Differential diagnosis occurs when symptoms match more than one condition and additional tests are needed before an accurate diagnosis can be made. The tests will narrow down the potential conditions included in your healthcare provider's list of differential diagnoses. The three main ones are clinical, diagnostic and laboratory, but there are several types of diagnoses. For example, when determining a medical condition is complicated, a differential diagnosis is used to rule out conditions until a clear diagnosis is made.
The practical diagnosis can be a list of possible diagnoses (a differential diagnosis) or a single potential diagnosis. Usually, doctors will consider more than one hypothesis or diagnostic possibility to explain the patient's symptoms and will refine this list as they learn more during the diagnostic process. The practical diagnosis should be shared with the patient, including an explanation of the degree of uncertainty associated with a practical diagnosis. Each time the practical diagnosis is reviewed, this information must be communicated to the patient. As the diagnostic process progresses, a fairly large list of possible diagnoses can be reduced to a smaller number of potential options, a process referred to as modification and refinement of the diagnosis (Kassirer et al.
As the list is reduced to one or two possibilities, the diagnostic refinement of the practical diagnosis becomes diagnostic verification, in which it is verified that the main diagnosis is adequate to explain the signs and symptoms, its consistency with the patient's context (physiology, risk factors) and whether a single diagnosis is appropriate. When considering invasive or risky diagnostic tests or treatment options, the diagnostic verification step is particularly important so that the patient is not exposed to these risks without a reasonable possibility that the test or treatment options will be informative and likely to improve patient outcomes. Related factors are the circumstances or conditions related to the onset of the nursing diagnosis. Related factors are used in nursing diagnoses focusing on problems, syndromes, and sometimes health-promoting ones. Related factors are conditions or circumstances that underlie or contribute to the patient's health problem.
While the cause may not always be known, the nurse aims to understand the root cause in order to develop appropriate interventions. The defining characteristics and risk factors serve as observable evidence supporting the chosen nursing diagnosis. However, they should not be used interchangeably. Defining characteristics are observable characteristics that support a problem-based diagnosis or health promotion syndrome.
The defining characteristics are the signs or symptoms of clinical pathology. Risk factors are primarily used for risk-focused nursing diagnoses. Risk factors replace the defining characteristics of problem-based nursing diagnoses. In the same way, they provide evidence to support the nursing diagnosis.
Unlike the defining characteristics, risk factors describe why the patient is more likely to suffer from the undesirable health outcome identified by the nurse. Risk factors can be biological, psychological, family, or community. Patients may have one or more risk factors that support a risk diagnosis. A problem-based nursing diagnosis is a nursing diagnosis that addresses a current health challenge. Unlike other nursing diagnoses that address potential problems or opportunities for health improvement, a problem-based diagnosis refers to a current and known health condition.
To make this type of diagnosis, the characteristics that define it must be present at the time of the evaluation. The defining characteristics include the patient's signs, symptoms, and health history. The defining characteristics serve as clues for the nurse and, when grouped together, form patterns that allow a diagnosis to be assigned. Related factors should also be described as part of a nursing diagnosis focused on the problem.
Issue-focused nursing diagnoses are three-part statements that include the problem, etiology, and symptoms (PES framework). For a problem-focused nursing diagnosis, the signs and symptoms described are the characteristics that define the nursing diagnosis. The nurse must link the etiology with the signs and symptoms stating “as manifested by (AMB)” or “as demonstrated (AEB)”. The ability to create and develop mental models through repetition explains why medical experts are more likely to rely more on pattern recognition when making diagnoses than novices (a continuous commitment to diseases allows the expert to develop more reliable mental models of the disease) by retaining more specimens, creating more nuanced prototypes or developing more detailed disease scripts.
A possible nursing diagnosis is not a type of diagnosis, as are the actual diagnosis, the risk, the promotion of health and the syndrome. The four types of nursing diagnosis are actual diagnosis (focused on the problem), risk, health promotion and syndrome. Learn what a nursing diagnosis is, its history and evolution, the nursing process, the different types and classifications, and how to write nursing diagnoses correctly. The Mammogram Quality Standards Act (MQSA), overseen by the Food and Drug Administration, was the first accreditation program required by the government for any type of medical facility; it focused on obtaining radiographic images for breast cancer.
Developing checklists for the diagnostic process can be an important task; until now, checklists have been developed for discrete, observable tasks, but the complexity of the diagnostic process, including associated cognitive tasks, may represent a fundamentally different type of challenge (Henriksen and Brady, 201. The committee uses the term diagnostic tests to include all types of tests, including medical imaging, anatomical pathology and laboratory medicine, as well as other types of tests, such as mental health evaluations, vision and hearing tests and neurocognitive tests.
