nursing process & critical thinking cld

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A review of the nursing process. Critical thinking

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nursing process & critical thinking cld

  1. 1. Nursing Health Assessment Maria Carmela L. Domocmat, MSN, RN Instructor, Nursing Health Assessment School of Nursing Northern Luzon Adventist College
  2. 2. • Review of the Nursing Process• Critical Thinking Maria Carmela L. DOmocmat. RN, MSN
  3. 3. Nursing Process: A Review• What is the nursing process and why learn about it? Maria Carmela L. DOmocmat. RN, MSN
  4. 4. Nursing Process• Nursing Process and Maslow are the main frameworks for the local board and the NCLEX Exams.• Remember ONLY the RN can assess, develop a plan of care, evaluate and educate clients. Maria Carmela L. DOmocmat. RN, MSN
  5. 5. Nursing Process cont.• is the framework for professional nursing practice. Maria Carmela L. DOmocmat. RN, MSN
  6. 6. Nursing Process cont.• Is a systematic, dynamic way of giving systematic, nursing care• Promotes humanistic, outcome-focused, humanistic, outcome-focused, cost- cost-effective care Maria Carmela L. DOmocmat. RN, MSN
  7. 7. Nursing Process cont.• Pushes nurses to continually examine what they are doing and to study how it can be done better.• Consists of five interrelated steps Maria Carmela L. DOmocmat. RN, MSN
  8. 8. Nursing Process cont.1. Assessment2. Diagnosis3. Planning4. Implementing5. Evaluating Maria Carmela L. DOmocmat. RN, MSN
  9. 9. Maria Carmela L. DOmocmat. RN, MSN
  10. 10. Nursing Process• Why systematic?• Why dynamic?• Why humanistic?• Why outcome-focused? outcome-• Why cost-effective cost- Maria Carmela L. DOmocmat. RN, MSN
  11. 11. Systematic• Like a problem-solving method problem-• It consists of five steps during which you take deliberate steps to maximize efficiency and attain long-term long- beneficial results. Maria Carmela L. DOmocmat. RN, MSN
  12. 12. Dynamic• As you gain more experience, you’ll find yourself moving back and forth between the steps, sometimes combining activities, yet getting the same end result. Maria Carmela L. DOmocmat. RN, MSN
  13. 13. Dynamic cont.• For example, new nurses often need to methodically assess a patient for quite some time before coming to a diagnosis, whereas experienced nurses often immediately suspect a diagnosis, then assess the patient more closely to see of they are correct. Maria Carmela L. DOmocmat. RN, MSN
  14. 14. Humanistic• The nursing process involves looking at the whole patient at all times.• It personalizes the patient.• As nurses, we deal with the body, mind and spirit.• He is not "the CVA in bed # 5." Maria Carmela L. DOmocmat. RN, MSN
  15. 15. Humanistic• We strive to understand each individual’s health problems and the corresponding impact on one’s sense of well-being and ability to do daily well- activities. Maria Carmela L. DOmocmat. RN, MSN
  16. 16. Humanistic• The process provides a roadmap that ensures good nursing care and improves patient outcomes. Maria Carmela L. DOmocmat. RN, MSN
  17. 17. Outcome- Outcome-focused• Result-oriented Result-• The steps of the nursing process are designed to keep the focus on determining whether people seeking health care are getting the best results in the most efficient way. Maria Carmela L. DOmocmat. RN, MSN
  18. 18. Why learn about it?• The nursing process provides the basis for the board exams –you need to be thoroughly familiar with it to think your way to through the questions. Maria Carmela L. DOmocmat. RN, MSN
  19. 19. Why learn about it?• It help you think critically in the clinical setting— setting—you must master the principles behind the nursing process. Maria Carmela L. DOmocmat. RN, MSN
  20. 20. Why learn about it?• Using the nursing process complements what other health care professionals do by focusing on both the medical problems and human response –how the person responds to medical problems, treatment plans, and changes in activities of daily life. Maria Carmela L. DOmocmat. RN, MSN
  21. 21. ComparisonPhysician’s data Nurse’s data• Disease focus Wholistic focus – considering their problems and their effect on the person’s ability to function independently. Maria Carmela L. DOmocmat. RN, MSN
  22. 22. Physician’s data• Mrs. Garcia has pain and swelling in all joints. Diagnostic studies indicate that she has rheumatoid arthritis. We will start her in a course of anti-inflammatories to treat anti- the rheumatoid arthritis.• (Focus is on treating the arthritis) arthritis) Maria Carmela L. DOmocmat. RN, MSN
  23. 23. Nurse’s data• Mrs. Garcia has pain and swelling in all joints, making it difficult to dress herself. She has voiced that it’s difficult to feel worthwhile when she can’t even feed herself. She states that she is depressed because she misses seeing her two small grandchildren. Maria Carmela L. DOmocmat. RN, MSN
  24. 24. Nurse’s data• We need to develop a plan to help her pain, to assist with her feeding and dressing, to work through feelings of low self- self-esteem, and for special visitations with the grandchildren.• (Focus is on Mrs. Garcia) Maria Carmela L. DOmocmat. RN, MSN
  25. 25. WHAT IS CRITICALTHINKING IN NURSING? Maria Carmela L. Domocmat, RN, MSN
  26. 26. Critical Thinking Maria Carmela L. DOmocmat. RN, MSN
  27. 27. Critical Thinking• Unlike the mindless thinking we do when we do our daily routine, critical thinking is careful, deliberate, outcome- outcome- focused (results-oriented) (results- thinking. Maria Carmela L. DOmocmat. RN, MSN
  28. 28. What is critical thinking in nursing?Critical thinking in nursing:• Entails purposeful, outcome-oriented outcome- (results- (results-oriented) thinking.• Is driven by patient, family, and community needs. Maria Carmela L. DOmocmat. RN, MSN
  29. 29. Critical thinking in nursing:• Is based on principles of nursing process and scientific method• Requires knowledge, skills and experience• Is guided by professional standards and ethics codes. Maria Carmela L. DOmocmat. RN, MSN
  30. 30. Critical thinking in nursing:• The ability to: • identify a problem • analyze it • develop a response • follow through Maria Carmela L. DOmocmat. RN, MSN
  31. 31. Critical thinking in nursing:• Requires strategies that maximize human potential (e.g., using individual strengths) and compensate for problems created by human nature (e.g., the powerful influence of personal perspectives, values and beliefs.) Maria Carmela L. DOmocmat. RN, MSN
  32. 32. Critical thinking in nursing:• Is constantly re-evaluating, self- re- self- correcting, and striving to improve.(Source: Alfaro-LeFevre (1999). Critical thinking in nursing: Alfaro-A practical approach. Philadelphia: W. B. Saunders. ) Maria Carmela L. DOmocmat. RN, MSN
  33. 33. How to Become a Critical ThinkerCritical thinking is like any other skill: if you practice it, it becomes more automatic. Maria Carmela L. DOmocmat. RN, MSN
  34. 34. • Take a few moments to look at the list of the characteristics of critical thinkers, and evaluate your current habits of thinking• Check each characteristics and ask yourself, “Is this me?”• Put a mark next to the ones you want to develop or improve. Maria Carmela L. DOmocmat. RN, MSN
  35. 35. Characteristics of Critical ThinkersCritical Thinkers are:• Aware of their strengths and capabilities: capabilities: They’re confident that they can reason to find answers and make good decision. Maria Carmela L. DOmocmat. RN, MSN
  36. 36. • Sensitive to their own limitations and predispositions: predispositions: They know their weaknesses, values, and beliefs and recognize when these may hamper their ability to assess a situation or solve a problem. Maria Carmela L. DOmocmat. RN, MSN
  37. 37. • Open minded: They listen to new ideas minded: and viewpoints and consider the situation from many perspectives. Maria Carmela L. DOmocmat. RN, MSN
  38. 38. • Humble: They overcome their own Humble: tendency to feel that they should have all the answers. Maria Carmela L. DOmocmat. RN, MSN
  39. 39. • Creative: They are constantly looking Creative: for better ways to get things done. They follow recommended procedures; however, they continually examine whether these are the best way to meet the goals and objectives. Maria Carmela L. DOmocmat. RN, MSN
  40. 40. The Client in Context• Proactive: they accept Proactive: responsibility and accountability for their actions. They study situations, anticipate problems, and find ways to avoid them before they happen. Maria Carmela L. DOmocmat. RN, MSN
  41. 41. • Flexible: They recognize the Flexible: importance of changing priorities and interventions when planned approaches don’t seem to be getting results. Maria Carmela L. DOmocmat. RN, MSN
  42. 42. • Aware that errors are stepping-stones stepping- to new ideas: They turn mistakes into ideas: learning opportunities, reflecting on what went wrong and identifying ways to avoid the same mistake in the future. Maria Carmela L. DOmocmat. RN, MSN
  43. 43. • Willing to persevere: They know that persevere: sometimes there are no easy answers and that there may be time-consuming time- struggles to find the best answer. Maria Carmela L. DOmocmat. RN, MSN
  44. 44. • Cognizant to the fact that we don’t live in a perfect world: world: • They realize that sometimes the best answer may not be the perfect answer. answer. Maria Carmela L. DOmocmat. RN, MSN
  45. 45. • Introspective: Introspective: • They evaluate and correct their own thinking. Maria Carmela L. DOmocmat. RN, MSN
  46. 46. Critical Thinkers also:• Maintain questioning attitude: attitude: • They ask questions like: “What’s going on here?”; “What does it mean?”; and “What else could it mean, and how else could it be interpreted?” Maria Carmela L. DOmocmat. RN, MSN
  47. 47. • Ask for clarification when they don’t understand: understand: • For example, they say, “I’m not clear about this. Can you tell me more?” or ask questions like, “What do you mean by better, better in what way?” Maria Carmela L. DOmocmat. RN, MSN
  48. 48. • Apply previous knowledge to new situations: situations: • They see similarities and differences between one experience and another, between one concept and another. Maria Carmela L. DOmocmat. RN, MSN
  49. 49. • See the situation from many perspectives: perspectives: • They value all viewpoints and watch that their judgments are based on facts, not facts, personal feelings, views, or self-interests. self- Maria Carmela L. DOmocmat. RN, MSN
  50. 50. • Weigh risks and benefits (advantaged and disadvantages) before making a decision: decision: • They avoid risky decisions and find ways to reduce adverse reactions before putting a plan into action. Maria Carmela L. DOmocmat. RN, MSN
  51. 51. • Seek help when needed. needed.• Put first things first: first: • They ask, “What is the most important thing to do here?” Maria Carmela L. DOmocmat. RN, MSN
  52. 52. Critical Thinkers use logic.• They test first impressions to make test sure they are as they appear: appear: • They double-check the logic of their double- thinking and workability of their solutions. Maria Carmela L. DOmocmat. RN, MSN
  53. 53. • Distinguish between fact and fallacy: fallacy: • They take time to verify important information to be sure it’s true. Maria Carmela L. DOmocmat. RN, MSN
  54. 54. • Distinguish fact from inference (what they believe the fact means): means): • For example, they recognize that because someone is sitting quietly in a corner may not mean that the individual is withdrawn; withdrawn; It means that they are sitting quietly in a corner and that it would be helpful to find out why. Maria Carmela L. DOmocmat. RN, MSN
  55. 55. • Support views with evidence: evidence: • They wouldn’t state that the person above is withdrawn without providing additional supporting evidence, such as the individual saying he wants nothing to do with anyone. Maria Carmela L. DOmocmat. RN, MSN
  56. 56. • Determine what’s relevant and what’s irrelevant: irrelevant: • They recognize what’s important for understanding a situation and what’s unimportant. Maria Carmela L. DOmocmat. RN, MSN
  57. 57. • Apply the concept of “cause and effect”: effect”: • They look for what’s causing a problem to more fully understand the problem itself. They anticipate responses to their actions before performing the actions. For example, critical thinkers would attempt to find out the cause of pain before deciding how to treat it. They would determine how someone might respond to a medication before administering it. Maria Carmela L. DOmocmat. RN, MSN
  58. 58. • Withhold judgment until all the necessary facts are in: in: • They realize the dangers of jumping to conclusions. Maria Carmela L. DOmocmat. RN, MSN
  59. 59. Maria Carmela L. DOmocmat. RN, MSN
  60. 60. 15 minutes

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