NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
Diagnosis at a glance
| Code | 00004 |
|---|---|
| Label | Risk for infection |
| Spanish label | Riesgo de infección |
| Domain | 11. Safety / protection |
| Class | 1. Infection |
| Type | Risk |
| Status | Current |
What it means
It describes a patient with no infection right now, but with open portals of entry or weakened defenses that make it easier for microorganisms to invade. The nurse's job is to close those portals and catch the earliest sign that an infection has started.
Explanation written by our team. The official definition is in the NANDA-I 2024-2026 book.
When to use it
Clinical situations where it commonly shows up. The diagnosis is confirmed by your assessment, not by the medical diagnosis.
- Patients with IV lines, indwelling urinary catheters, drains or mechanical ventilation.
- Surgical or traumatic wounds, burns and ulcers.
- Malnutrition, poorly controlled diabetes, chemotherapy or corticosteroid therapy.
- Preterm newborns and frail older adults.
- Long hospital stays.
- Bedbound or low-mobility patients at risk for pneumonia and skin breakdown.
What to assess
- Invasive devices: insertion date, condition of the insertion site and whether each device is still needed.
- Wounds: edges, drainage, odor, warmth and redness around the site.
- Temperature, heart rate and level of consciousness.
- Nutritional status: weight loss, intake and, if available, albumin or lymphocyte count.
- Blood glucose in patients with diabetes.
- Immunization status, personal hygiene and what the patient knows about caring for the wound or catheter.
- Skin and mucous membranes: dryness, cracks, pressure injuries, oral condition.
- Available WBC count and culture results, as ordered.
Risk factors
What makes the problem more likely, and what nursing can monitor or modify.
- Inadequate hand hygiene by the patient, family or staff.
- Inadequate care of the catheter insertion site or wound.
- Insufficient protein and calorie intake.
- Insufficient knowledge about avoiding exposure to pathogens.
- Prolonged immobility, which promotes pooling of secretions and skin breakdown.
- Dry, cracked or moisture-macerated skin.
- Blood glucose out of target range due to poor adherence to medication or diet.
- Smoking.
- Incomplete immunization schedule.
At-risk populations
- Newborns, especially preterm infants.
- Frail older adults.
- Patients with long hospital or ICU stays.
- People who are malnourished or underweight.
- Nursing home and long-term care residents.
Associated conditions
- Invasive procedures: catheters, tubes, drains, mechanical ventilation.
- Recent surgery.
- Immunosuppression: chemotherapy, corticosteroids, transplant, HIV.
- Diabetes mellitus.
- Burns and chronic wounds.
- Chronic kidney disease on hemodialysis.
Risk factors are the ones nursing can change independently: hygiene, nutrition, what the patient knows. Associated conditions (a central line, chemotherapy, diabetes) increase the risk but are not treated with independent nursing interventions. Many instructors want them kept separate; if your program asks for it, write them as "in a patient with...".
How to write it (PES)
Risk for infection related to malnutrition, inadequate care of the insertion site and insufficient knowledge of catheter care, in a patient with a central venous catheter (associated condition).
A risk diagnosis has no "as evidenced by" clause: there are no signs yet. You only list the risk factors.
Example written by our team for a fictional patient. Adapt it to your own patient's data. Build your statement with the PES generator.
Goals / expected outcomes
Written in measurable terms: what, how much and by when.
- Patient remains free of signs of local or systemic infection throughout the hospital stay.
- Temperature stays below 38 °C (100.4 °F).
- Catheter insertion site and wound remain clean, without redness or drainage.
- Patient or caregiver explains and demonstrates hand hygiene and device care before discharge.
- Patient eats at least 75% of the prescribed diet by day 3.
Nursing interventions and rationales
| Intervention | Rationale |
|---|---|
| Perform hand hygiene at the WHO 5 Moments: before touching the patient, before an aseptic task, after body fluid exposure risk, after touching the patient and after touching the patient's surroundings. | It is the single most effective measure for reducing healthcare-associated infections. |
| Inspect catheter insertion sites every shift and review whether each device is still needed. | Every extra day with an unnecessary device adds risk. |
| Use aseptic technique for dressing changes, line care and catheterization. | Prevents introducing microorganisms into sterile tissues or circuits. |
| Keep dressings clean, dry and dated, and change them if they loosen or get wet. | A wet or loose dressing no longer works as a barrier. |
| Check temperature and document signs of local infection every shift. | Early detection allows treatment before the infection spreads. |
| Encourage adequate protein and fluid intake, and consult the dietitian if intake stays low. | Malnutrition delays healing and weakens immune defenses. |
| Mobilize the patient and encourage coughing and deep breathing. | Prevents pneumonia in bedbound and postoperative patients. |
| Provide daily oral care and skin care, with repositioning based on risk. | The mouth and broken skin are common portals of entry. |
| Teach the patient and family hand hygiene and warning signs. | They keep up prevention at home and seek care early. |
NOC outcomes and NIC interventions
Outcomes (NOC) and interventions (NIC) that published sources link to this diagnosis. Pick the ones that fit your patient.
NOC outcomes
- 0703Infection Severity
- 1902Risk Control
- 1900Immunization Behavior
NIC interventions
- 1876Tube Care: Urinary
- 6540Infection Control
- 2440Venous Access Device Maintenance
- 5606Teaching: Individual
Linkages drawn from care plans published by health services, universities and nursing journals. Labels may vary depending on the NIC and NOC edition your facility uses.
Case study: Patient with a central line and a Foley catheter
Patient. 71-year-old woman with type 2 diabetes, admitted to a medical unit 6 days ago for hyperglycemic decompensation. She has a central venous catheter and an indwelling urinary catheter.
Assessment
- Central venous catheter in place for 5 days; the dressing is lifting at one edge and damp.
- Urinary catheter in place for 4 days; urine is clear and she reports no discomfort.
- Temperature 36.9 °C (98.4 °F), heart rate 84 bpm, no signs of local infection.
- Fingerstick glucose 210 to 245 mg/dL over the last 24 hours.
- Eating about 40% of meals; albumin 2.8 g/dL.
- Neither she nor her daughter knows when to perform hand hygiene.
Nursing diagnosis
Risk for infection related to inadequate care of the insertion site, insufficient protein intake and insufficient knowledge of infection prevention, in a patient with a central venous catheter, indwelling urinary catheter and diabetes mellitus (associated conditions).
Goal
Patient remains afebrile, with no signs of infection at the catheter site or in the urine, throughout the hospital stay.
Interventions
- Change the catheter dressing using aseptic technique and date it.
- Review daily with the provider whether the urinary catheter is still needed.
- Monitor blood glucose per the ordered schedule and report out-of-range values.
- Request a dietitian consult and offer a supplement if recommended.
- Teach the patient and her daughter hand hygiene and warning signs.
Evaluation
By day 5 she is still afebrile, the insertion site is clean and dry, and the urinary catheter was removed on day 5. Intake rose to 75% and both demonstrate hand hygiene. The diagnosis stays active while the central line remains in place.
How it differs from similar diagnoses
- Risk for surgical wound infection (00500): More specific: it applies to the surgical site. If the risk is general, use 00004.
- Risk for shock (00205): If an infection is already present and threatens perfusion, the focus shifts to risk for shock.
- Hyperthermia (00007): Hyperthermia is an actual (problem-focused) diagnosis: the temperature is already elevated. Risk for infection is used before any signs appear.
Common mistakes
- Adding an "as evidenced by" clause to a risk diagnosis.
- Keeping the diagnosis after the infection is confirmed: at that point you work with the actual problems it causes (hyperthermia, pain, impaired tissue integrity).
- Listing only medical conditions as factors ("related to diabetes") with nothing nursing can modify.
- Applying it to every inpatient without specific factors that justify it.
Used in these conditions
Other diagnoses in the Infection class
Domain 11, Safety / protection. See every diagnosis in this domain.
Frequently asked questions
What is the NANDA code for risk for infection?
00004. It belongs to Domain 11 (Safety/protection), Class 1 (Infection), and is still current in the 2024-2026 edition.
Does risk for infection need an "as evidenced by" part?
No. Risk diagnoses only include risk factors, because there are no signs yet.
Is an IV catheter a risk factor?
It is an invasive procedure, which the taxonomy treats as an associated condition. It raises the risk, but nursing acts on factors such as hygiene and knowledge.
What's the difference from risk for surgical wound infection?
00500 focuses on the surgical site. 00004 is general.
When do I resolve this diagnosis?
When the factors behind it are gone, for example once the catheter is removed and intake recovers. If an infection develops, resolve it and write diagnoses for the actual problems.
Study material: the explanation, characteristics, factors, examples and case study on this page were written by our editorial team. The official text for Risk for infection (00004) is in NANDA International Nursing Diagnoses: Definitions and Classification 2024-2026. This page does not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes · Spanish edition table of contents · NOC/NIC: source 1, source 2, source 3. Reviewed November 2, 2026.