Critical Thinking and Nursing Judgment


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  • Critical thinking involves taking a situation and evaluating it considering all the aspects using a knowledge base gathered through experience and ethical principles.
    We begin by asking questions and formulating a plan of care based on the needs of the patient and our knowledge of best practices, or EVIDENCE BASED PRACTICE.
  • Nursing Practice Application - pg 81
    1. collect and clarify data in an orderly fashion
    2. be open minded and do not make assumptions
    3. look for relationships within information you have collected
    4. be objective in your determination of the nursing action you need to perform
    5. make sure you have support in your conclusions and use experiential knowledge and scientific bases
    6. review your methods and correct any problems identified
  • Basic – learner believes that the experts are correct and do thing according to the book
    Complex – the critical thinker begins to develop their own way of thinking
    Ex.- Doctors orders state the patient must walk 4x a day but he is vomiting and is unable to do as ordered
    Commitment – person accepts responsibility of making own decisions or is accountable for actions
  • Scientific – uses reasoning to solve problems, used by nurse resershes
    identify the problem
    collect the data
    formulate the hypothesis – a way to study the problem
    test the hypothesis – see if it works
    Problem solving – obtain information and find a solution and then solve problem and evaluate the solution
    Decision making – end point of critical thinking
    define problem
    assess the options
    weigh all the factors
    make final decision
    Diagnostic reasoning – using the data you gather to determine plan of care
    Clinical decision making – making a decision based on a problem which has been identified
    involves determining the priority thing to do
  • Read pages 88-92
  • Explained on page 93 and 94
  • Critical Thinking and Nursing Judgment

    1. 1. 1Slide 1 Critical ThinkingCritical Thinking and Nursing Judgmentand Nursing Judgment NPN 105 Joyce Smith RN, BSN
    2. 2. 2Slide 2 What is Critical Thinking?What is Critical Thinking? • It is something you do every day • It is a life skill you learned as you developed into adulthood • It is not a difficult task • It is the way you make decisions in your daily life • It can also be called deductive reasoning • It is a system which allows nurses to make choices which are best for the patients
    3. 3. 3Slide 3 Clinical DecisionsClinical Decisions in Nursing Practicein Nursing Practice • Clinical decision-making skills separate professional nurses from technical and ancillary staff. • Patients have problems for which there are no textbook solutions. • You need to seek knowledge, act quickly, and make sound clinical decisions.
    4. 4. 4Slide 4 Critical Thinking DefinedCritical Thinking Defined • Profetto-McGrath and others (2003) • Critical thinking is both a process and set of skills. • Chaffee (2002) • Active, organized, cognitive process used to examine one’s thinking and that of others • Settersten and Lauver (2004) • Recognize, analyze, evaluate, and draw conclusions
    5. 5. 5Slide 5 Critical Thinking SkillsCritical Thinking Skills • Interpretation • Analysis • Inference • Evaluation • Explanation • Self-regulation
    6. 6. 6Slide 6 Attributes of a Critical ThinkerAttributes of a Critical Thinker • Seek the truth, nothing but the truth • Accept others ideas and beliefs • Watch for problems and plan for them ahead of time • Be organized and work toward good results • Trust in your own abilities • Look for opportunities for learning • Realize that there may be other ways besides yours
    7. 7. 7Slide 7 Aspects of Critical ThinkingAspects of Critical Thinking • Reflection • Review what you did and ways to improve • Did you follow the standards? • Language • Always communicate clearly to the patient and staff • Intuition • Develop a “gut feeling” based on your experience and knowledge
    8. 8. 8Slide 8 Thinking and LearningThinking and Learning • Levels of thinking in nursing • Basic critical thinking • Complex critical thinking • Commitment
    9. 9. 9Slide 9 Critical Thinking CompetenciesCritical Thinking Competencies • Scientific method • Problem solving • Decision making • Diagnostic reasoning • Clinical decision making • Nursing process
    10. 10. 10Slide 10 A Critical Thinking ModelA Critical Thinking Model • Models serve to explain concepts and help you make decisions and judgments about your patients. • Kataoka-Yahiro and Saylor (1994) • Define the outcome of critical thinking as nursing judgment that is relevant to nursing problems in a variety of settings
    11. 11. 11Slide 11 Components of Critical ThinkingComponents of Critical Thinking • Five components of critical thinking • Knowledge base • Experience • Competence • Attitudes • Standards
    12. 12. 12Slide 12 Nursing Process OverviewNursing Process Overview • Use of the nursing process enables the nurse to: • Assess a patient’s health care needs • Determine nursing diagnosis • Plan care • Implement nursing interventions • Evaluate the effectiveness of care