Jen Ch 15

Question 1

critical thinking

Answer 1

Active, purposeful, organized, cognitive process used to carefully examine one’s thinking and the thinking of other individuals. (“Why?”, “What am I missing?”, “What do I really know about this patient’s situation?”, and “What are my options?”)

Question 2

evidenced based knowledge

Answer 2

knowledge based on research or clinical expertise, makes you an informed critical thinker.

Question 3

critical thinking skills

Answer 3

• Interpretation
• Analysis
• Inference
• Evaluation
• Explanation
• Self regulation

Question 4

Concepts for critical thinkers

Answer 4

• Truth seeking
• Open-mindedness
• analyticity
• systematicity
• self-confidence
• inquisitiveness
• Maturity

Question 5

Interpretation

Answer 5

Critical Thinking Skill: Look for patterns to categorize data (e.g., nursing diagnoses. Clarify any data you are uncertain about.

Question 6

analysis

Answer 6

Critical Thinking Skill: Be open-minded as you look at information about a patient. Do not make careless assumptions. Do the data reveal what you believe is true, or are there other options?

Question 7

Inference

Answer 7

Critical thinking skill: Look at the meaning and significance of findings. Are there relationships between findings? Do the data about the patient help you see that a problem exists?

Question 8

evaluation

Answer 8

critical thinking skill: Look at all situations objectively. Use criteria (e.g., expected outcomes, pain characteristics, learning objectives) to determine results of nursing actions. Reflect on your own behavior.

Question 9

explanation

Answer 9

critical thinking skill: Support your findings and conclusions. Use knowledge and experience to choose strategies to use in the care of patients.

Question 10

self-regulation

Answer 10

critical thinking skill: Reflect on your experiences. Identify the ways you can improve your own performance. What will make you believe that you have been successful?

Question 11

truth-seeking

Answer 11

critical thinking concept: Seek the true meaning of a situation. Be courageous, honest, and objective about asking questions.

Question 12

open-mindedness

Answer 12

critical thinking concept: Be tolerant of different views; be sensitive to the possibility of your own prejudices; respect the right of others to have different opinions.

Question 13

analyticity

Answer 13

critical thinking concept: Analyze potentially problematic situations; anticipate possible results or consequences; value reason; use evidence-based knowledge.

Question 14

systematicity

Answer 14

critical thinking concept: Be organized, focused; work hard in any inquiry.

Question 15

self-confidence

Answer 15

critical thinking concept: Trust in your own reasoning processes.

Question 16

inquisitiveness

Answer 16

critical thinking concept: Be eager to acquire knowledge and learn explanations even when applications of the knowledge are not immediately clear. Value learning for learning’s sake.

Question 17

maturity

Answer 17

critical thinking concept: Multiple solutions are acceptable. Reflect on your own judgments; have cognitive maturity.

Question 18

basic critical thinking

Answer 18

learner trusts that experts have the right answers for every problem. Thinking is concrete and based on a set of rules or principles

Question 19

Complex critical thinking

Answer 19

analyze and examine choices more independently. The person’s thinking abilities and initiative to look beyond expert opinion begin to change.

Question 20

commitment

Answer 20

third level of critical thinking - a person anticipates when to make choices w?o assistance from others and accepts accountability

Question 21

scientific method

Answer 21

1 Identifying the problem

2 Collecting data

3 Formulating a question or hypothesis

4 Testing the question or hypothesis

Question 22

problem solving

Answer 22

Methodical, systematic approach to explore conditions and develop solutions, including analysis of data, determination of causative factors, and selection of appropriate actions to reverse or eliminate the problem.

Question 23

decision making

Answer 23

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..

Question 24

diagnostic reasoning

Answer 24

Process that enables an observer to assign meaning to and classify phenomena in clinical situations by integrating observations and critical thinking.

Question 25

inference

Answer 25

process of drawing conclusions from related pieces of evidence and previous experience with the evidence. An inference involves forming patterns of information from data before making a diagnosis.

Question 26

clinical decision making

Answer 26

Problem-solving approach that nurses use to define patient problems and select appropriate treatment.

Question 27

nursing process

Answer 27

lem-solving method by which nurses individualize care for each patient. The five steps of the nursing process are:

• assessment,
• diagnosis,
• planning,
• implementation, and
• evaluation.

Question 28

Clinical Decision Making for Groups of Patients

Answer 28

• Identify the nursing diagnoses and collaborative problems of each patient

• Analyze patients’ diagnoses/problems and decide which are most urgent on the basis of basic needs, the patients’ changing or unstable status, and problem complexity (see Chapter 18).
• Consider the time it will take to care for patients whose problems are of high priority (e.g., do you have the time to restart a critical intravenous (IV) line when medication is due for a different patient?).
• Consider the resources you have to manage each problem, nursing assistive personnel assigned with you, other health care providers, and patients’ family members.
• Consider how to involve the patients as decision makers and participants in care.
• Decide how to combine activities to resolve more than one patient problem at a time.
• Decide which, if any, nursing care procedures to delegate to assistive personnel so you are able to spend your time on activities requiring professional nursing knowledge.
• Discuss complex cases with other members of the health care team to ensure a smooth transition in care requirements.

Question 29

Yahiro and Saylor model: critical thinking components

Answer 29

• knowledge base,
• experience,
• critical thinking competencies (with emphasis on the nursing process),
• attitudes, and
• standards.

The elements of the model combine to explain how nurses make clinical judgments that are necessary for safe, effective nursing care

Question 30

Specific Knowledge Base

Answer 30

knowledge base includes information and theory from the basic sciences, humanities, behavioral sciences, and nursing

Question 31

experience

Answer 31

Clinical learning experiences are necessary to acquire clinical decision-making skills. knowledge combined with clinical expertise from experience defines critical thinking.

Question 32

Critical Thinking Attitudes and Applications in Nursing Practice

Answer 32

• Confidence

Learn how to introduce yourself to a patient; speak with conviction when you begin a treatment or procedure. Do not lead a patient to think that you are unable to perform care safely. Always be well prepared before performing a nursing activity. Encourage a patient to ask questions.

• Thinking independently

Read the nursing literature, especially when there are different views on the same subject. Talk with other nurses and share ideas about nursing interventions.

• Fairness

Listen to both sides in any discussion. If a patient or family member complains about a co-worker, listen to the story and then speak with the co-worker as well. If a staff member labels a patient uncooperative, assume the care of that patient with openness and a desire to meet that patient’s needs.

• Responsibility and authority

Ask for help if you are uncertain about how to perform a nursing skill. Refer to a policy and procedure manual to review steps of a skill. Report any problems immediately. Follow standards of practice in your care.

• Risk taking

If your knowledge causes you to question a health care provider’s order, do so. Be willing to recommend alternative approaches to nursing care when colleagues are having little success with patients.

• Discipline

Be thorough in whatever you do. Use known scientific and practice-based criteria for activities such as assessment and evaluation. Take time to be thorough and manage your time effectively.

• Perseverance

Be cautious of an easy answer. If co-workers give you information about a patient and some fact seems to be missing, clarify the information or talk to the patient directly. If problems of the same type continue to occur on a nursing division, bring co-workers together, look for a pattern, and find a solution.

• Creativity

Look for different approaches if interventions are not working for a patient. For example, a patient in pain may need a different positioning or distraction technique. When appropriate, involve the patient’s family in adapting your approaches to care methods used at home.

• Curiosity

Always ask why. A clinical sign or symptom often indicates a variety of problems. Explore and learn more about the patient so as to make appropriate clinical judgments.

• Integrity

Recognize when your opinions conflict with those of a patient; review your position, and decide how best to proceed to reach outcomes that will satisfy everyone. Do not compromise nursing standards or honesty in delivering nursing care.

• Humility

Recognize when you need more information to make a decision. When you are new to a clinical division, ask for an orientation to the area. Ask registered nurses (RNs) regularly assigned to the area for assistance with approaches to care.

Question 33

Reflective Journaling questions

Answer 33

1 Which experience, situation, or information in your clinical experience seems confusing, difficult, or interesting?

2 What is the meaning of the experience? What feelings did you have? What feelings did your patient have? What influenced the experience? Which guesses or questions developed with the first connection in question 1? Give examples.

3 Do the feelings, guesses, or questions remind you of any experience from the past or present or something that you think is a desirable future experience? How does it relate? What are the implications/significance?

4 What are the connections between what is being described and what you have learned about nursing science, research, and theory? What are some possible solutions? Which approach or solution would you choose and why? How is this approach effective?

Question 34

concept map

Answer 34

a visual representation of patient problems and interventions that shows their relationships to one another. It offers a nonlinear picture of a patient that can then be used for comprehensive care planning