THINKING CRITICALLY TO ANALYZE DATA Flashcards
is the process of international higher level of thinking to define a client’s problem, examine the evidence-based practice in caring for the client, and make choices in the delivery of care.
CRITICAL THINKING
- … reasonable reflective thinking that is focused on deciding what to believe or do (Ennis, 2000)
- Process through which nurses analyze and make sense of situations in order to make sound clinical decisions.
CRITICAL THINKING
is the way in which the nurse processes information using knowledge, past experiences, intuition, and cognitive abilities to formulate conclusions or diagnoses.
CRITICAL THINKING
is a cognitive process that uses thinking strategies to gather and analyze client information, evaluate the relevance of the information, and decide on possible nursing actions to improve the client’s physiological outcomes.
CLINICAL REASONING
YES OR NO, IS THIS A PURPOSE OF CRITICAL THINKING? : Nurses use knowledge from subject and fields. Nursing use critical thinking skills when they reflect on knowledge derived from other interdisciplinary subject areas.
YES
YES OR NO, IS THIS A PURPOSE OF CRITICAL THINKING?: Nurses deals with change in stressful environments. Critical thinking enables the nurse to recognize important cues, respond quickly and adapt interventions to meet specific client needs at the right time.
YES
YES OR NO, IS THIS A PURPOSE OF CRITICAL THINKING?: Nurses make important decisions.
YES
YES OR NO, IS THIS A PURPOSE OF CRITICAL THINKING?: Nurses use critical thinking skills and clinical reasoning to make judgments about the client’s care.
YES
YES OR NO, IS THIS A PURPOSE OF CRITICAL THINKING?: Creativity is thinking that results in development of new ideas and products
YES
Techniques in Critical Thinking
- Critical Analysis
- Socratic Questioning
- Inductive Reasoning
- Deductive Reasoning
is the application of a set of questions to a particular situation or idea to determine essential information and ideas and discard unimportant information and ideas.
- Critical Analysis
are formed from a set of facts or observations.
- Inductive Reasoning generalizations
by contrast, is a reasoning from general premise to the specific conclusion.
- Deductive Reasoning
(develop by Socrates) is a techniques one can use to look beneath the surface, recognize and examine assumptions, search for inconsistencies examine multiple points of view and differentiate what one knows from what merely believes.
- Socratic Questioning
TRUE OR FALSE: When a nurse uses international thinking, a relationship develops among knowledge, skills, and attitude that are attributed to: critical thinking, and clinical reasoning, the nursing process and the problem solving process.
TRUE
TRUE OR FALSE: 1. Nursing process is a systematic, rational method of planning and providing individualized nursing care.
Implementation of the nursing process provides nurses with a creative approach to thinking and doing to obtain and analyze client data and plan actions that will meet the client’s needs.
TRUE
TRUE OR FALSE: 2. Problem Solving is a mental activity in which a problem is identical that represent an unsteady state.
Problem solving for one situation contributes to the nurse’s body of knowledge for problem solving in similar situations.
TRUE
Commonly used approaches to problem solving include:
- Trial and Error in which a number of approaches are tried until a solution is found.
____________is the understanding or learning of things without the conscious use of reasoning. It is a problem solving approach that relies on a nurse’s inner sense. It is an essential and legitimate aspect of clinical judgment acquired thorugh knowledge and experience.
- Intuition
______________ in nursing is an decision making process to ascertain the right nursing action to be implemented at the appropriate time in the client’s care.
o Clinical judgment
_____________ is a formalized, logical systematic approach to solving problem. The classic quantitative research process is most useful when the researcher is working in a controlled situations require a modified approach for solving problems.
- Research Process
TRUE OR FALSE: * Nurses use critical thinking skills when making decisions about client care.
* The decision making process includes prioritizing care not only with one client but when providing care to many clients.
TRUE
TRUE OR FALSE: * Nurses must make decisions and also assist clients to make decisions.
* When faced with several client needs at the same time, the nurse must prioritize and decide which client to assist first.
TRUE
_______________ often referred to as the diagnostic phase or critical reasoning phase because the end result or purpose is identification of a nursing diagnosis, collaboration problem, or need for referral to another health care professional.
Data Analysis
- The purpose of assessing client’s health status:
o To analyze the subjective and objective data collected.
SEVEN ESSENTIAL ELEMENTS OF CRITICAL THINKING
- Keep an open mind.
- Use rationale to support opinions or decisions
- Reflect on thoughts before reaching a conclusion
- Use past clinical experiences to build knowledge
- Acquire an adequate knowledge base that continues to build.
- Be aware of the interactions of others.
- Be aware of the environment.
- Analysis of data include:
- Health promotion diagnosis
- Risk diagnosis
- Actual diagnosis
- Collaborative problems
- Referred to health care providers for possible medical problems
Analysis of Data and Critical Thinking – Step two of the Nursing Process
- Nurse is required to use diagnostic reasoning skills to interpret data accurately
- Nurse must think critically – in rational, self-directed, intelligent and purposeful manner.
- Essential Elements of Critical Thinking
Collection and organization of assessment data
Validation of data
Documentation of data
- Assessment Phase
Grouping and organizing data
Validating data and comparing the data with norms
Clustering data to make inferences
Generating possible hypothesis regarding the client’s problems.
Formulating a professional clinical judgment.
Validating the judgment with the client.
- The Diagnostic phase of the Nursing Process
7 STEPS OF DATA ANALYSIS
Step 1: Identify Strengths and Abnormal Data
Step 2: Cluster Data
Step 3: Draw Inferences
Step 4: Propose Possible Nursing Diagnoses
Step 5: Check for Defining Character
Step 6: Confirm or Ruel out Diagnoses
Step 7: Document Conclusions
- Nurse should compare collected assessment data with findings in reliable charts and references that provide standard and values for physical and psychological norms.
- Nuse should have a basic knowledge of risk factors for the client.
- Subjective for the client.
- Subjective and Objective data
- Identified strengths: used in formulating health promotion diagnoses.
- Identified potential weaknesses: used in formulating risk diagnoses
- Actual weakness/abnormal findings: used in formulating actual nursing diagnoses.
Step one: Identify Strengths and Abnormal Data
- Identify strengths and abnormal findings for cues that are related.
- Cluster both strengths cues and abnormal cues.
- Consider again, if additional data are needed.
Step two: Cluster Data
- Write down “hunches” or assumptions about each cue cluster.
- Consider nursing diagnosis, Collaborative problem, referral.
Referral can be defined as connecting clients with other professionals and resources.
Step three: Draw Inferences
- Actual diagnosis – indicates that the client is currently experiencing the stated problem or has a dysfunctional pattern.
- Risk diagnosis indicates that the client does not currently have the problem but is vulnerable to developing it.
- Wellness or health promotion diagnosis indicates that the client has the motivation to increase well-being and enhance health behavior.
Step Four: Propose Possible Nursing Diagnoses
- Validate diagnosis with client and other health care providers who are caring for the client.
- Validation is also important if client has collaborative problem or requires a referral.
Step six: Confirm or Rule out Diagnosis
- Defining characteristics are observable cues/inferences that cluster as manifestations of a problem-focused, health promotion diagnosis or syndrome. It assists with ruling out invalid diagnosis and selecting valid diagnosis
- Use reference test such as NANDA
Diagnoses: Definitions and Classifications 2015-2017
Step Five: Check for Defining Characteristics
- Wellness or health promotion diagnoses
- Risk diagnoses
- Collaborative problems and referrals.
Step seven: Document Conclusions
FORMUALTING DIAGNOSTIC STATEMENTS
- One-part statement
- Basic two -part statements PE format
- Basic three-part statements
o Health promotion diagnoses beginning with “Readiness for Enhanced”
- One-part statement
o Problem (P)
o Etiology (E)
o Joined by the words “related to”
- Basic two -part statements PE format
o PES format
Problem (P)
Etiology (E)
Signs and symptoms (S)
- Basic three-part statements
o Currently experiencing the stated problem
o Problem present at the time of assessment
o Presence of associated signs and symptoms
o Ineffective breathing pattern r/t respiratory muscle weakness
- Actual diagnosis
STATUS OF THE NURSING DIAGNOSES
- Actual diagnosis
- Risk nursing diagnosis
- Health Promotion Diagnosis or Wellness Diagnosis
- Syndrome diagnosis
o Does not currently have the problem but is vulnerable to developing it
o Problem does not exist.
o Presence of risk factors.
o Risk for impaired skin integrity r/t immobility
- Risk nursing diagnosis
o Indicates that the client has the motivation to increase well-being and enhance health behaviors.
o Preparedness to implement behaviors to improve their health condition.
o Readiness for enhanced self-care
- Health Promotion Diagnosis or Wellness Diagnosis
o Cluster of nursing diagnoses that occur together and are best addressed together and through similar interventions.
- Syndrome diagnosis
COLLABORATIVE PROBLEMS AND REFERRALS
- Collaborative problems should be documented as risk for complications.
- Nursing goals for collaborative problems should also be documented as which parameters the nurse must monitor and how often they should be monitored.
- The nurse needs to indicate when the healthcare provider should be notified and identify nursing intervention to help prevent the complication from occurring.
- If a referral is indicated, documented the problem, the need for immediate referral, and to whom the client is being referred.
DEVELOPING DIAGNOSTIC REASINING EXPERTISE AND AVOIDING PITFALLS
- Expertise comes with knowledge and experience, time and practice.
- Pitfalls occur during the assessment phase and the analysis of data phase.
- Too many or two few data
- Unreliable or invalid data
- Insufficient number of cues available to support the diagnoses
- Clustering cues that are unrelated to each other.
- Quickly diagnosing without hypothesizing several diagnoses
- Incorrectly wording the diagnostic statement.
WAYS TO INCREASE ACCURACY OF DIAGNOSTIC REASONING SKILLS
- Identify Strengths and Abnormal Data
- Cluster Data
- Draw Inferences
- Propose Possible Nursing Diagnoses
- Check for Defining Characteristics
- Confirm or rule out Diagnoses
- Document Conclusion
