Critical Thinking & Clinical Judgement Flashcards
Are essential processes for safe, effecient, and skillful nursing intervention
critical thinking and clinical judgement
The ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process
Critical thinking
Aim to focus on the important issues in any clinical situation and make decisions that produce desired patient outcomes
Critical thinking
Enables you to face each new experience and problem involving a patient’s care with open-mindness, confidence, and continual inquiry
Sound clinical judgement
It is a process mastered only through experience, commitment, and an active curiosity toward learning
Sound clinical judgement
Partly relies on “knowing the patient” and the patient’s typical pattern of responses, as well as engaging with patients about their concerns
Sound clinical judgement
Are responsible for making accurate and appropriate clinical decisions that ensure patients receive safe, appropriate, timely, and effective nursing interventions
Registered Nurses (RN)
Defined by the national council of state boards of nursing (NCSBN) as the observed outcome of critical thinking and decision making
Clinical judgement
Is a conclusion about a patient’s needs or health problems that leads to taking or avoiding action, using or modifying standard approaches, or creating new approaches based on the patient’s response
Clinical judgement
It is a process that uses nursing knowledge, experience, and critical thinking to observe and assess presenting situations, identify a prioritized patient concern, and generate the best possible evidence-based solutions to make the decisions needed to deliver safe patient care
Clinical judgement
Are influenced more by nurse’s experience and knowledge than by the objective data about the situation at hand
Clinical judgement
Are influenced by the context of clinical situations and the culture of patient care settings
Clinical judgement
The format of this process is unique to the discipline of nursing and provides a common language and process for nurse to “think through” patient’s clinical problems
Clinical judgement
Requires a nurse to use general and specific critical thinking competencies
Clinical judgement
Separates proffessional nurses from technicians or other assistive personnel (AP
Clinical decision making
She described the research-based model of clinical judgement
Dr. Christine Tanner
Helps to explain concepts
Model
This model explains the many variables involved as you make decisions and clinical judgements about your patients
Clinical judgement model
Offers a valuable conceptual approach to understanding the nature of nursing practice
Clinical judgement model
Components of critical thinking in nursing judgement
Critical thinking competence
Knowledge base
Environment
Experience
Attitude
Standard
Guide nurses in making sound clinical judgements necessary for relavant and appropriate clinical decisions
Components of critical thinking
Described by the American nurses association (ANA) as the framework nurses use to apply critical thinking in nursing practice for making clinical decisions
Nursing process
A process described by ANA as having six steps: assessment, diagnosis, outcome identification, planning, implementation, and evaluation
Nursing process
The purpose of this is to diagnose and treat human responses to patient’s health problems
Nursing process
It encompasses significant actions taken by RNs and forms the foundation of the nurse’s clinical decision making
Nursing process
Allows nurses to help patients meet agreed-on outcomes for better health
Nursing process
Enables nurses to apply the nursing process in clinical decision making
Cognitive skills
6 (six) cognitive skills
- Recognize cues
- Analyze cues
- Prioritize problems/diagnoses
- Generate solutions
- Take actions
- Evaluate outcomes
Are the cognitive processes a nurse uses to make judgements about the clinical care of patients. These include general critical thinking, specific critical thinking in clinical situations, and specific critical thinking in nursing
Critical thinking competencies
Are not unique to nursing; they include the scientific method, problem solving, and decision making
General critical thinking
Include diagnostic reasoning and clinical decision making
Specific critical thinking competencies
Is the nursing process, which incorporates each of the specific critical thinking competencies
Specific critical thinking competency in nursing
Is a methodical way to solve problems by using reasoning
Scientific method
It is a systematic, ordered approach to gather data and solve problems
Scientific method
Healthcare researchers, including nurse scientists use this method when testing research questions
Scientific method
5 (five) steps of scientific method
- Identify problem
- Collect data
- Formulate a question or hypothesis
- Test the question or hypothesis
- Evaluate results of the test or study
Is an unsettled state
Problem
An action for a problem
Solution
Requires you to obtain information that clarifies the nature of problem, suggest possible solutions, and try the solution over time
to evaluate that it is effective
Problem-solving
Is one problem-solving approach that relies on one’s inner sense
Intuition
It is the ability to understand something immediately, without the need for conscious reasoning
Intuition
Often perceived as being a form of guessing and thus inappropriate when making nursing decisions; viewed by others as a legitimate approach to making clinical judgements
Intuition
Is commonly invoked for well-structured and familiar decision tasks
Intuitive thinking
Is triggered for ill-structured and unfamiliar decision tasks
Analytic thinking
Is a form of decision making that involves being able to understand and think through clinical problems, gather information about the problem, analyze clues and or individual cues, understand the meaning of evidence, and know when there is enough information (pattern of data) to make an accurate diagnosis
Diagnostic reasoning
The national academies of sciences, engineering, and medicine (2015) reports that the right ___ is a key aspect of healthcare because it explains a patient’s health problems and informs subsequent health care decisions
Diagnosis
It requires you to assign meaning to behaviours and physical signs and symptoms presented by a patient
Diagnosis
Is a technique for looking beneath the surface, recognizing and examining assumptions, searching for inconsistencies, examining multiple points of view and biases, and differentiating what one knows from what one merely believes
Socratic questioning
These types of questions are common when a nurse completes an end of shift or reviews a patient’s history and progress
Socratic questioning
Moves from reviewing specific data elements to making an inference by forming a conclusion about the related piece of evidence
Inductive reasoning
Moves from general to the specific
Deductive reasoning
Is an in-depth knowledge of a patient’s patterns of responses within a clinical situation and knowing the patient as a person
Knowing the patient
Offers a nurse “the big picture” and “knowing the whole person” so that suitable patient-centered decisions can be made to protect patient’s from harm
Knowing the patient
2 (two) components of knowing the patient
- Nurse’s understanding of a specific patient
- Subsequent selection of interventions
3 (three) levels of critical thinking
- Basic critical thinking
- Complex critical thinking
- Commitment
A level where a learner trusts that experts have the right answers for every problem
Basic critical thinking
A level where thinking is concrete and based on a set of rules of principles
Basic critical thinking
Answers to complex problems are perceived as either right or wrong
Basic critical thinking