Critical Thinking

A continuous process characterized by open-mindedness, continual inquiry, and perseverance, combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant.

Critical Thinking

Recognizing that an issue exists analyzing information, evaluating information, and making conclusions.

Interpretation

Analysis

Inference

Evaluation

Explanation

Self-regulation

What are the 6 Critical Thinking Skills?

Learning

__________ is a lifelong process.

Intellectual, Knowledge

_______________ and _____________ growth involves learning new knowledge, as well as refining the ability to think, solve problems, and make judgments.

Science

The ____________ of nursing continues to grow. Nurses need to be flexible and open to new information.

Truth Seeking, Analytic approach, Maturity

Concepts for a Critical Thinker:

________ __________

Open-mindedness

__________ ____________

Systematic approach

Self-confidence

Inquisitiveness

__________

Knowledge base, Experience, Nursing process competencies, Attitudes, and Standards

What are the 5 components of Critical Thinking?

Scientific, Problem, Decision, Diagnostic, Clinical, Competency

What are the 6 Critical Thinking Competencies?

____________ method

___________ solving

____________ making

____________ reasoning and inference

___________ decision making

Nursing process as a ______________

Assessment, Diagnosis, Planning, Implementation, and Evaluation

What are the 5 steps of the nursing process?

Confidence, Responsibility, Discipline

Attitudes a nurse needs:

____________

Independence

Fairness

_______________

Risk taking

_____________

Nursing Assistive Personnel (NAP)

Effective communication is needed between registered nurses (RNs) and __________ _____________ _____________ for giving feedback and clarifying tasks and patient status.

Change

When patients' clinical conditions __________, warranting attention by RNs, clear directions are necessary to avoid missed care.

care

Applying critical thinking can help an RN make the decision about when to appropriate delegate _______.

Circle of Meaning

The ________ of ____________ model adapted to nursing encourages concept clarification and a search for meaning in nursing practice. Uses a series of questions to help you through a clinical experience and to find meaning.

Reflective Journaling

A tool used to clarify concepts through reflection by thinking back or recalling situations.

Concept Mapping

A visual representation of patient problems and interventions that illustrates an interrelationship.

Dialogue

When nurses have a form means to discuss their experiences such as a staff meeting or a unit practice council, the ____________ allows for questions, differing viewpoints, and sharing of experiences.

Criticism

When nurses are able to discuss their practices, the process validates good practice and offers challenges and constructive ______________.

Assessment, Nursing Diagnosis, Planning, Implementation, and Evaluation

What is the five-step nursing process model?

Critical Thinking Synthesis

A reasoning process used to reflect on and analyze thoughts, actions, and knowledge. Requires a desire to grow intellectually. Requires the use of nursing process to make nursing care decisions.

Clinical decision making

requires careful reasoning so that the options for the best client outcomes are chosen on the basis of the client's condition and the priority of the problem

Concept Map

visual representation of client problems and interventions that shows their relationship to one another.

Critical Thinking

involves using knowledge and thinking skills to evaluate evidence and explanations

Decision Making

the process of making a choice or finding a solution

Diagnostic reasoning

process of determining a client's health status after you assign meaning to the behaiors, physical signs, and symptoms presented by the client

Evidence-based knowledge

Knowledge that comes from scientific investigation or knowledge that is based on clinical expertise

Inference

logical interpretation based on prior knowledge and experience

Nursing Process

Systematic problem-solving method by which nurses individualize care for each client. The five steps of the nursing process are ASSESSMENT,NURSING DIAGNOSIS, PLANNING, IMPLEMENTATION, and EVALUATION.

Problem solving

process of cognition that occurs when a goal must be reached by thinking and behaving in certain ways

Prognosis

a prediction of the course of a disease

Reflection

process of purposefully thinking back or recalling a situation to discover it's purpose or meaning.

Scientific method

Problem identification, collection of data, formulation of a research question or hypothesis, testing the question or hypothesis, evaluating results of the test or study

clinical decision making

Problem-solving approach that nurses use to define patient problems and select appropriate treatment.

concept map

-Care-planning tool that assists in critical thinking and forming associations between a patient's nursing diagnoses and interventions

-a visual representation of patient problems and interventions that shows their relationships to one another

critical thinking

Active, purposeful, organized, cognitive process used to carefully examine one's thinking and the thinking of other individuals.

decision making

Process involving critical appraisal of information that results from recognizing a problem and ends with generating, testing, and evaluating a conclusion. Comes at the end of critical thinking

diagnostic reasoning

Process that enables an observer to assign meaning to and classify phenomena in clinical situations by integrating observations and critical thinking.

evidence-based knowledge

Knowledge that is derived from the integration of best research, clinical expertise, and patient values.

nursing process

Systematic problem-solving method by which nurses individualize care for each patient. The five steps of the nursing process are assessment, diagnosis, planning, implementation, and evaluation.

problem solving

Methodical, systematic approach to explore conditions and develop solutions, including analysis of data, determination of causative factors, and selection of appropriate actions to reverse or eliminate the problem.

reflection

Process of thinking back or recalling an event to discover the meaning and purpose of that event. Useful in critical thinking.

scientific method

Codified sequence of steps used in the formulation, testing, evaluation, and reporting of scientific ideas.

basic critical thinking

think concretely and on the basis of a set of rules or principles. Follow step-by-step process without deviation. Trust expert has the right answers.

basic critical thinking

Ex: Hygiene/Creating a Sterile Field - follow return demonstration step by step - DO NOT DEVIATE. Once have more experience - may change procedure slightly to individualize patient care. Clean to Dirty

complex critical thinking

analyzes and examines choices independently. Students learn to think beyond and synthesize knowledge

complex critical thinking

EX: Pt refusing to take medication, trouble shooting an IV pump, caring for a pt how leaves the room al the time.

commitment

the third level of critical thinking. Students (soon to be future nurses) anticipate needs and make choices without assistance from others. You choose an action or belief based on the alternatives.

5 steps of scientific method

identify problem, collect data, formulate hypothesis, test hypothesis, evaluate results

decision making

Product of critical thinking that focuses on problem resolution. Does not have to be a problem.

as soon as you receive info about a patient

when does Diagnostic reasoning & inference begin?

diagnostic conclusion

EX. Turn a pt, notice a redden area on the coccyx (tailbone), press it, redden color does not go away, form a __ that the pt has a pressure ulcer.

drawing conclusions

inference

problem solving

While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the point of connection between the tubing and the IV catheter, and then checks the condition of the site where the intravenous catheter enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct rate. This is an example of:

problem solving

The nurse collects information and tries options until she is able to find a solution to the slowed infusion rate. The focus is on solving the problem with the patient's IV and not on solving the patient's health problem; thus this is an example of __.

diagnostic reasoning process

when you are trying to solve the patient's health problem, you use the __

diagnostic reasoning

The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient reports she is unable to sleep, feels very fatigued during the day, and is having trouble at work. The nurse asks her to clarify the type of trouble. The patient explains she can't concentrate or even solve simple problems. The nurse records the results of the assessment, describing the patient as having ineffective coping. This is an example of:

conducting reflective practice

A patient on a surgical unit develops sudden shortness of breath and a drop in blood pressure. The staff respond, but the patient dies 30 minutes later. The manager on the nursing unit calls the staff involved in the emergency response together. The staff discusses what occurred over the 30-minute time frame, the actions taken, and whether other steps should have been implemented. The nurses in this situation are:

reflective practice

a conscious process of thinking, analyzing, and learning from previous work situations.

analyticity and self-confidence

A nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker and states, "I feel funny." The nurse knows how patients often have behavior changes before developing sepsis when they have cancer. The nurse asks the patient questions to assess thinking skills and notices the patient shivering. The nurse goes to the phone, calls the physician, and begins the conversation by saying, "I believe that your patient is developing sepsis. I want to report symptoms I'm seeing." What examples of critical thinking concepts does the nurse show?

analyticity

analyzing information, gathering additional findings, and sensing a problem

clinical decision making for groups of patients

Considering how to involve patients in decisions and how to combine nursing activities to be more organized and allow for resolving more than one problem at a time are examples of:

consistent

The surgical unit has initiated the use of a pain-rating scale to assess patients' pain severity during their postoperative recovery. The registered nurse (RN) looks at the pain flow sheet to see the pain scores recorded for a patient over the last 24 hours. Use of the pain scale is an example of which intellectual standard?

consistent

Use of the same pain scale for assessing pain acuity is an example of being

integrity

The nurse reviews the position of requiring exercises to restore function and decides to try a different approach to proceed, which is an example of:

basic critical thinking

A nurse has been working on a surgical unit for 3 weeks. A patient requires a Foley catheter to be inserted, so the nurse reads the procedure manual for the institution to review how to insert it. The level of critical thinking the nurse is using is:

evaluation

A patient had hip surgery 16 hours ago. During the previous shift the patient had 40 mL of drainage in the surgical drainage collection device for an 8-hour period. The nurse refers to the written plan of care, noting that the health care provider is to be notified when drainage in the device exceeds 100 mL for the day. On entering the room, the nurse looks at the device and carefully notes the amount of drainage currently in it. This is an example of:

knowledge application

The nurse asks a patient how she feels about her impending surgery for breast cancer. Before the discussion the nurse reviewed the description of loss and grief and therapeutic communication principles in his textbook. The critical thinking component involved in the nurse's review of the literature is:

commitment

Anticipating when to make choices during decision making is unique to the __ level of critical thinking

basic

thinking concretely is __ critical thinking

complex

Analyzing and examining choices and weighing benefits and risks are characteristic of __ critical thinking

Inference

process of drawing conclusions from related pieces of evidence and previous experience with the evidence

Nursing Process

-Five step clinical decision making approach: assessment, diagnosis, planning, implementation, and evaluation.

-Its purpose is to diagnose and treat human responses to actual or potential health problems.