OPT: transformation of nursing process for contemporary practice.

Over time, clinical, educational, and social forces have influenced the development of three generations of traditional nursing process. The first generation was concerned with problems and process. Analysis of second-generation models revealed interest in understanding the nature of diagnosis and diagnostic reasoning. We have proposed a third generation model that underscores the importance of critical, metacognitive, and thinking skills that support outcome specification and testing in clinical reasoning. Clinicians, educators, managers, and administrators are invited to consider the OPT model as an alternative to traditional nursing process. The OPT model may be one of many transitional reasoning models needed for contemporary nursing practice.