The author examined whether nurses in an acute care setting use nursing diagnoses and correctly construct nursing diagnostic statements. Using a retrospective chart audit of a 237–bed acute care hospital, the author examined 150 diagnostic statements written by registered nurses. The Ziegler Criteria for Evaluating the Quality of the Nursing Process (ZCEQNP) was used to measure the components of the nursing diagnostic statements. The ZCEQNP is composed of 12 specific criteria that judge a diagnosis in general, and the response and etiology components individually. The findings revealed that only 4 of 150 diagnostic statements met all 12 criteria. The etiology component of the diagnostic statements was the least accurate: Only 16 out of 150 diagnostic statements met all of the etiology criteria. The findings indicate that nurses do not accurately compose nursing diagnostic statements. Implications and strategies for improvement are suggeste