Integration of NANDA International Nursing Diagnoses Into Italian Operational Procedures During the Digital Transition: A Narrative Review (2015-2024)

The digital transformation of the Italian National Health Service (NHS), accelerated by the National Recovery and Resilience Plan, requires the adoption of standardized terminology to ensure semantic interoperability and the measurability of care. This review analyzes the state of integration of NANDA International (NANDA-I) nursing diagnoses into hospital and community operational procedures in Italy from 2015 to 2024. A narrative review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search on PubMed, CINAHL, and Scopus yielded 54 selected sources, including legislative acts and peer-reviewed studies. Methodological quality was rigorously appraised using the Mixed Methods Appraisal Tool, applying a strict inclusion threshold of ≥60% to ensure robustness of the evidence. Thematic analysis of the retrieved records was conducted using NVivo 14 (Lumivero, Burlington, MA, USA) to identify recurring implementation patterns. The analysis reveals a heterogeneous implementation landscape. Northern regions (e.g., Emilia-Romagna, Tuscany) have successfully embedded NANDA-I into Electronic Health Records through regional mandates, whereas Southern regions face infrastructural challenges. Evidence confirms that standardized taxonomies improve diagnostic accuracy, patient safety outcomes (specifically fall prevention and heart failure management), and care continuity. The integration of NANDA-I represents a strategic asset for the digital evolution of the NHS. Future efforts must focus on mandatory education and national interoperability standards (SNOMED-CT mapping) to bridge the digital divide.