Nursing Critical Thinking Skills Quiz

Critical Thinking, Clinical Reasoning, Clinical Judgment, Clinical Decision Making and Nursing Process

• ATI Nurse Logic focuses on knowledge, clinical judgment, nursing concepts, and priority setting.
• ATI Engage Fundamental Module provides a clinical judgment process.
• CMS Fundamental Book Chapters 7 and 8 cover the topic.

Objectives

• Define critical thinking, clinical reasoning, clinical judgment, and clinical decision-making.
• Describe the importance of critical thinking for safe, effective, and professional nursing care.
• Identify critical thinking skills and attitudes.
• Discuss the relationships between critical thinking, problem-solving, and decision-making.
• Describe the nursing process and its phases.
• Explain the relationship between the nursing process and critical thinking.
• Explain how professional standards influence a nurse's clinical decisions.
• Define and describe clinical judgment.
• Discuss the attributes of clinical judgment.
• Identify the ways nurses make judgments.

Nursing Fundamentals

• Study progresses from simple to complex principles.
• Evidence-based practice is crucial.
• Conceptual frameworks and concept maps are essential.
• Benner's 5 Stages of Nursing are important concepts.

Critical Thinking as a Nurse

• Critical thinking is essential for safe practice, competency, and skill.
• Applying knowledge from other subjects is necessary.
• The ability to manage change, handle stressful situations, recognize patterns, and make decisions under pressure is important.
• Critical thinking improves patient outcomes, as it is essential for data collection, interpretation, problem-solving, and decision-making.

The Critical Thinking Process

• Critical Thinking leads to Clinical Reasoning, which in turn leads to Clinical Judgment.

Levels of Critical Thinking

• Critical thinking progresses through basic, complex, and commitment levels.
• Levels of critical thinking involve components of critical thinking such as specific knowledge base, experience, competencies, attitudes, and standards.

Developing Critical Thinking Attitudes/Skills

• Self-assessment is a crucial skill for critical thinking development.
• Tolerance of ambiguity is an important attitude.
• Seek out situations where good thinking is practiced.
• Create environments supporting critical thinking.

Critical Thinking Attitudes

• Confidence, Independence, Fairness, Responsibility, Risk-taking, Discipline, Perseverance, Creativity, Curiosity, Integrity, Humility are key attitudes.

Creativity

• Question, wonder, explore, be inquisitive, and proactive are essential for creativity
• Cultivate creativity in self and others.
• Creativity is important in nursing practice.

Critical Thinking Skills

• Interpretation involves recognizing, understanding, and describing.
• Analysis involves examining, organizing, validating, and prioritizing.
• Evaluation assesses credibility, strength of evidence, relevance, and significance of information.
• Inference involves drawing conclusions and identifying knowledge gaps.
• Explanation clarifies assumptions and justifies reasoning and conclusions.

Clinical Decision Making

• Knowing the patient is crucial for accurate clinical decision-making.

Interpretation, Analysis, Evaluation and Inference for a Dehydrated Patient.

• Recognize, understand and explain the situation of a patient with complaints of fever, cough, sore throat, body aches, and dehydration.
• Examine the findings in relation to the situation and gather additional data.
• Assess the relevance and significance of the findings.
• Draw conclusions based on the collected information

Critical Thinking Model - NCSBN

• Recognize cues
• Analyze cues
• Prioritize hypotheses
• Generate solutions
• Take action
• Evaluate outcomes

ATI Nursing Competence Concepts

• Client-centered care
• Interdisciplinary collaboration
• Evidence-based practice
• Quality improvement
• Informatics
• Safety
• Professionalism
• Leadership
• Priority setting

Standards for Critical Thinking

• Universal intellectual standards (Clear, Precise, Specific, Accurate, Relevant, Plausible, Consistent, Logical, Deep, Broad, Complete, Significant, Adequate for purpose, Fair)

How to Become a Critical Thinker

• Employing reflective thinking and journaling.
• Consulting with colleagues.
• Utilizing concept mapping.
• Seeking mentorship.

How Nurses Apply Critical Thinking and Clinical Decision-Making

• The Five-step Nursing Process.
• It's a shared language and method.
• Aids in "thinking through" clinical challenges.

Applying Critical Thinking to the Nursing Process

• The Nursing Process (NP) is a structured, rational approach for planning and delivering care.
• The Nursing Process involves five phases.
• Critical thinking is used in every phase of the Nursing Process
• Critical thinking is key in decision-making within each phase (e.g., prioritizing actions & anticipating potential outcomes).

Purpose of Nursing Process

• Identify client health status and potential needs
• Plan to meet patient needs
• Deliver interventions to meet needs
• Evaluate interventions

Nursing Process

• A client-centered approach emphasizing the client's response to health, diseases, or alterations in body structure.
• Involves decision-making in every phase, with phases often overlapping.
• Relies on interpersonal and collaborative efforts.

Types of Nursing Care Plans

• Informal (not written)
• Formal, including written and computerized plans.
• Standardized (developed for groups with similar conditions)
• Individualized (addressing unique client needs).

Nursing Process: Assessment Phase

• Systematic and continuous data collection, organization, validation, and documentation for a complete database.
• Accurate and thorough data collection is essential for all phases of the nursing process.

Assessment Phase

• The assessment phase creates a database of the client's response to health problems (not just illness).
• It includes perceived needs, health problems, related experiences, health practices, and health beliefs.

Types of Data in Assessment

• Objective data is observable and measurable (e.g., blood pressure, heart rate, swelling).
• Subjective data involves client-reported perceptions (e.g., pain, nausea, dizziness).

Sources of Data

• Primary (client, family members) and secondary sources (medical records, lab reports, other healthcare providers).

Analysis Phase

• The nurse uses critical thinking to analyze assessment data and identify client strengths and problems
• Nursing diagnosis statements define issues (using NANDA).
• This is a clinical judgment.

Priority Setting Frameworks

• Maslow's Hierarchy of Needs.
• ABCs (Airway, Breathing, Circulation) are prioritized.
• Safety and Risk Reduction, ranking risks by severity, least restrictive interventions, and least invasive interventions.

Types of Nursing Diagnoses

• Problem-focused or actual diagnoses (problems present at assessment)
• "related to..." & "as evidenced by..."
• At-risk diagnoses (problems predicted due to risk factors)
• Health Promotion diagnoses (positively-framed diagnoses).

Nursing, Medical, and Collaborative Diagnoses

• Nursing diagnoses are judgments of the nurse, reflecting the client's responses to health issues.
• They relate to the nurse's independent functions.
• Medical diagnoses are identified by physicians and describe conditions they can treat, using treatments requiring collaboration including medication administration.

Medical Diagnosis

• Medical diagnoses define conditions only physicians can treat.
• They outline disease processes and necessary therapies.
• Nurses carry out prescribed therapies as part of their collaborative responsibilities.

Key Differences

• Nurses differentiate between their own independent & dependent functions and medical diagnoses).

Collaborative Problems and Nursing Diagnoses

• Collaborative problems involve interdependent nursing interventions.
• They address issues often directly related to disease or treatments.

Planning Phase

• Deliberate, methodical decision-making and problem-solving to set priorities and determine direction.
• Identifying client goals and desired outcomes is critical.
• Determining proper patient care strategies.

Establish Client Goal and Outcome

• Goal Statement should be broad (describing the desired outcome).
• Desired Outcome should be specific (with concrete measurable details).
• Both statements must reflect the nursing diagnosis.
• They guide planning interventions and measure client progress.

Implementation: Nursing Interventions and Activities

• Interventions include independent, dependent, and collaborative actions.

Criteria for Selecting Interventions

• Interventions are safe, appropriate, achievable with resources, congruent with beliefs & values, based on knowledge and experience, and within established standards.

Process of Implementation

• Reassess the client, determine needs for assistance, implement interventions, supervise delegated care, correlate interventions with desired outcomes, conclude the patient's needs, then complete documentation.

Evaluation Phase

• Evaluate if goals have been met by reviewing the desired outcome achieved, verifying problem status resolution, and analyzing whether the potential issues were prevented or not.
• Interventions may require adjustments, but outcomes generally do not.