The purpose of the present study is to examine the reliability of items in an assessment guide for a specific diagnostic label, self‐care deficit, and its etiologies/contributing factors. Subjects assessed were 30 patients from an acute orthopedic unit in a large medical center. First, an estimate of internal consistency as a measure of reliability was obtained for items measuring self‐care deficit (Cronbach's alpha. 0.83). Second, inter‐rater reliability was obtained for the formulation of complete diagnostic statements; that is, selfcare deficit with etiologies. An 88% agreement was found with respect to the diagnosis self‐care deficit, bathing related to immobility. Overall, agreement on the five most commonly found nursing diagnoses with their etiologies was 69%. The use of an assessment instrument that has reliability and validity may contribute to more accurate diagnostic decisions and impact on appropriate and effective nursing interventions. Further work on assessment parameters for both the diagnostic labels and their etiologies/contributing factors, and the linking of diagnoses to interventions is reco