class 5 critical thinking Flashcards
Critical thinking is a combination of:
what 4 things?
reasoned thinking
openness to alternatives
an ability to reflect
a desire to seek truth.
Critical thinking definition
Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief of action.
Critical Thinking Skills
When planning nursing care, what 3 things do nurses do?
Gather information about the client
Draw tentative conclusions about the meaning of the information to identify the client’s problems.
Think of several different actions they might take to help solve or relieve the problem.
Concepts for a Critical Thinker
Critical thinkers are:
(5 things)
thinf
Flexible Nonjudgmental Inquisitive Honest Interested in seeking the truth.
3 Critical Thinking Competencies
Problem solving
Decision making
Clinical reasoning
4 examples of Clinical Decision Making
Scientific knowledge base
Experience
The nursing process competency
Attitudes for critical thinking
12 Attitudes for Critical Thinking
Courage Independent thinking Fairness Responsibility and accountability Risk taking Discipline Perseverance Creativity Curiosity Integrity Humility Empathy
Developing Critical Thinking Skills
(Seeing the BIG picture)
4 examples
Reflective journaling
Concept mapping
Case study discussion
Collaboration
Reflective Journaling
What do we ask in a deliberative process?
what 3 questions do we ask ourselves
(question may have to be rewritten when I understand wtf)
A deliberative process
What did I learn?
What did I miss?
How do I feel about it?
What are the implications for the future?
How will I deal with this next time?Colleagues
reword
Report Post Conference Case Models Simulation Collaboration Study groups
How do I learn?
(and how do my patients learn?)
what 5 considerations?
Education Experience Psychosocial needs Spiritual needs Cultural values
what are the Three Domains of Learning?
Cognitive learning
Affective learning
Psychomotor learning
Cognitive Learning Behaviors
includes what type of behaviors?
requires what?
Includes all intellectual behaviors and requires thinking.
what 6 things would we use with Cognitive Learning Behaviors
Knowledge Comprehension Application Analysis Synthesis Evaluation
Knowledge-Level Question example:
What do I know?
Who was the founder of the red cross?
Florence Nightingale
Dorothea Dix
Isabel Robb
Clara BartonClara Barton
what do you ask yourself with a Knowledge-Level Question
What do I know?
what do you ask yourself with a Comprehension-Level Question
What do I understand?
Comprehension-Level Question example:
What do I understand?
What is the Nursing Process?
The relationship between health care professionals
Standard for nursing practice
Description of nurse-patient relationship according to Peplau
Legally binding agreement for liability coverage for all nurses
insert answer here
what do you ask yourself with an Analysis-Level Question
What does it mean?
How do I step back, think and reflect?
Analysis-Level Question example:
Which of the following would be a priority for a student with getting a low grade? Select all that apply.
Cut back on work Organize daily schedule Drop the class Spend more time studying Do some reflective journaling
insert answer here
Application-Level Question what do you ask yourself?
How do I use it?
What do I do?
Application-Level Question example:
How do I use it? What do I do?
Which Standard of Professional Performance applies when you maintain CONFIDENTIALITY of patient information?
Quality of care
Performance Appraisal
Ethics
Collaboration
insert answer here
Synthesis and Evaluation-Level Question what do you ask yourself?
what is the response?
Synthesis and Evaluation-Level Question example:
A nurse has lost her license for diversion of controlled substances.
What does this tell you?
The nurse was under investigation by the Health Professional Recovery Program (HPRP)
The hospital failed to report the nurse to the Department of Consumer and Industry Affairs
The nurse likely has a past criminal record
The nurse was probably not following the treatment plan of the HPRP
insert answer here
Affective Learning Behaviors involves what 2 things?
within those 2 things (above) what 4 things does that include?
Involves changes of feelings and acceptance of attitudes, opinions or values.
Includes receiving and responding to new ideas, demonstrating a commitment to new ideas,
integrating new ideas into value system
what 3 teaching methods of Affective learning
Teaching methods for affective learning:
1:1 Listen
Discussion group
Role plays
what is Psychomotor Learning & Teaching Methods
Acquiring skills that include the integration of mental and muscular activity
Psychomotor Learning & Teaching Methods
Acquiring skills that include the integration of mental and muscular activity
what are the 5 skills? (is this question correct?)
Demo Practice Return demo with feedback Learner uses new skills under supervision Independent
does your state participate in the Nurse Licensure Compact?
Michigan is not a compact state
how might Nurse licensure compact be important when you become licensed in your state after graduation
The Nursing Licensure Compact (NLC) allows nurses to have one license to practice in multiple states. There are currently 34 states participate in LNC, meaning: they recognize the multi state license or have legislation pending
what is different bwtn certificate and licensure
perry and potter pg 10
liscensure is a nursing requirement to ensure minimum knowledge of nursing practice is met regardless of the nursing program completed. All 50 states require RN to pass the NCLEX-RN
certificate: beyond NCLEX-RN: work toward certification in a specific are of nursing practice. minimum requirements are set. Examples: critical care nurse, maternal-child nurse, research nurse
provide 3 examples how malpractice lawsuits could happen
Intentional tort: assault, battery, false imprisonment
quasi-intentional tort: invasion of privacy, defamation of character (slander, libel)
unintentional tort: negligence, malpractice
how can a nurse ensure that a malpractice action does not occur?
follow standards of care
adhere to policy and procedures of facility
give competent care
communicate with other providers
compassionate/caring rapport with patient / family members
accurate and timely documentation
patient 2:
The patient is a 20 year old male admitted to the ED with complaints of dizziness, weakness, and fatigue for 2 weeks. He is a college student that admits to being a strict vegan for the last 2 years. He does not eat meat, dairy or nuts. a CBC is drawn. Hemoglobin is 9.0 and hematocrit is 28. no signs of GI bleed.
name 2 nursing interventions:
teach importance of a diet high in iron increase H & H (oxygen transport to cells)
provide list of foods high in iron (spinach, legumes, pumpkin seeds, quinoa, broccoli, tofu)
religion plays and important role in recovery for many hospitalized patients
provide 2 nursing interventions that could assist a patient with spiritual needs
referral to spiritual care service. if religious preference, notify spiritual leader
referral for baptism services for newborn upon request
race can impact the illness of an individual due to biologic differences in those vulnerable to a specific disease.
provide an example of a specific condition related to race
perry and potter pg 541
skin cancer is higher in Caucasians
prostate cancer is higher in black men
culture plays a role in the hospitalized patient.
2 examples nursing interventions for each patient that would assure cultural caring
patient 1: 48 year old female that is 1st day post op with bariatric sleeve for weight loss. her goal is to lose 100lbs in the next year:
perry and potter pg 796
teach importance of exercise for health promotion and weight loss. patient will ambulate around the unit ever 2 hours during hospitalization. upon discharge, patient will ambulate 500 feet 3x/day; increasing distance by 100 ft per day
teach importance of adherence to diet plan. patient will consume 1 ounce of protein drink every hour. upon discharge patient will increase diet as ordered to clear liquids as instructed
culture of safety
list 3 strategies that healthcare organizations can implement to faster a safe and caring environment for the client
new hire orientation that includes policies, procedures, equipment demonstrations and a mentor
patient centered care strategies
patient rounding every hour of shift
accreditation of the facility (the joint commission or others)
annual education requirements including CPR
culture of safety
what does a patient-centered care mean, and why is it relevant to nursing?
potter and Perry pg 24
patient centered care is an approach to health care delivery that builds relationships among the healthcare providers, patients and their families.
Leads to improved outcomes and patient satisfaction.
Identifying expectations, knowledge, preferences, cultural beliefs, and values is an important part of patient centered care
culture of safety
how can an adverse event occur in the healthcare setting?
not following polices and procedures of the healthcare facility
list 5 interventions that nurses can implement to prevent an adverse event in the healthcare setting
proper body mechanics with lifting / moving patients
gait belt when ambulating a patient
infection control: hand washing b4 and after each patient encounter
infection control: adherence to isolation procedures
safety: identify patient with 2 identifiers
what is living will used for in health care
it is a written document that directs treatment in accordance with a patient’s wishes in the event of a terminal illness or condition. the patient is able to declare which medical procedures her or she wishes to have or not have when no longer able to speak for themselves
organizational ethics committees provide nurses with:
the teaching and processing of ethical issues and dilemmas. provide clinical ethics, consultations, developing and/or revising policies and procedures
how does ethical decision making apply to nursing students
health care ethics will change as socity and technologies change, but the common denominators remain:
the basic process to address issues and the nurses’ responsibility to deal with them,.
as future nurses, students will have a basic understanding of ethics and the steps to resolve an ethical dilemma
explain how the profession of nursing incorporates ethics into practice and the profession
perry and potter page 296
- ask the question, is this an ethical dilemma?
- gather information related to the case.
- clarify values, distinguish fact from opinion and values
- verbalize the problems. a clear simple statement of the issue
- identify possible course of action
- negotiate a plan
- evaluate the plan over time
what is the research process?
an orderly series of steps that allow a researcher to find answers to questions
a. identify a problem
b. review literature, develop a theoretical framework, discuss problem with experts
c. develop research questions / hypothesis
d. conduct the study
e. analyze the results - formulate recommendations for further research, determine implication for nursing, and release the findings
how does research relate to EBP?
perry and potter pg 60
provides knowledge that nurses will use to provide evidence-based nursing care
what is a systematic review
and
what are the types of systemic reviews
is a review of a clearly formulated question that uses systematic and reproducible methods to identify, select and critically appraise all relevant research, and to collect and analyze data from the studies that are included in the review.
- quantitative: will include studies that have numerical data.
- qualitative: derives data from observation, interviews, or verbal interactions and focuses on the meanings and interpretations of the participants. It will include focus groups, interviews, observations and diaries
Chochrane database of systematic review is a valuable source of high quality evidence.
MedLine & CINAHL are among the best-known online databases to search for scientific knowledge in healthcare
how do they??? relate to EBP
review of data about effects of the treatment and assess the evidence for any benefits or harms from those treatments. systematic review are able to summarize the existing clinical practice
what is their????? value to practice
practitioners can see considerable time and rely on someone else’s expertise when they are provided with access to evidence
why is EBP important to nursing practice?
the benefits of implementing EBP are numerous. increases in patient safety, reduction in variations of care, increases positive patient outcomes, and reduces costs associated with health care. as nurses we are accountable and responsible for providing the best nursing care possible. implementing EBP assists with effective, timely and appropriate clinical decisions.
what are the barriers to implementing EBP,
how might some of them be overcome?
barriers to successful implementation arise from multiple factors including varying education and clinical experiences of nursing staff, and a lack of understanding about its’ importance to optimal high quality patient care
