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Fundamentals

Critical thinkingA 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
Recognizing that an issue exists, analyzing information, evaluating information, and making conclusionsClinical Decisions in Nursing PracticeClinical decision making requires critical thinking.
Clinical decision-making skills separate professional nurses from technical and ancillary staff.
Patients often have problems for which no textbook answers exist.
Nurses need to seek knowledge, act quickly, and make sound clinical decisions ONFUNDAMENTALS SPECIFICALLY FOR YOUFOR ONLY$13. 90/PAGEOrder NowThinking and LearningLearning is a lifelong process.
Intellectual and emotional growth involves learning new knowledge, as well as refining the ability to think, solve problems, and make judgments.
The science of nursing continues to grow. Nurses need to be flexible and open to new information. Critical Thinking SkillsInterpretation Inference
Explanation
Analysis
Evaluation
Self regulationInterpretationBe orderly in data collection. Look for patterns to categorize data, (nursing diagnosis). Clarify any data you are uncertain about. InferenceLook at the meaning and significance of findings. Are there relationships between findings? Do the data about the patient help you see that a problem exists? ExplanationSupport your findings and conclusions. Use knowledge and experience to choose strategies to use in the care of patients. AnalysisBe open minded as you look at information about a patient. Do not make careless assumptions. Do the data reveal what you believe is true, or are there other options? EvaluationLooking at all situations objectively. Use criteria (expected outcomes, pain characteristics, learning objectives) to determine results of nursing actions. Reflect on your own behavior. Self regulationReflect on your experiences. Identify the ways you can improve you own performance. What will make you believe that you have been professional. Concepts for a Critical ThinkingTruth seeking
Open-mindedness
Analytic approach
Systematic approach
Self-confidence
Inquisitiveness
MaturityTruth seekingSeeking the true meaning of a situation, be courageous hones and objective about asking questions. Open-mindednessbe tolerant of different views, be sensitive, to the possibility of you own prejudices, respect the right of others to have different opinions. Analytic approachanalyze potentially problematic situations, anticipate possible results or consequences, value reason, use evidence based knowledge. Systematic approachbe organized, focused, work hard in any inquirySelf-confidencetrust in your own reasoning processes. Inquisitivenessbe eager to acquire knowledge and learn explanations even when applications of the knowledge are not immediately clear. Value learning for learning’s sake. Maturitymultiple solutions are acceptable, reflect on your own judgments, have cognitive maturity. Levels of critical thinking1. Basic
2. Complex
3. CommitmentBasic critical thinkingearly step in developing reason.
one right or wrong, need to learn to accept diverse opinions and advise of expertsComplexBegin to separate themselves from experts.
analyze choices and realize there is other opinions and optionsCommitmenta person anticipates when to make choices without assistance from others and accepts accountability for decisions made.
make choice base on available alternatives and support it. Crtical Thinking competenciesScientific method
problem solving
decision making
diagnostic reasoning and inference
clinical decision making
nursing process as a competencyScientific methodA series of steps followed to solve problems using reasoning. Identifying the problem, collecting data, formulating a question or hypothesis, testing the question or hypothesis, and evaluating results of the test or study. problem solvinginvolves evaluating the solution over time to make sure that it is effective. decision makinga product of critical thinking that focuses on problem resolution. diagnostic reasoning and inferencethe analytical process for determining a patient’s health problems.
necessary before a solution. clinical decision makingmaking a decision to improve a patient’s health or maintain wellness. This means reducing the severity of the problem or resolving the problem completely. nursing process as a competencya competency when delivering patient care. the nursing process is a five step clinical decision making approach, assesment, diagnosis, planning, impelmentation, and evaluation. Components of critical thinkingStandards
Attitudes
Competencies
Experience
Specific knowledge baseStandardsrefer to ethical criteria for nursing judgements, evidence based criteria used for evaluation, and criteria for professional responsibility.
Use critical thinking for the good of individuals. Attitudesguideline for how to approach a problem or decision making situation. Competenciesthird component, applying critical thinking components. ExperienceNursing is a practice discipline, clinical learning experiences are necessary to acquire clinical decision making skills. Specific knowledge baseprepares you to better anticipate and identify patients problems by understanding their origin and nature, varies by educational experience. Nursing Process/AnalysisAssessment
Diagnosis
Planning
Implementation
EvaluationMeeting With ColleaguesWhen nurses have a formal means to discuss their experiences such as a staff meeting or a unit practice council, the dialogue allows for questions, differing viewpoints, and sharing of experiences.
When nurses are able to discuss their practices, the process validates good practice and offers challenges and constructive criticism. Caring for Groups of PatientsIdentify the nursing diagnoses and collaborative problems of each patient.
Decide which are most urgent.
Consider the time it will take to care for those patients.
Consider the resources that you have to manage each problem.
Consider how to involve the patients as participants in care.
Decide how to combine activities.
Decide which nursing care procedures to delegate.
Discuss complex cases with the health care teamReflective JournalingThe Circle of Meaning model adapted to nursing encourages concept clarification and a search for meaning in nursing practice.
The Circle of Meaning model uses a series of questions to help you through a clinical experience and to find meaning. Critical Thinking and DelegationEffective communication is needed between registered nurses (RNs) and nursing assistive personnel (NAP) for giving feedback and clarifying tasks and patient status.
When patients’ clinical conditions change, warranting attention by RNs, clear directions are necessary to avoid missed care.
Applying critical thinking can help an RN make the decision about when to appropriately delegate care. Critical Thinking SynthesisA 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

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