Ch01 (3).pptx

Book cover for Understanding MedicalSurgical Nursing, Seventh Edition. Chapter 1 Critical Thinking, Clinical Judgment, and the Nursing Process Copyright ©2023 F.A. Davis Company Learning Outcomes  Explain the difference between critical thinking and clinical judgment.  Discuss why critical thi...

Book cover for Understanding MedicalSurgical Nursing, Seventh Edition. Chapter 1 Critical Thinking, Clinical Judgment, and the Nursing Process Copyright ©2023 F.A. Davis Company Learning Outcomes  Explain the difference between critical thinking and clinical judgment.  Discuss why critical thinking and clinical judgment are essential in nursing.  Compare the nursing process to the clinical judgment process.  Describe attitudes of good critical thinkers. Copyright ©2023 F.A. Davis Company Learning Outcomes (continued)  Define vigilance.  Prioritize patient care activities based on Maslow’s hierarchy of human needs.  Discuss the importance of collaboration in nursing practice.  Use the SBAR mnemonic to communicate a patient problem. Copyright ©2023 F.A. Davis Company Chapter Concepts  Clinical Judgment  Collaboration  Communication  Safety Copyright ©2023 F.A. Davis Company Thinking  Why is good thinking important? • Only 23% of new graduates are ready to practice safely • Must recognize changes in conditions • Must make quick, good decisions • Must avoid Failure to Rescue Copyright ©2023 F.A. Davis Company Critical Thinking  The use of those cognitive skills or strategies that increase the probability of a desirable outcome  Helps understand WHAT and WHY Copyright ©2023 F.A. Davis Company WHAT’S UP? Mnemonic  W – Where is it?  H – How does it feel?  A – Aggravating and alleviating factors  T – Timing  S – Severity  U – Useful other data  P – Patient’s perception of problem Copyright ©2023 F.A. Davis Company Clinical Judgment  The outcome of critical thinking and decision making  Requires critical thinking attitudes and skills as well as good knowledge  Helps determine what to DO after critically thinking about a problem Copyright ©2023 F.A. Davis Company Critical Thinking Attitudes  Intellectual humility  Intellectual autonomy  Intellectual integrity Copyright ©2023 F.A. Davis Company Avoid Failure to Communicate  CUS • C – I am CONCERNED • U – I am UNCOMFORTABLE • S – This is a SAFETY issue Copyright ©2023 F.A. Davis Company Activity: Practice CUS  The provider has written discharge orders for your patient, but you know that the patient is going home alone and has no one to help her. She has a history of falls and is forgetful. • Turn to a partner and plan a conversation with the provider using CUS. Be prepared to share with the class. Copyright ©2023 F.A. Davis Company Nursing Process and Clinical Judgment Nursing Process Clinical Judgment  Gather data.  Identify problems.  Determine outcomes.  Plan care.  Implement plan of care.  Evaluate outcomes.  Identify and analyze cues.  Prioritize hypotheses.  Generate solutions.  Take action.  Evaluate outcomes.  Repeat. Copyright ©2023 F.A. Davis Company Nursing Process and Clinical Judgment (continued) Copyright ©2023 F.A. Davis Company Vigilance  The act of being attentive, alert, and watchful  Anticipating possible patient problems and being ready for them  Identifying small problems before they become serious problems  Intervening as necessary to protect your patient Copyright ©2023 F.A. Davis Company Activity: Cue Recognition 1.1 You are shopping at your local grocery store and the customer in front of you in line collapses. What do you do? Copyright ©2023 F.A. Davis Company Cue Recognition 1.1: Answer  Check and open airway.  Is anyone with the customer? Is there a history?  Call 911. Copyright ©2023 F.A. Davis Company Communication With the Health Team  SBAR • • • • Situation Background Assessment/Analysis Recommendation Copyright ©2023 F.A. Davis Company Activity: SBAR Practice  Think of a problem you experienced with a patient. Develop an SBAR and share it with a partner. • • • • Situation Background Assessment/Analysis Recommendation Copyright ©2023 F.A. Davis Company Active Listening  Block out distractions.  Focus on speaker.  Verify what you hear.  Ask clarifying questions. Copyright ©2023 F.A. Davis Company Activity: Practice Active Listening  Team up with a partner.  One partner shares a recent patient care experience  The other partner listens actively  The listener then shares what they heard  The speaker verifies that the listener heard correctly – or not! Copyright ©2023 F.A. Davis Company Prioritizing Care  Prioritize patient problems. • Use Maslow’s hierarchy of human needs. • Prioritize physiological needs. ‒ Life-threatening ‒ Health-threatening ‒ Health-promoting Copyright ©2023 F.A. Davis Company Maslow’s Hierarchy of Human Needs Copyright ©2023 F.A. Davis Company Collaboration  Collaborate with the health team.  Provide patient-centered care. • The patient is the most important member of the team.  Participate in team meetings. Copyright ©2023 F.A. Davis Company Which Are Good Sources of Information? 1. 2. 3. 4. 5. 6. 7. A nursing textbook www.diabetes.about.com www.nlm.nih.gov www.mayoclinic.org A nursing journal A medical journal Ladies’ Home Journal Copyright ©2023 F.A. Davis Company Good Sources of Information 1. A nursing textbook 2. www.diabetes.about.com 3. www.nlm.nih.gov 4. www.mayoclinic.org 5. A nursing journal 6. A medical journal 7. Ladies’ Home Journal Copyright ©2023 F.A. Davis Company NCLEX-PN  Become familiar with the NCSBN Practice Analysis.  Sample items – the licensed practical nurse/licensed vocational nurse will • Organize and prioritize client care based on client needs. • Participate in client data collection. • Recognize and report change in client condition. Copyright ©2023 F.A. Davis Company Review Question #1 Which attitude is being used by the nurse who says, “I don’t know, but I’ll find out?” 1. Intellectual humility 2. Intellectual courage 3. Intellectual autonomy 4. Intellectual integrity Copyright ©2023 F.A. Davis Company Review Question #1 Answer Correct Answer: 1 Copyright ©2023 F.A. Davis Company Review Question #2 Order the steps in the clinical judgment process. 1. 2. 3. 4. 5. 6. Generate solutions. Prioritize hypotheses. Evaluate outcomes. Take action. Identify and analyze cues. Repeat. Copyright ©2023 F.A. Davis Company Review Question #2 Answer Correct Answer: 1. 2. 3. 4. 5. 6. Identify and analyze cues. Prioritize hypotheses. Generate solutions. Take action. Evaluate outcomes. Repeat. Copyright ©2023 F.A. Davis Company Review Question #3 Identify the questions in the WHAT’S UP? guide. 1. 2. 3. 4. 5. 6. 7. W H A T S U P Copyright ©2023 F.A. Davis Company Review Question #3 Answer Correct Answer: 1. Where is it? 2. How does it feel? 3. Aggravating and alleviating factors? 4. Timing? 5. Severity? 6. Useful other data? 7. Patient’s perception of the problem Copyright ©2023 F.A. Davis Company Review Question #4 The nurse is caring for a patient who is experiencing dyspnea, anxiety, hunger, and tremor. Which problem should the nurse address first? 1. Dyspnea 2. Anxiety 3. Hunger 4. Tremor Copyright ©2023 F.A. Davis Company Review Question #4 Answer Correct Answer: 1 Copyright ©2023 F.A. Davis Company