N210- Unit 2 Study Material From Class Lectures

Front 1

What is Critical Thinking?

Back 1

an active, organized, cognitive process used to examine one's thinking and the thinking of others/recognizing that an issue exists, analyzing and evaluating information and making conclusions

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Linda Caputi defines Critical Thinking (ct) as a complex thinking process that:

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is disciplined and self directed/ is based on master of many skills and abilities, is best developed by application to real world situations, involves thinking about the process of thinking while it is occurring; evaluates the decision or problem solution against a standard set of criteria

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Rosalinda Alara-LeFevre defines critical thinking as:

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critical thinking... the ability to focus your thinking to get the results you need. it's outcome focused thinking that is constantly reevaluating, self-correcting, and striving to improve.

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Critical thinking is contextual:

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should be applied to the situation you are in using 3 perspectives: thinking ahead, thinking in action, thinking back

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Why use critical thinking?

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nurses constantly integrate new information with old learning. CT and creativity within the nursing process enables us to solve problems and change actions in order to get the best result

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Significance of Critical thinking in nursing

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essential for safe, competent, skillful nursing practice; rapid and continuing growth of knowledge; make complex and import decisions (which effect ourselves, places of work, and clients); draw meaningful information from other subject areas; work in rapidly changing, stressful environments; recognize important cues, respond quickly, and adapt interventions

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Attitudes and Characteristics of a critical thinker

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independent thought, fair-mindedness, insight and recognition of egocentric or socioentric beliefs/behaviors, intellectual humility and suspension of judgement (negotiation)/ intellectual courage, integrity, perseverance, confidence in reason, interest in exploring both thoughts and feelings, curiosity

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Socratic Questioning

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questions that help look deeper into an issue: What then? Where from here? Most likely outcome?

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Critical analysis

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use a set of criteria for judging a situation, analyze from a clinical perspective

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Inductive reasoning

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use facts in order to decide general ideas

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Deductive reasoning

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use conceptual framework and make inferences about a particular situation, Think about signs and symptoms to find a cause

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Caputi's General skills of critical thinking

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argument analysis, problem solving, priortization/delegation of care, analysis of data, consideration of biases and ethical dilemmas, recall of purpose, procedure, and knowledge of diagnostic tests, understanding the physiology of body systems, identifying signs and symptoms

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Caputis Skills of gathering data (skills related to assessment)

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distinguishing relevant from irrelevant info; gathering complete and accurate data/ determining the importance of information; collaborating with coworkers; assessing systematically and comprehensively; checking accuracy and reliability; judging how much ambiguity is acceptable; using diagnostic reasoning; clustering related information; recognizing inconsistencies

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Caputi's skills of providing interventions

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determining the importance of information, applying the nursing process to develop a treatment plan, predicting and managing potential complications; setting priorities; teaching others; communicating effectively; resolving conflicts; resolving ethical dilemmas

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Caputi's skills of evaluating Data

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evaluating and correcting thinking, evaluating data, supporting conclusions with evidence

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Nursing process

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method of planning and providing individualized care, modified problem-solving process, assess, diagnose, plan, implement, and evaluate

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Problem solving process

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clarify the nature of a problem and suggests possible solutions, evaluate solutions and choose best one to implement, some approaches include: trial and error, intuition, research process, and scientific method

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Problem solving method- Trial and Error

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Try until you fine one that works, (sounds back, and can be dangerous, but can also be useful)

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Problem solving method- Intuition

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subconscious knowing, best if used by experience nurses

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problem solving method- Scientific Method=Research

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most rigorous; controlled

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Problem solving method- modified scientific method

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like nursing process, is logical and systematic, but less controlled

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Attitudes of a critical thinker

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be willing to examine yourself, tolerate ambiguity, seek situation where critical thinking is practiced, create environments that support critical thinking

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Patricia Benners Stages of Critical Thinking

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Novice- black and white, know the rules (concrete thought) Advanced beginner- gaining experience; still using rules but starting to apply concepts (start thinking beyond what teacher is saying-1st year) Competent- 2-4 years-able to recognize own actions and able to plan and use environment to guide actions. Proficient- 3+ years-sees whole situation and recognize self as part of whole, applies knowledge to specific situations which are different than what was taught. Expert- 5+ years does not depend on rules or regulations, use vase base of knowledge and experience to evaluate and act, search for way sot share oneself with others

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Mind map

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Triggers-complex problems/dilemmas >>Starting points- intuition, brain storming, thinking aloud reflections>>Scaffolds- knowledge base, ct skills, life/professional experience, expertise>>Processes- reflection in knowing, reflection in action, convergent/divergent thinking, problem solving, nursing process, creative thinking>>Outcomes- problem resolution, clinical judgement, reflective practice

Front 25

How to critical think?

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Ask questions-Why, How, Who, What, What then, What else, What if? Think about different perspectives, use your own unique way of learning, stay flexible, be self-motivated and disciplined, paraphrase, summarize, compare, contrast, reflect, create mnemonics, organize and reorganize info

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What is the nursing process?

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a systematic way to provide care for clients, communicating role in planning, and carrying out client-centered activities to clients, families, and other health care professionals; encourages orderly thoughts and what needs to be done, how , and when

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Purpose of nursing process

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to provide individualized, holistic, effective, and efficient care to clients

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5 steps of the nursing process

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assessment, diagnosis, planning, implementation, and evaluation

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Interview techniques

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establish rapport, ask open questions, and closed questions when need a quick response, reflection, use active listening

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consistent terminology

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having consistent terminology in nursing diagnoses helps in communication, research, reimbursement/payment, and learning

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subjective data

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feelings, opinions, cant be validated with the 5 senses, must come from the patient

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objective data

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can be validated with senses

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cues

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anything you can know from your senses (objective)

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Inference

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interpretation of a cue (subjective)

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Nursing Diagnosis

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terminology used for a clinical judgment by the professional nurse that identifies the client's or aggregates actual, risk wellness, or syndrome response to a health state, problem, or condition

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Actual nursing diagnosis

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represents a problem that has been validated by the presence of major defining characteristics. Has four components: label, definition, defining characteristics, and related factors.

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actual nursing diagnosis components-label

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should be in clear, concise terms that convey the meaning of a diagnosis.

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actual nursing dx components-definition

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should add clarity to the diagnostic label. it should help ti differentiate a particular diagnosis from similar diagnoses

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actual nursing dx components- defining characteristics

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are signs and symptoms that when seen together represent the nursing diagnosis. they are broken in to major and minor designations. Major-non-research diagnoses, at lease one must be present for validation of the diagnoses, for research diagnoses-(at least one in 80-100% group)Minor- provide supporting evidence but may not be present

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Actual nursing dx components- Related Factors

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contributing factors that have influenced the change in health status grouped in 4 categories: Pathophysiologic,biologic, or psychological; treatment-related; situational; maturational