Critical thinking process
provides nurses with the ability to use purposeful thinking and reflective reasoning to examine ideas, assumption, principles, conclusions, beliefs and actions in the context of professional nursing practice.
Watson & glaser 1964 concept of critical thinking
combination of abilities needed to define problems, recognize assumptions, formulate and select hypothesis, draw conclusions, and judge validity of interferences.
Scriven & Paul 1987 concept of critical thinking
Critical thinking is that mode of thinking about any subject, content, or problem in which the thinker improves the quality of his or her thinking by skillfully taking charge of the structures inherent in thinking and improving intellectual standards upon them.
(process of self disciplined, self directed rational thinking verifies- what we know and clarifies what we do not know)
Ennis 1989 concept of critical thinking
Reasonable reflective thinking focused on deciding what to believe or do
importance of critical thinking
to function effectively in complex rapidly changing health care environments nurses must use high order thinking skills and apply content knowledge to clinical practice in order to provide safe and effective care to diverse populations.
reflective thinking
is an active process valuable in learning and changing behaviors, perspectives, or practices
nursing process
A method of critical thinking focused on solving patient problems in a professional practice.
(represents a universal intellectual standard by which problems are addressed and solved.)
steps of the nursing process
- Assessment - collecting data
- Diagnosis- analyzing data gathered identifies the problem
- Planning- (plan of care) identification of pt goals and determination of how to reach said goals and selecting pt interventions
- Implementation- of planned interventions (when nursing orders are actually carried out.)
- evaluation- nurse examines the pt’s progress in relation to the goals and outcome criteria to determine whether a problem is resolved, is in the process of being resolved, or is in resolved.
step 1 nursing process
Assessment - collecting data
Step 2 of the nursing process
Diagnosis- analyzing data gathered identifies the problem
step 3 nursing process
Planning- (plan of care) identification of pt goals and determination of how to reach said goals and selecting pt interventions
step 4 nursing process
Implementation- of planned interventions (when nursing orders are actually carried out.)
step 5 nursing process
evaluation- nurse examines the pt’s progress in relation to the goals and outcome criteria to determine whether a problem is resolved, is in the process of being resolved, or is in resolved
importance of evaluation (step 5 nursing process)
was care plan effective, if it wasn’t go back and reassess the situation change the care plan and evaluate if that was effective
the model that tanner developed in 2006
clinical judgement model- to consistently make good clinical judgements in rapid changing nursing environment
4 major phases of clinical judgement model
- noticing
- interpreting
- responding
- reflecting
contextualization
helps nurses to apply clinical reasoning to a specific pt situation and make appropriate pt-specific clinical judgements. contextualization uses clinical judgement and critical thinking to develop critical reasoning
(put into context then apply knowledge & critical thinking to help pt have a better outcome)
critical reasoning
helps with multiple variables that can happen in pt care
example of multiple variable
two pts come in for appendectomy 1 is 26yr old no med history. 1 is 56yr old w/ COPD & HTN both are having appendectomy but the context s different
novice nurses (new to nursing)
- need to follow clear cut rules
- often unaware of resources
- lack knowledge gained from actual doing
- may be hindered by anxiety and lack of self confidence
expert nurse (old nurse)
- stores knowledge in highly organized structured manner
- aware of resources
- usually more self confident
- knows which rules are flexible and when it is appropriate to bend the rules
- assess and considers different options or intervening before acting
Subjective data
describes pt needs, feelings, strengths, perceptions of the problem. (symptoms)
objective data
collected through observation and are measurable (vitals, signs)
nursing diagnosis
identifies the problems the pt is experiencing as a result of the disease process (the human response to the illness, injury or threat) (PES writing nursing dx P-problem NANDA label E-Etiology casual factors S- Signs &symptoms defining characteristics
