38 terms

Chapter 15: Critical Thinking

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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.
clinical decisions in nursing practice
Nurses are responsible for making accurate and appropriate clinical decisions. This separates nurses from technical personnel. Nurse observes changes, recognizes potential problems, identifies new problems as they arise, takes immediate action.
evidence-based knowledge
Knowledge based on research or clinical expertise
critical thinking defined
Requires cognitive skills, the habit of asking questions, remaining well informed, being honest in facing personal biases, and always willing to reconsider and thinking clearly about issues.
Recognizing an issue exists, analyzing information, evaluation information, and making conclusions.
critical thinking skills
1. Interpretation.
2. Analysis.
3. Inference.
4. Evaluation.
5. Explanation.
6. Self-regulation.
interpretation
First critical thinking skill. Be orderly in data collection. Look for patterns to categorize data. Clarify any data you are uncertain about.
Analysis
Second critical thinking skill. Be 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?
Inference
3rd critical thinking skill. Look at the meaning and significance of findings. Are there relationships between findings? Does the data about the patient help you see that a problem exists?
Evaluation
4th critical thinking skill. Look at all the situations objectively. Use criteria (expected outcomes, pain characteristics, learning objectives) to determine results of nursing actions. Reflect on your own behavior.
Explanation
5th critical thinking skill. Support your findings and conclusions. Use knowledge and experience to choose strategies to use in the care of patients.
Self-regulation
6th critical thinking skill. Reflect on your experiences. Identify the ways you can improve your own performance. What will make you believe that you have been successful?
concepts for a critical thinker
1. Truth seeking.
2. Open-mindedness.
3. Analytic approach.
4. Systematic approach.
5. Inquisitiveness.
6. Maturity.
levels of critical thinking
Basic, complex, and commitment. Model that nursing students use when beginning critical thinking.
basic critical thinking
Early stage in developmental reasoning. Learns to accept the diverse opinions and values of experts.
complex critical thinking
Begin to separate themselves from experts. Analyze and examine choices more independently. Learns that alternative and conflicting solutions exist.
Commitment critical thinking
Anticipates when to make choices without assistance from others and accepts accountability for decisions made.
Critical thinking competencies
Scientific method.
Decision making.
Clinical decision making.
Problem solving.
Diagnostic reasoning and inference.
Nursing process as a competency.
scientific method
General critical thinking. The way to solve a problem using reasoning. Systematic, ordered approach to gathering data and solving problems.
five steps of the scientific method
1. Identifying the problem.
2. Collecting data.
3. Formulating a question or hypothesis.
4. Testing the question or hypothesis.
5. Evaluating results of the test or study.
problem solving
General critical thinking. Evaluating the solution over time to make sure that it is effective.
decision making
General critical thinking. A product of critical thinking that focuses on problem resolution.
diagnostic reasoning
Specific critical thinking. The analytical process for determining a patient's health problems. Requires you to assign meaning to the behaviors and physical signs and symptoms present by a patient.
inference
The process of drawing conclusion from related pieces of evidence and previous experience with the evidence. Involves forming patterns of information from data before making a diagnosis.
clinical decision making
Specific critical thinking. A problem solving activity that focuses on defining a problem and selecting an appropriate action. Requires careful reasoning.
nursing process
A five step clinical decision making approach; assessment, diagnosis, planning, implementation, and evaluation. Purpose is to diagnose and treat human responses to actual or potential health problems.
five components of critical thinking model
1. Knowledge base.
2. Experience.
3. Nursing process competencies.
4. Attitudes.
5. Standards.
Knowledge base
1st component of critical thinking model. Knowledge prepares you to better anticipate and identify patients problems by understanding their origin and nature. Nurses' knowledge continually changing as science progresses. Offers a physical, psychological, social, moral, ethical, and cultural view.
experience
2nd component of critical thinking model. Knowledge combined with clinical expertise from experiences defines critical thinking. Learn from observing, sensing, talking with patients and families, and reflecting on all experiences.
Nursing process competencies
3rd component of critical thinking. In your practice you apply critical thinking components during each step of the nursing process.
Attitudes
4th component of critical thinking. Confidence, independence, fairness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, humility. Guidelines for how to approach a problem or decision making situation.
Standards
5th component of critical thinking. Intellectual standard; guideline or principle for rational thought. Preciseness, accuracy, consistency.
Professional standards; Ethical criteria for nursing judgements, evidence based criteria used for evaluation, and criteria for responsibility.
developing critical thinking skills
It is important to learn how to connect knowledge and theory with practice.
Reflection
The process of purposefully thinking back or recalling a situation to discover its purpose or meaning.
reflective journaling
A tool used to clarify concepts through reflection by thinking back or recalling situations. Gives an opportunity to define and express clinical experience in your own words.
Concept mapping
A visual representation of patient problems and interventions that illustrates an interrelationship. Offers a nonlinear picture of a patient that can be used for comprehensive care planning. Assessment data, nursing diagnoses, health needs, nursing interventions, and evaluation measures.
meeting with colleagues
Regular meeting with colleagues to discuss and examine work experiences. Allows you to continually learn and develop expertise and knowledge.
Delegation
Effective communication is needed between RNs and CNAs for giving feedback and clarifying tasks and patient status. RN must follow up on task completion. Cannot assign task that requires teaching or an assessment.
critical thinking synthesis
A reasoning process used to reflect on and analyze thoughts, actions, and knowledge. Requires a desire to grow intellectually, and the use of nursing process to make nursing care decisions.
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