copyright 2011 delmar, cengage learning. all rights reserved. chapter 5 critical thinking, decision...

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 5

Critical Thinking, Decision Making, and the Nursing Process


Critical Thinking

• “…reasonable reflective thinking that is focused on deciding what to believe or do” (Ennis, 1987)

• Process through which nurses analyze and make sense of situations to make sound clinical decisions


Components of Critical Thinking

• Mental operations• Knowledge• Attitudes


Development of Critical Thinking Skills

• Identify goals• Determine knowledge• Assess margin for error• Determine time available for decision

making• Identify resources• Recognize influencing factors


Critical Thinking Skills

• Interpretation• Analysis• Influence• Explanation• Evaluation• Self-regulation


Critical Thinking and Creativity

• Barriers:– Habit– Comfort with status quo– Fear of making mistakes– Tradition– Use of meaningless routines and rituals– Rigid mind-set


Critical Thinking and Problem Solving

• Critical thinkers avoid pitfalls of problem solving by:– Defining problem– Analyzing data– Understanding causes– Creating new ideas that lead to problem

resolution


Critical Thinking and Decision Making

• Critical thinking used to develop and support sound clinical decisions

• Implement safe, effective nursing interventions only after:– Reflection– Reasoning


Nursing Process

• Historical perspective– Framework for providing professional, quality

nursing care• Assessment• Planning• Implementation• Evaluation

(continued)


Nursing Process

• Overview:– Assessment– Diagnosis– Outcome identification and planning– Implementation– Evaluation


Assessment

• Collect data• Validate data• Organize data• Identify pattern• Devise initial inferences• Record or report data


Diagnosis

• Analyze and synthesize data• Types:

– Actual problems– Potential problems

• “Risk for”– Wellness conditions– Collaborative problems


Outcome Identification and Planning

• Prioritize nursing diagnoses• Identify and write outcomes and goals• Develop specific interventions• Record plan


Implementation

• Execute plan• Necessary skills:

– Continual assessment– Psychomotor– Interpersonal– Critical thinking

(continued)


Implementation

• Necessary skills:– Communication

• Writing• Reporting


Evaluation

• Evaluate goals– Met– Not met– Partially met/Ongoing

• Reassess• Make necessary changes• Continual process


Critical Thinking Applied to Nursing

• Learned skill• Vital tool• Nurses need to have questioning attitude

in every phase of nursing process

copyright 2011 delmar, cengage learning. all rights reserved. chapter 5 critical thinking, decision...

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