multi-site research that enables us to validate diagnoses across populations with large enough samples to clarify the critical assessment criteria that must be present to make a diagnosis.

Completely agree. I consider a priority to create a international research network on clinical validation of nursing languages​​. I do not know if there is any. AENTDE (Spanish Association of Nomenclature, Taxonomies and Nursing Diagnosis) has recently launched the network REITE (Spanish Research Network on Nursing languages) (More info at www.aentde.com). The truth is that I do not know if there is a similar initiative at the international level. Anyone know?

Interesting discussion. Excellent contributions.

In Italy there are many university textbooks about ND, but rarely in the Italian literature there are studies on the implementation in clinical practice. Instead, I have found many Brazilian or Spanish studies. I think that in addition to NANDA is from this geographical and cultural area that can reach the strong contribution to the spread of ND in the clinical setting. I know the in Europe the ACENDIO (Association for Common European Nursing Diagnoses, Interventions and Outcomes) promotes the development of nursing’s professional language and provides a network across Europe for nurses interested in the development of a common language to describe the practice of nursing.

Best regards.

The insight to rerpresent nursings’ body of knowledge in classifications, and the need for SNLs in EHRs is growing

I absolutely agree with you, Maria. I believe this is really a "categorical imperative" for our discipline.

I agree with José Manuel that AENTDE's (Spanish Association of Nomenclature, Taxonomies and Nursing Diagnosis) network REITE (Spanish Research Network on Nursing languages) (More info at www.aentde.com) provides opportunities to foster research collaboration; and also ACENDIO (Association for Common European Nursing Diagnoses, Interventions and Outcomes) provides a platform to share research information and start new projects (http://www.acendio.net).

Research projects fostering high quality publications are performed at several Spanish Universities, at the University Tor Vergata, Rome (I), at the University of IOWA, Center for Nursing Classification & Clinical Effectiveness (https://nursing.uiowa.edu/cncce/nursing-interventions-classification-overview), at the College of Nursing University of Florida (https://nursing.ufl.edu/faculty/gail-keenan-phd-rn/) at the Universidade Federal do Rio Grande do Sul Porto Alegre, Rio Grande do Sul, Brazil and in many other research centers.