Chapter 15: Critical Thinking in Nursing Flashcards
Keep looking for resources until you find successful approach. Not satisfied with minimal effort but works to achieve highest level of care.
Ex: patient unable to speak, nurse finds different communicating approach until an appropriate solution is found. This is what attitude in critical thinking?
Perseverance
Original thinking. Find solutions outside standard routine of care, while staying inside standards of practice. This is what attitude in critical thinking?
Creativity
A.The Scientific Method
The way to solve problems using reasoning.
1. Ex. Problem Solving and Assessment
2.Ex. Checking Labs, X-Rays, and Nutritional Status
3. Ex. Find a relationship between the Data and the Problem to develop a Nursing Diagnosis
4. Ex. Apply intervention after determining Nursing Diagnosis
5. Ex. Reassess the patient and see if you were correct.
- Identifying the Problem
- Collecting Data
- Formulating a Question or Hypothesis
- Testing the Question or Hypothesis
- Evaluating Results of the Test or Study
Honest and willing to admit mistakes or inconsistencies in his or her own behavior, ideas and beliefs. Ex: Nurse tries to follow highest standards of practice. This is what attitude in critical thinking?
Integrity
Challenge the way others think and look for rational and logical answers to problems. Independent thinking and reasoning improve nursing practice by raising important questions. This is what attitude in critical thinking?
Thinking Independently
Does not always have negative outcomes. Willingness to take chances comes from experience with similar problems. This leads to advances in patient care. This is what attitude in critical thinking?
Risk Taking
Favorite question is “why?” Data patterns appear that are not always clear. This is what attitude in critical thinking?
Curiosity
You will rethink situation, learn more, use new information to form opinions and take action. This is what attitude in critical thinking?
Humility
Raises the bar on the responsibility and accountability that a nurse assumes when guaranteeing quality health care to the public. Ex. Criteria used for staging for pressure ulcers. This is what standard for Critical Thinking?
Professional Standards
This helps identify problem accurately and appropriate intervention.
Ex: Patient in pain instead of pain scale you can ask specific questions on character of pain. Such as where does it hurt? What makes it worse? This is what attitude in critical thinking?
Discipline
Intellectual and emotional growth impacts learning new knowledge and refining your ability to think, problem solve, and make judgements.
Thinking and Learning
This is what specific critical thinking competency? EX: patient lost appetite and weight over last month. Nurse reports nutritional problem, she forms nursing diagnosis of imbalanced nutrition that is less than body requirements. You cannot make diagnosis on first meeting with patient. When uncertain of diagnosis continue data collection.
Inference
Look at situation objectively and consider all viewpoints to understand the situation completely before making a decision. Ex: if you do not agree with obesity you do not allow your personal feelings to patient care if they are overweight. This is what attitude in critical thinking?
Fairness
This is a guideline or principle for rational thought. They are applied when using the nursing process. Preciseness, accuracy, consistency must be use to make sure all clinical decisions are sound. This is what standard for Critical Thinking?
Intellectual Standards
Process involving critical appraisal of information that results from recognizing a problem? Is this considered Critical Thinking or Clinical Decision Making?
Clinical Decision Making
Care planning tool that assists in critical thinking and forming associations between a patients nursing diagnosis and interventions.
Concept Map
Formal means to discuss allows a dialogue, deferring viewpoints, and sharing experiences. Much can be learned from hearing others perspectives and experiences to promote reflective critical thinking. What is the name of this practice that develops your critical thinking skills?
Meeting with Colleagues
This is what specific critical thinking competency? EX: patient is light headed with blurred vision and history of diabetes. Nurse observes patterns and themes which include weakness, hunger, visual disturbances. Which suggests hypoglycemia. The nurse makes decision to use food that contains glucose.
Diagnostic Reasoning
Ex. Methodically inspects the infected area of the skin, measures the size of the ulcer, and notes the appearance of any drainage. Asks the patient how she cared for her ulcer to determine if teaching was necessary. Asked her what exactly did she use to wash the ulcer and how often? This is what standard for Critical Thinking?
Intellectual Standards
This is what specific critical thinking competency? Nurse identifies patient problem and selects nursing intervention. This can be improved by knowing patient.
Clinical Decision Making:
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. Is this considered Critical Thinking or Clinical Decision Making?
Critical Thinking
This is what general critical thinking competency? EX: This occurs when the patient decides on health care provider. This leads to informed conclusion that are supported by evidence and reason. Is this considered Critical Thinking or Clinical Decision Making?
Clinical Decision Making
Process involving critical appraisal of information that results from recognizing a problem and ends with generating, testing, and evaluating a conclusion. Comes at the end of critical thinking.
Clinical Decision Making
Process that enables an observer to assign meaning and to classify phenomena in clinical situations by integrating observations and critical thinking.
Diagnostic Reasoning
Knowledge based on research or clinical expertise, makes you an informed critical thinker.
Evidence-Based Knowledge
Determine to find effective solutions. Learn as much as possible about problem and try various approaches to care. This is what attitude in critical thinking?
Perseverance
Sometimes an action can be not acting or delaying an action until a later time. Delays are chosen as a result of your experience and knowledge. Evaluate results for appropriateness for the situation. What level of critical thinking is this?
Commitment Level of Critical Thinking
The process of drawing conclusions from related pieces of evidence and previous experience with the evidence. This is what part of the critical thinking process?
Inference
Systematic problem solving method by which nurses individualize care for each patient.
The Nursing Process
The process of purposefully thinking back or recalling a situation to discover its purpose or meaning. This is what part of the critical thinking process?
Reflection
Nursing students ask yourself these questions: What do i know to improve the patients condition?
In which way will specific therapies affect the patient?
What should be my first action?
Thinking and Learning
Used for testing research questions in nursing practice situations.
Scientific Method
Benner defines ”________” is a judgment that requires clinical and reflective thinking and action and application of scientific and practical logic.”
Clinical Decisions Making
Methodical, systematic approach to explore conditions and develop solutions, including analysis of data determination of causative factors, and selection of appropriate actions to reserve or eliminate the problem.
Problem Solving
A nurse takes an educated risk when a patient was on the brink of death. She saved the patients life but was called to the board of ethics and defended her decision with journals regarding advances in evidence based practice supporting her actions. Her case was dismissed. What level of critical thinking is this?
Commitment Level of Critical Thinking
Consider what is important depending on the situation. Explore and imagine creative alternatives. Considers ethical principles. Is this considered Critical Thinking or Clinical Decision Making?
Critical Thinking
In Practice: Learn how to introduce yourself to a patient. Speak with conviction when you begin a treatment or procedure. Always be prepared before performing a nursing activity.
Encourage patient to ask questions. This is what attitude in critical thinking?
Confidence
Makes informed decisions about the care of patients? Always ask why? what am I missing? What do I really know about this patients situation? And what are my options? Stay informed and do research though nursing literature and journals. Is this considered Critical Thinking or Clinical Decision Making?
Critical Thinking
You are responsible for performing based on nursing standard practice. Nurses are answerable or accountable for decisions and outcome of actions. This is what attitude in critical thinking?
Responsibility and Accountability
Knowledge prepares you to anticipate your patients needs, identify, and offer appropriate care.
Requires cognitive skills and the habit of asking questions, remaining well informed, being honest and facing personal biases, and always be willing to reconsider and think clearly about issues. This is what part of the critical thinking process?
Evidence
Look at the big picture from all perspectives.
Focus on options for solving problems and making decisions rather than quickly and carelessly forming quick solutions. Avoid premature and inappropriate decisions. This is what part of the critical thinking process?
Evidence
Must be flexible and open to learning new information.
You will become better at forming assumptions presenting ideas, and making valid conclusions.
Thinking and Learning
Be orderly in data collection. Look for patterns to categorize data and clarify any data you are uncertain about. This is what part of the critical thinking process?
Interpretation
Learn to look beyond the obvious. Explore the patients unique responses and recognize what actions are needed to benefit the patient?
Thinking and Learning
Be open minded as you look at information about a patient. Do not make careless assumptions. Does the data reveal what you believe is true or are there other options? This is what part of the critical thinking process?
Analysis
Look at the meaning and significance of findings. Are there relationships between these findings? Does the data about the patient help you see a problem that exists? This is what part of the critical thinking process?
Inference
In Practice: Recognize when your opinions conflict with those of a patient. Do not compromise nursing standards or honesty when delivering nursing care. This is what attitude in critical thinking?
Integrity
Nursing students ask yourself these questions:
What is the patients status now?
How am I to change and why?
Which physiological and emotional responses do I anticipate?
Thinking and Learning
Look at all situations objectively. Use designated criteria, expected outcomes, pain characteristics, and learning objectives to determine results of nursing actions and reflect on your own behavior. This is what part if the critical thinking process?
Evaluation
This involves investigating clinical situations so you get all information needed to make decision. Ex: question family, consulting physician, reviewing scientific literature. This is what attitude in critical thinking?
Curiosity
Answers to problems are right or wrong and one right answer usually exists for each problem. Early step in developing reasoning. Weak competencies and inflexibility lead to the inability to advance. What level of critical thinking is this?
Basic Level of Critical Thinking
Learner trusts that experts have the right answers for every problem. Not open minded to alternative therapies. Thinking is concrete and set on rules and principles. No experience to individualize procedures. What level of critical thinking is this?
Basic Level of Critical Thinking
Reflect on your own experiences. Identify the ways you can improve your own performance. What will make you believe that you have been successful? This is what part of the critical thinking process?
Self-Regulation
Ex. Using a manual to insert a Foley cath. What level of critical thinking is this?
Basic Level of Critical Thinking
This is a visual representation of patients problems and interventions that show their relationship to one another. Non-linear view of problems that can be used to create a care plan. What is the name of this practice that develops your critical thinking skills?
Concept Mapping
Critical thinking shows the complex nature of clinical decision making.
Use critical thinking to become an advocate and make better informed choices about their care.
This is what part of the critical thinking process?
Evidence
Begin to separate themselves from experts. They analyze and examine choices more independently. Looks beyond expert opinions. What level of critical thinking is this?
Complex Level of Critical Thinking
Support your finding and conclusions. Use knowledge and experience to choose strategies to use in the care of patients. This is what part of the critical thinking process?
Explanation
Motivates you to think of options and unique approaches.
Ex: patient has difficulty getting out of chair because of knee pain. Nurse puts wood blocks under chair to elevate so patient can sit or stand with ease. This is what attitude in critical thinking?
Creativity
Anticipates when to make choices without assistance from others and accepts accountability. Choose an action or belief based on the available alternatives and support it. What level of critical thinking is this?
Commitment Level of Critical Thinking
What are the four Components of Critical Thinking?
Competencies Attitudes Standards Experiences Specific Knowledge Base
This is what general critical thinking competency? Obtain information and use it plus what you already know to find a solution.
Problem Solving
Cognitive process a nurse uses to make judgments about the clinical care of patients.
General and Specific Critical Thinking Competency
Level 3 Commitment
Level 2 Complex
Level 1 Basic
What are these levels called?
Levels of Critical Thinking
This is what general critical thinking competency? The criteria may be personal based on an organized policy or a professional standard. EX: patient care priority, choosing dressing wound, or best teaching approach for family care giver. Is this considered Critical Thinking or Clinical Decision Making?
Decision Making
This is what general critical thinking competency? Ex. Patient Non compliant with medications has difficulty reading labels and doesn’t know the times of administration. Nurse gives patient time rationed pill organizer and has pharmacist increase font size on bottles.
Evaluate solution to maintain effectiveness. This is what part of the critical thinking process?
Problem Solving
Alternative and conflicting solutions exist. Each solution has benefits and risks that must be weighed before making critical decisions. Becomes creative and innovative open-minded to other options to routine procedures when complications arise. What level of critical thinking is this?
Complex Level of Critical Thinking
This is what specific critical thinking competency? Analytic process for determining patient Health problems. Accurate recognition is necessary before deciding on solutions or implementation actions. Assign meaning to behavior and physical symptoms, this begins when interact with patient.
Diagnostic Reasoning
Admit any limitations to knowledge or skill. Admit what you do not know and locate the information needed to make an informed decision. This is what attitude in critical thinking?
Humility
This is what general critical thinking competency? Recognize or define the problem or situation, and assess all options. The person has to weigh each option against a set of personal criteria, test possible outcomes or options, consider consequences, and make final choice. Is this considered Critical Thinking or Clinical Decision Making?
Clinical Decision Making
Refers to ethical criteria for nursing judgments. Evidence based criteria used for evaluation and criteria for professional responsibility. Requires you to use critical thinking for the good of individuals or groups. This is what standard for Critical Thinking?
Professional Standards
In Practice: Listen to both sides in any discussion. If a staff member labels a patient uncooperative. Assume care of that patient with openness and the desire to meet that patients needs. This is what attitude in critical thinking?
Fairness
This is what specific critical thinking competency? Asses/monitor patients closely and compare signs and symptoms with those that are common to their medical diagnosis. This helps health care providers to pinpoint nature of problem quickly to select proper therapies.
Diagnostic Reasoning
Drawing conclusions from pieces of evidence and previous experience with the evidence. This involves forming patterns of information from data before making diagnosis. This is what part of the critical thinking process?
Inference
Use “_______” to set priority of what intervention to implement first.
Clinical Decision Making
Nurse must observe clinical situations, asks questions, considers what she knows about post-operative pain and risk for immobility, and takes action. Is this considered Critical Thinking or Clinical Decision Making?
Clinical Decision Making
In Practice: Use known scientific and practice based criteria for activities such as assessment and evaluation. Take time to be thorough and manage your time effectively. This is what attitude in critical thinking?
Discipline
These are the steps to selecting what?
- Identify status of patient
- Data collected from patient
- Knowledge of clinical variables and how they are linked
- Judgment of likely outcomes of events and outcome
- Considering any health risks to patient
- Relevant data about patients daily life, functional capacity, and social resources
- Knowledge about nursing therapy options.
How to select a nursing therapy.
Ability to think critically, improve clinical practice, and decrease error in clinical judgments is vision on nursing practice.
Critical Thinking Model for Clinical Decision Making
Nurses knowledge varies according to education, experience, continued education. Nurses must think holistically about patients problem. This makes up what branch of Clinical Decision Making?
Specific Knowledge Base
Practiced discipline, and clinical rotations are necessary to acquire clinical decision making skills to develop this. Knowledge with clinical expertise gained through learning defines critical thinking. This makes up what part of the critical thinking process?
Experience
Nursing Practice is a reflection of this? Maintain a sense of self- awareness through conscious awareness of their beliefs, values, feelings, and multiple perspectives that patients, family members, and peers present in clinical situations. This is what standard for Critical Thinking?
Professional Standards
In clinical situations you learn from observing, sensing, talking, and reflecting actively. With experience you begin to understand clinical situation, recognize cue from patient, health patterns, and interpret cues as relevant or irrelevant. This makes up what part of the critical thinking process?
Experience
The nursing process is not a critical thinking competency. True or False?
False
Knowing when you need more information, knowing when information is misleading, and recognizing own knowledge limits are example of how this decides critical thinking. This is what part of the nursing process?
Attitudes for Critical Thinking
Physical health, lifestyles, culture relationships with family and friends, living environment, and experiences creates every unique patient. Is this considered Critical Thinking or Clinical Decision Making?
Clinical Decision Making
Ex: why is one type of surgical dressing ordered over another.
In Practice: Read the nursing literature, talk with other nurses, and share ideas about nursing interventions. This is what attitude in critical thinking?
Thinking Independently
Critical thinker deals with situations justly. No biased or prejudice will enter into situations. This is what attitude in critical thinking?
Fairness
You feel certain about accomplishing task or goal. Such as performing procedure or making diagnostic decision. Lack of this attitude leads to anxiety and distracts from giving patient attention. This is what attitude in critical thinking?
Confidence
You are accountable for recognizing when nursing care is ineffective and knowing scope of practice limits.
Ex: Failing to identify patient or preparing medication for multiple patients at the same time. This is what attitude in critical thinking?
Responsibility and Accountability
This can be used as a model to decide on what is priority in nursing care?
Maslow’s Hierarchy of Needs
Critical thinking is a reasoning process by which you reflect on and analyze your own thoughts, actions, and knowledge. Then you incorporate elements of critical thinking with the nursing process.
Critical Thinking Synthesis
In Practice: Ask for help if you are uncertain about how to perform a nursing skill. Report any problems immediately and follow standards of practice in your care. This is what attitude in critical thinking?
Responsibility and Accountability
When doing something new and innovative consider all options, follow safety guidelines, analyze any potential danger to patient and act in well reasoned, logical, and thoughtful manner. This is what attitude in critical thinking?
Risk Taking
Misses few details and follows orderly or systematic approach when collecting information, making decisions, or taking action. This is what attitude in critical thinking?
Discipline
In Practice: If problems of the same type continue to occur on a nursing division bring coworkers together look for a pattern and find a solution. Don’t always select the easy or first answer. This is what attitude in critical thinking?
Perseverance
Process of purposefully thinking back or recalling a situation to discover its purpose or meaning. What is the name of this practice that develops your critical thinking skills?
Reflective Journaling
In Practice: Look for different approaches if interventions are not working for a patient when appropriate involve the patients family in adapting your approaches to care methods used at home. This is what attitude in critical thinking?
Creativity
In Practice: Explore and learn more about the patient so as to make appropriate clinical judgments. This is what attitude in critical thinking?
Curiosity
Documents using anatomical terms. Able to determine that ulcer healed and since the last assessment by following the same policies used for the first assessment. This is what standard for Critical Thinking?
Intellectual Standards
Clinical practice guidelines include standards for the treatment of select clinical conditions such as stroke, deep vein thrombosis, and pressure ulcers. Standards of nursing are the same cited in the ANA nurse practice acts. This is what standard for Critical Thinking?
Professional Standards
Helps to synthesize relevant data about a patient, including assessment data, nursing diagnosis, health needs, nursing interventions, and evaluation measures. What is the name of this practice that develops your critical thinking skills?
Concept Mapping
Discussing anticipated and unanticipated outcomes in any clinical situation allows you to learn and develop your expertise and knowledge. What is the name of this practice that develops your critical thinking skills?
Meeting with Colleagues
Helps to gain a holistic view of the patient’s diagnosis and the data that supports it to better understand the patients clinical situation. Similarities and differences that you see among patients build your decision making skills. What is the name of this practice that develops your critical thinking skills?
Concept Mapping
In Practice: Recognize when you need more information to make a decision. Ask RNs regularly assigned to the area for assistance with approaches to care. This is what attitude in critical thinking?
Humility
Involves recognizing that an issue exists.
Analyzing information about the issue.
Evaluating information. Making conclusions.
Is this considered Critical Thinking or Decision Making?
Critical Thinking
uestion and test own knowledge and beliefs. This builds trust with coworkers. This is what attitude in critical thinking?
Integrity
Non-linear process. Nurse must assess changes of condition and take action. Nurses are not told what to do like a NAP. This is what part of the critical thinking process? Is this considered Critical Thinking or Decision Making?
Clinical Decisions Making
Ex. Patient has pain but refuses ordered pain medications. Nurse fears delay in healing. Upon communicating with patient nurse learns that patient prefers to meditate. Nurse begins to use non-pharmacological pain relief interventions. What level of critical thinking is this?
Complex Level of Critical Thinking
Be aware of what you know and what you do not know. Never attempt procedure on patient unless you have knowledge or based or feel confident. Builds trust between you and your patient. This is what attitude in critical thinking?
Confidence
Involve ability to recognize that problems exist and that there is need for evidence to support truth in what you think is true. Interpreting, evaluating, and making judgment about adequacy of various arguments and available data are important parts of critical thinking. This is what part of the nursing process?
Attitudes for Critical Thinking
In Practice: Be willing to recommend alternative approaches to nursing care when colleagues are having little success with patients. This is what attitude in critical thinking?
Risk Taking
You learn to consider wide range of ideas and concepts before forming opinion or judgment. You do not ignore other peoples ideas instead you consider all sides of a situation. This is what attitude in critical thinking?
Thinking Independently
This is what specific critical thinking competency? Ex: patient is less mobile and develops red area. The nurse makes a decision that identifies problem of impaired skin integrity in form of pressure ulcer and implemented skin care and turning schedule. Used to reduce severity of problem or reduce problem completely. Patient should be center of focus during clinical situation. Is this considered Critical Thinking or Clinical Decision Making?
Clinical Decision Making
