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Ever since nurses began examining and encouraging the use of nursing diagnosis, it has been a challenge to develop feasible labels. Progress, though, is being made. Developing nursing diagnoses that all nurses can use is the first step in identifying effective and appropriate interventions. This author has perceived the need to examine more closely the problem of urinary incontinence. A literature search combined with clinical observation and review of anatomy and physiology helped to identify five specific nursing diagnoses. They are: urinary retention, stress incontinence, urge incontinence, reflex incontinence, and uncontrolled incontinence. The following is intended to show the development of these nursing diagnoses and to examine what characteristics were helpful in their development.

At the first conference on nursing diagnoses, diagnostic labels were derived through brainstorming among nurses (Fehring, 1983). This was a starting place. At the sixth conference, Gordon (1984) expressed the need for refinement of nursing nomenclature and taxonomy to allow for a more cognitively manageable system of nursing diagnoses. She suggested that this refinement, in part, consist of brevity in labels and identification of a few critical defining characteristics for each diagnosis (Gordon, 1984).

At the fifth North American Nursing Diagnosis Association (NANDA) conference, a taxonomy was developed using all existing, accepted nursing diagnoses. It was discovered that labels are on several levels of abstraction. Many think that frustration in making diagnoses is in part related to use of labels that are too abstract. The committee that developed the taxonomic tree indicated areas where movement toward more concrete levels of diagnosis might occur.

This article describes the movement of a relatively abstract nursing diagnosis “Alterations in Urinary Elimination” to the formation of five more concrete diagnoses.