Epidemiological Surveillance of Nursing Diagnoses (ESND) represents an emerging field within Community and Public Health Nursing, aiming to strengthen the visibility of nursing‑sensitive phenomena in health information systems. This study applied the Community Assessment, Intervention and Empowerment Model (MAIEC) to evaluate the empowerment level and diagnose the community process of a Primary Health Care Island Unit in the Autonomous Region of the Azores, Portugal, regarding the promotion of ESND. A descriptive, cross‑sectional design was used, combining documental analysis, a community empowerment assessment, and a structured questionnaire administered to 172 nurses. Results revealed substantial gaps in community leadership, including low levels of knowledge about ESND, the Local Health Diagnosis, and documentation in priority ICNP® foci. Community participation indicators showed limited clarity of the ESND process, low awareness of organizational structures and partnerships, and a lack of visible formal leadership. Community coping was characterized by minimal prior ESND experience and low training levels, although more than half of participants identified contextual strengths. Overall, the findings indicate a community with developmental potential but requiring targeted interventions to strengthen leadership, participation, and coping capacities. Enhancing training, communication, and organizational structures will be essential to support the sustainable implementation of ESND and reinforce the contribution of nursing to public health surveillance.

This study assessed community process and empowerment in a Primary Healthcare Island Unit in the Azores to support the implementation of Epidemiological Surveillance of Nursing Diagnoses (ESND), focusing on three priority areas: tobacco use, drug dependence, and adolescent decision-making related to sexuality and life planning. Strengthening the visibility of nursing-sensitive phenomena requires integrating nursing diagnoses into epidemiological surveillance systems. A multimethod descriptive study was conducted between September and November 2025, combining document analysis, a community empowerment assessment, and a structured questionnaire. The total population included 328 nurses, with 172 participants (response rate: 52.4%) using a non-probabilistic sampling approach. Data were analyzed using descriptive statistics (frequencies, percentages, means, and standard deviations). Priority nursing foci were identified according to the ICNP^® 2019 classification: tobacco use, drug dependence, and decision-making process related to sexuality and life planning. Results showed that all three dimensions of the MAIEC were weak: community leadership was limited, particularly in knowledge indicators; participation was constrained by unclear organizational structures and insufficient communication; and coping capacity was insufficient due to limited training and experience. Empowerment assessment confirmed structural weaknesses in leadership, organizational support, and resource mobilization. Overall, the community process and empowerment profile indicate that the conditions required to sustain ESND are not yet sufficiently developed. Strengthening leadership, improving communication, and expanding training in ESND and ICNP^® documentation are essential to support nurse-centered surveillance and enhance the visibility of nursing contributions to population health.