Ongoing evaluation of the use of nursing diagnoses at the clinical level is critical to the facilitation of further development and refinement of the language of nursing. Therefore, the purpose of this study was to identify the status of utilization of nursing diagnosis in Illinois. A survey instrument was mailed to 239 Illinois hospitals 139 (58%) responded. Results included: 78% of the responding hospitals had implemented nursing diagnosis, with almost all (95%) utilizing NANDA terminology. Components of continuing education efforts related to nursing diagnosis were identified by 75% of the hospitals. Ongoing monitoring of quality improvement methods was reported by 45% of the respondents. The barriers to implementation cited most frequently included: limited ongoing education, lack of motivation to learn, or nurses’ difficulties in adjusting to its us