Critical Thinking Flashcards
Essential in the nursing process.
Involves knowing as much as possible about each patient
Need to sort out the information into patterns to clarify problems, recognize changes, and make appropriate care decisions under pressure
Essential process for safe, efficient, and skillful nursing intervention
Improves patients’ outcomes
Critical Thinking
__________ = problem solving approach that nurses use to define problems and select appropriate treatment
Clinical decision making
___________ is a conclusion about a patient’s needs or health problems. What is going on with the patient and what is the best action to take in response? Good clinical judgment and decision making require you to investigate and analyze all aspects of the clinical problem and then apply scientific and nursing knowledge to choose the best course of action.
Clinical judgment
It is influenced by a nurse’s experience and knowledge. Your experience and knowledge help you to better determine what your assessment data means. Each pt you care for builds your experience and knowledge.
Clinical Judgment in Nursing Practice
_________ does involve knowing your patient, as well. What is their baseline? How do they typically respond to things? You need to get to know your patient and what their concerns are. Don’t just rely on the chart information or experience with other patients. Each pt is an individual with problems that are as unique as they are. Their problems are influenced by their physical health, lifestyle, culture, relationships, living environment, and their experiences.
So, you don’t always have a completely clear idea of what your patient’s needs are or what interventions are appropriate when you first meet them.
Clinical judgment
Conclusion about a patient’s needs or health problems
Influenced by a nurse’s experience and knowledge
Partly relies on knowing the patient
Influenced by the context of clinical situations and the culture of patient care settings
Nurses use a combination of different reasoning approaches
Clinical judgment in Nursing Practice
The ability to think in a systematic and logical manner
Critical Thinking
A continuous process
Identifying issues, analyzing and interpreting information, then drawing conclusions
Evidence-based knowledge in __________
critical thinking
____________ requires you to recognize issues, analyze and interpret information, then make conclusions based on this interpretation. (does this sound familiar? Like coming up with a nursing diagnosis)
Critical thinking
Interpretation
Analysis
Inference
Evaluation
Explanation
Self-regulation
Critical Thinking Skills
In nursing practice, this is collecting patient data in an orderly fashion; using reasoning while looking for patterns; categorizing the data (like with nursing diagnoses); and collecting more data or clarifying data that you are not sure about (confirm that chart data with the patient, for example).
Interpretation
Being open-minded when you examine patient data and not making careless assumptions; Does the data support what you believe about a problem, or could it be something else?
Analysis
Look at the meaning and significance of your findings. Are there any relationships between the findings? Does the data help you see that a problem exists?
Inference
Look at all situations objectively (putting your feelings or biases aside); Use certain criteria to evaluate (what are the expected outcomes, pain characteristics, or learning objectives for the patient?) to determine the results of your actions. Reflect on your actions and behavior.
Evaluation
Support your findings and conclusions with data and evidence-based rationale. Using knowledge and experience to choose the best strategies to use in caring for patients.
Explanation
Reflect on your experiences. Be responsible for connecting your actions with outcomes. Identify how you can improve your performance as a nurse. Think about what will make you believe that you have been successful in caring for your patients.
Self Regulation
t/f: reflection is intuitive?
FALSE, it is not intuitive
R Recall the events. Review the facts about the situation and describe what happened.
E Examine your responses. Think about your thoughts and actions at the time of the situation.
F Acknowledge feelings. Identify any feelings you had during the situation.
L Learn from the experience: Review and highlight what you have learned from the situation –such as your actions and the patient responses to them. This includes learning from mistakes you or others have made.
E Explore options: Think about your options for similar situations in the future.
C Create a plan of action: How will you act in the future with similar situations?
T Set a time for your plan of action to be completed by.
REFLECT model
It is purposefully visualizing a past situation and taking the time to honestly review everything you remember about it.
Allows you to gain new knowledge and raise questions about your practice
Improves ability to problem solve
Reflection
This is where you start to rely less on expert opinion and trust your own decisions more. This allows you to be more flexible to change viewpoints and find original solutions to specific problems when traditional interventions are not effective
Complex critical thinking
______________ the student is more task oriented and focused on performing skills and nursing care activities. Thinking is more concrete and based on rules and principles. You are more likely to follow procedures step by step, rather than adjusting them to the patient’s unique needs. Learners at this level haven’t had the experiences to anticipate how to individualize procedures when problems occur.
Basic level of critical thinking
This is where a nurse can anticipate when to make choices without assistance from others and accept accountability for the decisions that they make. At this level, you choose actions that are based on the available alternatives and support it. Because of this accountability, you look at the results of your decision and determine if it was appropriate (this occurs with reflection and evaluation).
Commitment critical thinking
The book gave a great example with a patient not being able to deliver a medication dose from an inhaler. A nurse with ______ ______ might consult the procedure manual, while a nurse with ________thinking would recognize that cannot activate it due to weakness in their hands and find a type of inhaler that they could activate. They would also give the patient instructions for coordinating the inhalation of the medication
basic critical thinking, complex critical
At this level, you choose actions that are based on the available alternatives and support it. Because of this accountability, you look at the results of your decision and determine if it was appropriate (this occurs with reflection and evaluation).
commitment critical thinking
___ ____ _____are the cognitive processes that a nurse uses to make judgments about the clinical care of patients. These include general critical thinking and specific critical thinking.
Critical thinking competencies
Identify the problem; collect data; formulate a question or hypothesis; test the question or hypothesis; and evaluate the results of the test or study.
five steps in the scientific method
_____ _____ _____ is a general type of critical thinking that uses a methodical process to problem solve with reasoning.
The scientific method
_____ ______ requires you to obtain information that clarifies the nature of the problem, suggest possible solutions, and try the solution over time to make sure it is effective. With patient care, solutions need to be consistently effective to help the patient become stable. If a problem recurs, then you need to try other options. Each time you solve a problem this adds to your nursing experience, so that you can apply it to future situations.
Problem solving
_____ _______ occurs when you select a course of action from several options. Following a set of criteria can help guide your decisions. The criteria can be based on personal standards, organizational policies or standards, or professional nursing standards. To make the decision, a person must first identify the problem, assess their options, weigh each option against the criteria, test possible options, consider the consequences of the decision, and make the final decision. A person may go back and forth in the steps of this process to consider all the criteria. This helps you make informed conclusions that are supported by evidence and reasoning.
Decision making
Diagnostic reasoning and inference
Clinical decision making
Inductive reasoning
Inference
Deductive reasoning
Knowing the patient
Specific critical thinking
______ ________ is a specific type of critical thinking. This involves being able to understand and think through clinical problems, look for clues, understand the meaning of evidence (the signs, symptoms, and behaviors presented by the patient), and know when you have enough evidence to make an accurate nursing diagnosis. Your nursing diagnosis needs to be accurate so that the interventions select are appropriate to the patient and their problem.
Diagnostic reasoning
Part of diagnostic reasoning is the decision-making skill of inference. __________ involves forming patterns of information with data that lead you to make the nursing diagnosis. If a patient had a surgical incision, was guarding the area, had a tense facial expression, and experienced tenderness around the incision site, you would most likely infer that the patient had the nursing diagnosis of acute pain.
Inference
_____ _____ _____ is the same as decision making but involves choosing a course of action to resolve a patients’ clinical problem. You identify the problem (nursing diagnosis) then select the best interventions for it, that are relevant to that patient. Effective clinical decision making requires inductive reasoning, inference, deductive reasoning, and knowing the patient.
Clinical decision making
A set of facts and observations about a patient lead a nurse to make generalizations. When these facts and observations are viewed together, they suggest a particular interpretation. This leads to inference. The conclusion made may not be correct.
Inductive reasoning
while ___________is forming a conclusion about related pieces of evidence, it also considers your previous experiences. Example: you may infer that a patient is at risk of falling when you observe that they have weak extremities, an unsteady gait, and have a history of falls, while also considering your experience with patients who have been fall risks or have fallen.
inference
_______ _______moves from a general concepts or rules to specific conclusions. If all patients need airway clearance to breathe, then having an ineffective airway clearance would be a priority nursing diagnosis that require interventions to help clear their airway.
deductive reasoning
The nursing process requires a nurse to use the __________ and ____________ critical thinking competencies
general, specific
Reflective journaling
Meeting with colleagues
Concept mapping
ways of developing critical thinking skills
Competence
Specific knowledge base
Experience
The nursing process competency
Attitudes for critical thinking
Standards for critical thinking
model components of a critical thinking model for clinical decision making
