Critical Thinking in Nursing Practice PDF

1/30/25, 7:11 PM Critical Thinking in Nursing Practice Critical Thinking and Clinical Judgment in Nursing 🤔 Objectives Explain differences in the levels of critical thinking. Explain the relationship between c...

1/30/25, 7:11 PM Critical Thinking in Nursing Practice Critical Thinking and Clinical Judgment in Nursing 🤔 Objectives Explain differences in the levels of critical thinking. Explain the relationship between critical thinking and clinical judgment. Analyze benefits of clinical experiences that contribute to critical judgment in nursing practice. Interpret the value of applying a clinical judgment model in nursing practice. Apply critical thinking attitudes during assessment of a patient condition. Explain when to use intellectual standards. Contrast the differences between basic problem-solving and diagnostic reasoning. Evaluate the ability to make accurate clinical decisions. 📚 Key Terms Evidence-based knowledge: Knowledge based on scientific evidence. Nursing process: A systematic approach to patient care. Clinical decision making: The process of making judgments about patient care. Problem solving: A systematic approach to identifying and solving problems. Inductive reasoning: Reasoning from specific observations to general conclusions. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 1/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Clinical judgment: The process of making judgments about patient care based on clinical experience and knowledge. Reflection: The process of thinking about one's experiences and learning from them. Inference: A conclusion reached on the basis of evidence and reasoning. Critical thinking: The objective analysis and evaluation of an issue in order to form a judgment. Intuition: The ability to understand something immediately, without the need for conscious reasoning. Deductive reasoning: Reasoning from general principles to specific conclusions. Knowing the patient: Understanding a patient's unique needs and preferences. Diagnostic reasoning: The process of using clinical data to make a diagnosis. 🧠 Critical Thinking in Everyday Life and Nursing “Everyday critical thinking examples include troubleshooting a computer error, deciding whether to walk the dog in the rain, or choosing an app on your phone. These involve considering past experiences, available knowledge, time constraints, and desired accuracy or reacting to intuition.” “For nurses, critical thinking is more complex, involving recognizing patient needs, forming clinical judgments using critical thinking, and making timely decisions. This may include gathering more data, consulting colleagues, or intervening to manage problems. Nurses use critical thinking routinely for optimal patient outcomes.” 👩‍⚕️ Clinical Judgment in Nursing Practice “A clinical judgment is defined as a conclusion about a patient's needs or health problems that leads to taking or avoiding action, using or modifying standard approaches, or creating new approaches based on the patient's response. It uses nursing knowledge, experience, https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 2/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice and critical thinking to observe and assess situations, identify prioritized concerns, and generate evidence-based solutions.” “Clinical decision-making distinguishes professional nurses from assistive personnel. RNs analyze changes in a patient's condition, identify problems, plan strategies, and take action, whereas assistive personnel perform basic care based on patient needs but lack the expertise to analyze changing conditions.” 💡 Applying Critical Thinking: A Case Study Mr. Lawson, a 68-year-old post-abdominal surgery patient, experiences incisional pain (rated 7/10). His nurse, Tonya, assesses his condition, noting his supine position, tense facial expression, and limited mobility. After reviewing his chart and administering an analgesic (as ordered), Tonya uses the nursing process (assessment, planning, implementation, evaluation) to address his pain and immobility, considering the risks of prolonged immobility (e.g., deep vein thrombosis, pneumonia). Tonya demonstrates critical thinking by applying evidence-based knowledge, reflecting on previous patient experiences, and using clinical judgment to create a patient- centered care plan that leads to improved patient outcomes. 📊 Table 15.1 (Example - Content from Table 15.1 is missing from provided transcript.) Lecture Notes: Clinical Decision Making 🩺 Clinical Decision-Making Process The lecture discussed the clinical decision-making process, highlighting its iterative and complex nature. The process involves evaluating patient information, considering various factors, and selecting the best course of action. This is not a linear process; it often involves revisiting earlier steps and adapting to new information. 🧠 Integrating Patient Information https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 3/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Effective clinical decision-making relies on efficiently integrating various types of patient information. This includes: Subjective data: Information reported by the patient (symptoms, history). Objective data: Measurable and observable findings (vital signs, lab results). Patient's context: Socioeconomic factors, cultural background, and support systems. 📊 Data Analysis and Interpretation Analyzing and interpreting data is crucial. This involves: Identifying patterns and trends in the data. Recognizing inconsistencies or conflicting information. Considering the probability of different diagnoses. 💡 Hypothesis Generation and Testing The process involves forming hypotheses about the patient's condition and testing those hypotheses through further investigation, including additional tests or consultations. 💉 Treatment and Management Once a diagnosis is established (or a likely working diagnosis is formed), the next step involves selecting appropriate treatment and developing a plan for ongoing management. This includes: Considering the risks and benefits of different treatments. Communicating treatment plans clearly to the patient. Monitoring patient progress and adjusting treatment as necessary. 🔄 Iterative Nature The lecture emphasized that clinical decision-making is not a one-time event. It's an ongoing, iterative process that adapts to new information and patient responses. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 4/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice 📚 Resources and Guidelines The use of clinical guidelines, textbooks, and other reliable resources are essential tools to aid in the process of clinical decision-making. “Clinical guidelines offer evidence-based recommendations for managing specific conditions, promoting consistent and effective care. They're not rigid rules but rather useful guides.” 🧑‍⚕️ Collaboration and Communication Effective collaboration and communication with other healthcare professionals, as well as the patient and their family, are crucial for optimal clinical decision-making and patient care. Nursing and Critical Thinking Critical Thinking in Nursing 👩‍⚕️ “Critical thinking in nursing involves the cognitive processes nurses use to make clinical judgments and decisions. It goes beyond simply recalling facts; it requires analysis, interpretation, and application of knowledge to unique patient situations.” General Critical Thinking Processes: These are not unique to nursing and include the scientific method, problem-solving, and decision-making. These processes involve gathering information, identifying problems, suggesting solutions, and evaluating effectiveness. Specific Critical Thinking Competencies: These are unique to nursing and include diagnostic reasoning and clinical decision-making. The nursing process itself incorporates these competencies. The Nursing Process 👣 https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 5/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice “The nursing process is a systematic approach to patient care involving six steps: assessment, diagnosis, planning, implementation, evaluation, and documentation.” Diagnostic Reasoning 🤔 “Diagnostic reasoning is a crucial critical thinking competency. It involves understanding and thinking through clinical problems, gathering information, analyzing clues, interpreting evidence, and determining when sufficient information exists to make an accurate diagnosis.” Example: A nurse notices a patient isn't following their medication schedule. Through questioning and observation, the nurse identifies a problem (patient has difficulty managing multiple medications) and implements a solution (relabeling medications with clear time indicators). Clinical Decision-Making 💡 “Clinical decision-making involves weighing options, considering consequences, and making informed conclusions based on evidence and reason. Nurses use personal criteria (experience, patient preferences, resources) to make the best choices for their patients.” Example: A nurse helps a patient choose a healthcare provider, considering factors like location, reputation, and the patient's personal preferences. The nurse weighs the pros and cons of each option before helping the patient make a decision. Critical Thinking Competencies in Action 💪 Competency Description Example General Critical Scientific method, problem- Using the scientific method to test a new approach Thinking solving, decision-making. to wound care. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 6/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Competency Description Example Specific Critical Diagnostic reasoning, clinical Diagnosing a patient's altered mental status by Thinking decision-making. gathering and analyzing information (vital signs, medications, recent events). Nursing Process Assessment, diagnosis, Using the nursing process to manage a patient with planning, implementation, post-operative pain; assessing pain levels, planning evaluation, documentation. interventions, giving medication, and evaluating effectiveness. Lecture Notes: Problem Solving and Intuition in Nursing Intuitive Problem Solving 🤔 Intuitive problem-solving is a method that relies on a nurse's instincts and past experiences. It involves assigning meaning to behaviors and physical cues to make quick decisions. This approach is crucial in fast-paced environments like emergency rooms. However, relying solely on intuition can be risky; it's essential to back up intuitive decisions with evidence-based practices. “Intuition: A problem-solving method relying on personal instincts and past experiences to quickly make decisions. Often used in fast-paced situations, but should always be supported by evidence-based practices.” Critical Thinking and Clinical Reasoning 🧠 Critical thinking and clinical reasoning are vital for effective problem-solving. They involve systematically analyzing information, identifying patterns, and formulating evidence-based solutions. This process moves beyond gut feelings, ensuring decisions are supported by the best available data. “Critical thinking: The objective analysis and evaluation of an issue in order to form a judgment. In nursing, it involves using evidence-based practices and established guidelines https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 7/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice to solve clinical problems.” “Clinical reasoning: The process of using critical thinking skills to make decisions about patient care. This includes assessing the patient's condition, considering the patient's history and preferences, and evaluating potential interventions.” Evaluating Outcomes 📊 Evaluating the outcomes of interventions is a critical component of the problem-solving process. This involves assessing whether the chosen actions were effective in achieving desired results. This feedback loop allows for adjustments and improvements in future care. The NCSBN (2019) emphasizes the importance of this process. “Outcome Evaluation: The process of determining the effectiveness of an intervention based on the observed results and comparing them to the expected outcomes. This informs future decision-making.” Examples of Problem-Solving in Nursing 🏥 The lecture provided various examples of nurses applying critical thinking and intuition in various clinical situations. These real-world scenarios highlighted the complexities of nursing practice and the necessity of a multifaceted approach to problem-solving. Specific examples included: [Note: Specific details from the transcript regarding these examples were unreadable and could not be included here.] Combining Intuition and Evidence-Based Practice 🤝 The ideal approach combines intuitive insights with a rigorous, evidence-based methodology. A nurse's intuition can help identify potential problems quickly, but critical evaluation and data- driven decisions must follow to ensure optimal patient care. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 8/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Lecture Notes: Nursing Judgment and Decision-Making 💉 Intuition in Nursing Decisions The role of intuition in nursing decision-making is a complex one. Some view it as a form of guessing, inappropriate for critical care decisions, particularly regarding extremities where clots can form, travel to the lungs, and cause serious issues (e.g., shortness of breath, sharp chest pain, coughing up pink mucus, irregular heart rate). Others see intuition as a legitimate approach to clinical judgment. “Tanner (2006) suggests less experienced nurses, including students, may rely more heavily on intuition.” 🦠 Healthcare-Associated Infections (HAI): Clostridium difficile The incidence of healthcare-associated infections (HAI), specifically Clostridium difficile, has increased. A discussion among a hospital's Infection Control specialist, Clinical Nurse specialist in medicine, and a team of nurses explored factors contributing to this rise. This included examining hand hygiene practices (both with antiseptic hand rubs and traditional washing) and their effectiveness in preventing the spread of infection. A staff member questioned the efficacy of hand rubs. Studies have investigated the hand hygiene practices of visitors to hospitalized patients. 📊 Nursing Diagnoses and Diagnostic Reasoning Nurses collect and analyze data to formulate nursing diagnoses. Diagnostic reasoning involves understanding the nature of a patient's problem and their response. Experienced nurses identify "red flags," recognizing patterns and themes in symptoms. This process utilizes both data analysis and clinical judgment. Staff members search literature to ensure appropriate responses and diagnoses. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 9/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice “A nursing diagnosis is a clinical judgment about individual, family, or community responses to actual or potential health problems and life processes.” 💊 Medication Considerations The notes mention a patient's medication history over the past three days (specific medications not listed in transcript). The impact of these medications on the patient's condition was not detailed. Nursing Study Guide: Critical Thinking and Clinical Decision Making Levels of Critical Thinking 👩‍⚕️ The development of critical thinking in nursing progresses through three levels: Basic Critical Thinking: At this level, learners rely on experts and trust that the information they receive is correct. They are primarily focused on performing skills and organizing nursing care activities. They follow procedures and rules without necessarily understanding the underlying rationale. Complex Critical Thinking: Nurses at this level begin to separate themselves from experts and explore different options and perspectives. They question existing procedures and develop their own approaches. They are able to identify and consider multiple options based on their patients' unique situations. They are able to analyze and critically evaluate information. Commitment Critical Thinking: Nurses at this level are responsible and accountable for their own decisions and actions. They can anticipate potential problems and make independent clinical judgments. They accept accountability https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 10/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice for the outcomes of their decisions. They are able to justify their actions based on a sound rationale. Clinical Decision Making 🤔 Clinical decision-making involves analyzing a patient's situation, identifying problems, and selecting appropriate actions from available options. This process improves with experience and the development of critical thinking skills. It is a continuous process of assessment and reassessment. Example: A nurse observes a patient who is less mobile and develops redness over the hip. The nurse uses clinical decision-making to identify the problem (impaired skin integrity, possibly a pressure injury) and to choose the best course of action. Another example is a patient who has had surgery: the nurse anticipates postoperative pain and anxiety which may require intervention. The nurse needs to prioritize, based on severity and patient situation. Deductive vs. Inductive Reasoning 🔎 Two types of reasoning are used in clinical decision-making: Deductive Reasoning: This moves from the general to the specific. For example, a nurse might start with the general knowledge that postoperative patients often experience pain and then assess a specific patient for signs and symptoms of pain. Inductive Reasoning: This moves from specific observations to general conclusions. For example, a nurse might observe several patients who develop pressure injuries after surgery and conclude that postoperative patients are at increased risk for pressure injuries. “Deductive reasoning is top-down; inductive reasoning is bottom-up.” Knowing the Patient 🤝 https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 11/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice “"Knowing the Patient" refers to an in-depth understanding of a patient's unique situation, including their medical history, preferences, and psychosocial factors. This understanding informs clinical decisions and allows nurses to provide more individualized and effective care. It evolves over time through interactions and observations.” Lecture Notes: Critical Thinking in Nursing Levels of Critical Thinking 🤔 Basic Critical Thinking: Accepting information as right or wrong without question. “This is the most fundamental level of critical thinking. It involves accepting information that is presented to you without questioning its validity or considering alternative perspectives. It is often based on habit or routine rather than critical analysis.” Complex Critical Thinking: Questioning information and considering multiple perspectives. “At this level, individuals begin to question the information they receive, consider multiple perspectives, and form their own opinions. It involves a more in-depth analysis of information and a willingness to challenge assumptions.” Commitment Critical Thinking: Making responsible choices based on personal reflection. “This is the highest level of critical thinking. It involves using knowledge and experience to make independent judgments. It involves taking ownership of https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 12/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice one's decisions and being accountable for the consequences.” Clinical Decision Making 👩‍⚕️ Factors influencing decision-making: Patient knowledge: Understanding the patient's history and current condition is crucial for effective decision-making. Forming strong relationships with patients improves this understanding. Expert opinions: While valuable, complex critical thinkers learn to rely less on expert opinions and more on their own analysis and judgment. Multiple points of view: Considering various perspectives, including potential biases, enhances decision-making. An example is comparing the perspective of a nurse with years of experience on a surgical unit to a newly graduated nurse. Differentiating belief from knowledge: Knowing the difference between what you know to be true based on evidence and what you believe to be true based on opinion is essential. Improving Clinical Decision-Making 💡 Strategies: Analyzing diagnoses and problems: Identify the most urgent issues to prioritize care effectively. Establishing relationships with patients: Building rapport improves understanding and decision-making accuracy. This provides you with a better "big picture" understanding of the patient. Regulating IV fluids: Correctly regulating infusion rates is a key example of practical decision-making in nursing. Group decision-making: Collaborating with colleagues is often necessary, necessitating effective communication and shared decision-making processes. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 13/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Lecture Notes: Clinical Judgment & Critical Thinking in Nursing Clinical Judgment Model 👩‍⚕️ The lecture highlighted the crucial role of clinical judgment in nursing practice. Nurses must move beyond simply following orders and utilize critical thinking to make informed decisions. This involves several key components: Patient data: This includes all information relevant to the patient's condition, including vital signs, medical history, lifestyle, and social circumstances. Experience: A nurse's experience with similar situations and patient interactions plays a vital role in shaping their clinical judgment. This experience builds a knowledge base that informs decision-making. Skill competence: Proficiency in various nursing skills contributes to effective clinical judgment. This encompasses both technical skills and interpersonal skills. Environment: Contextual factors such as time pressure, setting, and available resources impact clinical judgment. The ability to adapt to varying environments is essential. “Clinical judgment is the process of using knowledge, skills, and experience to make informed decisions about patient care. It moves beyond following protocols and involves critical thinking to address unique patient needs.” Case Study: Mr. Lawson 🤕 The lecture presented a case study of Mr. Lawson, a patient experiencing chest pain. Initial symptoms suggested abdominal pain, but a nurse (Tonya) exhibited critical thinking by: https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 14/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Gathering additional data (vital signs: heart rate increased from 88 to 102 and irregular). Recognizing the potential for a life-threatening condition. Notifying the physician immediately. “This case illustrates how critical thinking leads to better patient outcomes by challenging assumptions and actively seeking further information.” Enhancing Clinical Judgment 💡 The lecture emphasized several strategies for enhancing clinical judgment: Knowing a patient's typical behaviors, schedules, and circumstances: This allows for the identification of deviations from the norm, which can signal potential problems. Considering alternative options: Challenging assumptions and exploring different approaches prevents premature conclusions. Valuing all patient experiences: Every patient interaction provides opportunities for learning and improving clinical judgment. Applying all elements of the clinical judgment model: This ensures a holistic approach to decision-making. Flexibility and original solutions: Nurses must be adaptable and creative in finding effective solutions, especially when traditional approaches are inadequate. “By mastering these components, nurses enhance their ability to provide optimal patient care.” Key Terms & Concepts 📝 https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 15/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Term Definition Clinical Judgment The process of using knowledge, skills, and experience to make informed decisions about patient care. Critical Thinking Analyzing information objectively, considering different perspectives, and making reasoned judgments. Knowledge Base The accumulated knowledge and experience that informs a nurse's clinical decision-making. Skill Competence The mastery of both technical and interpersonal skills necessary for effective nursing practice. Patient Data All information related to a patient's condition, medical history, lifestyle, and social circumstances. Life-threatening A condition with the potential to cause death. condition References Kelley, et al. (2013). [Insert citation details here] Papathanasiou et al. (2014). [Insert citation details here] Critical Thinking in Clinical Judgment Attitudes for Critical Thinking 🤔 Confidence: Having assurance in one's own abilities and decisions. Independent Thinking: Forming one's own judgments and opinions, rather than relying solely on others. Intellectual Curiosity: A persistent desire to learn and explore new ideas. Fairness: Approaching situations and individuals with impartiality and objectivity. Responsibility: Accepting accountability for one's own actions and decisions. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 16/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Discipline: Being organized, methodical, and focused in one's approach to problem-solving. Standards for Critical Thinking 🎯 Intellectual Standards Clear: Easily understood and unambiguous. Precise: Specific and accurate. Specific: Detailed and focused. Accurate: Free from errors and mistakes. Relevant: Pertinent to the issue at hand. Plausible: Reasonable and believable. Consistent: Free from contradictions. Broad: Encompassing a wide range of perspectives. Complete: Thorough and comprehensive. Significant: Important and meaningful. Adequate: Sufficient for the purpose. Fair: Impartial and unbiased. Professional Standards 1. Standards of practice: Adhering to established guidelines and procedures. 2. Ethical criteria for nursing judgment: Making decisions that align with ethical principles. 3. Criteria for evaluation: Establishing clear measures for assessing outcomes. 4. Professional responsibility: Taking ownership of one's actions and decisions. Levels of Critical Thinking 🧠 https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 17/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Level 1: Basic critical thinking; data collection based on preselected categories. Level 2: Complex critical thinking; anticipating required data based on knowledge. For example, a nurse knowing a patient has diabetes mellitus will assess for circulatory problems and vision issues. Level 3: Commitment; making choices and accepting accountability for those decisions; considering the results and determining if the decision was appropriate. Environmental Factors Affecting Clinical Decision Making 🌎 Environmental factors such as task complexity, time pressure, work setting, and interruptions significantly influence clinical decision-making. A complex patient situation, coupled with time constraints, can compromise the clarity of decision-making. Expert nurses adapt to these challenges, weighing risks and consequences accordingly. Components of Critical Thinking in the Clinical Judgment Model 📝 The clinical judgment model highlights the iterative nature of critical thinking, emphasizing the ongoing collection and analysis of patient data to inform decisions. The process involves questioning the nature of a patient's problem, identifying data gaps, and considering individual patient uniqueness. It's a dynamic process, continually refined by new information and changing circumstances. Nursing Study Guide: Critical Thinking & Competence Critical Thinking in Nursing 👩‍⚕️ Nurses must be critical thinkers to provide safe and effective patient care. This involves: https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 18/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Observing and sensing patient information. Talking with patients and their families. Reflecting on experiences. Anticipating and identifying patient problems. Using data to enlist help and support. Adapting approaches to fit the setting and patient. Knowing your limitations and seeking help when needed. “Critical thinking is the objective analysis and evaluation of an issue in order to form a judgment. It involves questioning assumptions, identifying biases, and considering multiple perspectives before making a decision.” A nurse's knowledge base includes information, theories, and experiences from caring for previous patients. This knowledge is used to make informed judgments and decisions. Developing Critical Thinking Skills 🧠 The process of developing critical thinking skills is described as a laboratory for testing and developing approaches. This involves: Gathering data from various sources (patients, families, colleagues). Interpreting this data to understand patient problems' origins and nature. Using this data to enlist help, support and advice from colleagues and interprofessional teams. “Critical thinking skills are developed through experience, reflection, and continuous learning. They are essential for effective decision-making in nursing.” Critical Thinking Attitudes 🤔 Critical thinking involves specific attitudes, including: https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 19/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Independent thinking: Forming your own judgments based on evidence and reasoning, not solely relying on what you've learned in school. Discipline: Being systematic and thorough in your approach to problem-solving. This helps identify problems more accurately. Perseverance: Being determined to find solutions, especially crucial when dealing with complex patient care problems. Confidence: Trusting your judgment and abilities while remaining open to new information and perspectives. “Critical thinking attitudes are the mindset and dispositions that support critical thinking. They influence how you approach problems and make decisions.” Competence in Nursing 🏥 Competence in nursing combines knowledge, skills, and attitudes for effective care. It involves: Being a better-informed critical thinker. Learning scientific concepts and patient care. Actively reflecting on experiences. “Competence is the ability to perform tasks effectively and efficiently. In nursing, it requires a combination of knowledge, skills, and attitudes. It's about being able to successfully apply your understanding and abilities to meet the needs of your patients.” Critical Thinking in Nursing Practice 🤔 Attitudes of Inquiry “Attitudes of inquiry involve recognizing problems, considering their context, and seeking evidence to support beliefs. Critical thinking guides problem-solving approaches.” https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 20/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Recognize problems: Identifying existing issues. Consider context: Understanding the environment surrounding the problem. Seek evidence: Looking for supporting data to validate assumptions. 🧐 Critical Thinking Skills in Nursing “This section details the crucial skills involved in critical thinking within a nursing context.” Confidence: Grows with experience and logical problem-solving. Asking questions about your approach is key. Creativity: Finding solutions beyond standard procedures while adhering to practice standards. Example: A home care nurse uses blocks to raise a chair, aiding a patient with arthritis. Fairness: Avoiding bias in decision-making. Example: Providing equal care to an overweight patient, regardless of personal feelings about obesity. Discipline: Striving for high-quality care; not settling for minimal effort. Example: Thoroughly assessing a patient to identify the root cause of anxiety. Perseverance: Continuously trying different communication methods until an effective one is found. Example: Using message boards or alarm bells for a patient unable to speak. Objectivity: Considering all viewpoints to fully understand a situation before deciding. Curiosity: Asking "Why?" to uncover patterns and seek further information. Example: A nurse questioning why one type of surgical dressing is preferred over another. 🧑‍⚕️ Responsibility and Accountability in Nursing https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 21/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice “This section explains the importance of responsibility and accountability in nursing practice.” Responsibility: Acknowledging accountability for decisions, actions, and critical thinking. Accountability: Performing nursing care based on standards of practice; avoiding shortcuts. 🗣️ Communication and Collaboration “Effective communication and collaboration are essential for critical thinking in nursing.” Speak with conviction: Confidently communicate interventions to patients without implying inability to perform care safely. Encourage patient questions: Promote open communication to ensure understanding. Share ideas: Collaborate with colleagues to gain diverse perspectives and improve interventions. 📚 Using Evidence-Based Practice “Evidence-based practice is a core component of critical thinking in nursing.” Questioning clinical practices: Examining the rationale behind procedures and seeking evidence to support them. Seeking further information: Recognizing when more information is needed to make informed decisions. Disciplined inquiry: Thoroughly investigating clinical problems to find evidence- based solutions. 🤔Disciplined Support https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 22/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Disciplined support is crucial for colleagues experiencing difficulties with patients, particularly when established methods prove ineffective. Maintaining adherence to the highest standards of practice is paramount in these situations. 🤝Collegial Support & High Standards The text highlights the importance of providing support to colleagues who are struggling. This support should be disciplined, meaning it follows established procedures and best practices. The goal is to help colleagues improve their approach to patients while adhering to the highest standards of practice. The implication is that simply offering encouragement isn't sufficient; active guidance and a structured approach are necessary. 👨‍⚕️Patient Care & Best Practices The focus is on improving patient care by ensuring colleagues maintain the highest standards of practice. This suggests a professional environment where continuous learning and improvement are expected and supported. It's likely that the context includes a healthcare setting, where best practices are crucial to patient well-being and safety. Clinical Judgment in Nursing 👩‍⚕️ Meeting With Colleagues 🤝 A way to develop and evaluate your critical thinking is to regularly discuss and reflect on cases with colleagues. This shared learning helps identify strengths and weaknesses in clinical reasoning. Evaluating Clinical Thinking 🤔 Use of criteria for professional judgment: The process involves applying established standards and guidelines to assess patient care. Reviewing facts and describing what happened: A thorough analysis of the situation requires a clear understanding of all relevant details. Considering possible outcomes: Forecasting potential positive and negative results helps in making informed decisions. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 23/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Exploring alternative approaches: This broadens the perspective and enhances the decision-making process. Professional Judgment and Patient Safety 🏥 “Professional judgment in nursing involves using critical thinking and clinical reasoning skills to make safe and effective decisions for patient care. It requires a comprehensive understanding of patient needs, combined with knowledge of nursing practices and relevant guidelines.” Patient-centered care: Decisions are focused on the unique needs and preferences of the individual patient. Evidence-based practice: Current research and best practices inform clinical decisions. Collaboration: Working with other healthcare professionals enhances decision- making and improves outcomes. Safety: Prioritizing patient safety is paramount in all clinical judgments. Example Scenario 📝 The provided text contains a largely unintelligible segment. Therefore, a specific example scenario cannot be extracted and included in the study guide. The provided text seems to be a garbled or corrupted transcription. Lecture Notes: Clinical Decision- Making 🤔 Clinical Practice Guidelines & Standards Clinical practice guidelines provide standards for treating specific conditions (e.g., stroke, deep vein thrombosis). They use logic and significance to ensure the plan of care is relevant to a patient's needs. Following these standards prevents haphazard thinking and improves problem- solving. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 24/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice 🧠 Concept Mapping & Reflection in Clinical Practice Concept mapping is a visual tool to organize information about a patient's multiple diagnoses and collaborative problems. It helps understand the connections between different aspects of a patient's care. “Reflection: A process of reviewing your clinical experiences to improve your ability to apply theory in practice. It can help you identify subtle aspects of situations and enhance your decision-making. However, over-reliance on reflection can hinder exploring new evidence.” 📊 Data Analysis for Sound Clinical Decisions Analyzing patient data, including trends and patterns, allows for early detection and prevention of future problems. This is crucial for making informed clinical decisions. Examples of data that may be analyzed include lab results (blood tests), imaging results (lung scans, chest x-rays). 👨‍⚕️Ethical and Evidence-Based Criteria in Clinical Decision-Making Nurses must consider both ethical and evidence-based criteria when making clinical decisions. This ensures patient care is aligned with professional standards and best practices. Patient identity must always be protected. 📝 Journaling for Improved Clinical Judgment Regularly journaling clinical experiences (perceptions, thoughts, etc.) helps develop the ability to apply theory to practice, improving clinical judgment. This allows for review and reflection. 📝 Critical Thinking in Nursing Critical thinking is a crucial component of nursing practice that involves analyzing and evaluating information to make informed decisions. It requires nurses to be open-minded, truth- seeking, and reflective in their practice. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 25/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice 🤔 Definition of Critical Thinking “Critical thinking is the systematic evaluation and analysis of information and ideas to form a judgment or decision. It involves identifying patterns, relationships, and inconsistencies, and using this information to make informed decisions.” 📊 Components of Critical Thinking The following are key components of critical thinking: Knowledge: understanding of the patient's condition, treatment options, and potential outcomes Analysis: breaking down complex information into smaller parts to understand relationships and patterns Evaluation: assessing the credibility and relevance of information to make informed decisions Application: using critical thinking to make decisions and take action 📈 Types of Critical Thinkers There are two types of critical thinkers: Type Characteristics Basic Critical Thinker task-oriented, focuses on completing tasks and following procedures Complex Critical uses experience to anticipate and individualize nursing procedures, recognizes Thinker patterns and relationships 📝 Decision Making in Nursing Decision making in nursing involves using decision criteria to prioritize patient problems and make informed decisions. The following are key decision criteria: https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 26/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Clinical condition of the patient Advantages and disadvantages of each treatment option Maslow's hierarchy of needs Risks involved in treatment delays Environmental factors Patient expectations of care 📊 Prioritizing Patient Problems To prioritize patient problems, nurses should use the following steps: 1. Assess the patient's clinical condition 2. Identify the advantages and disadvantages of each treatment option 3. Consider the patient's hierarchy of needs 4. Evaluate the risks involved in treatment delays 5. Consider environmental factors and patient expectations of care 📝 Improving Clinical Decision Making The following strategies can improve clinical decision making: Working the same shift each day to develop a routine and anticipate patient needs Spending time during patient assessment to gather information and identify patterns Knowing the early mobility protocol guidelines to promote patient mobility and prevent complications Caring for the patient on consecutive days to develop a relationship and anticipate patient needs https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 27/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice Knowing the pattern of patient behavior to anticipate and respond to patient needs# Lecture Notes: Clinical Judgment in Nursing Practice 🤔 Critical Thinking Attitudes & Intellectual Standards 🤔 During clinical care, nurses must apply critical thinking attitudes and intellectual standards. Critical Thinking Attitudes: Be objective in asking patient questions. Be tolerant of the patient's views and beliefs. Recognize your own knowledge limits. Know when information is misleading and when you need more information. Develop a plan of action based on patient priorities. Intellectual Standards: These are guidelines for rational thought during the nursing process. After making a clinical decision, use reflection to consider the meaning of your findings and explore their possible meaning in solving patient problems. An example is a nurse's awareness that many cancer patients struggle with pain management due to fear of addiction, highlighting pain control as a priority in cancer care. 💡 Problem-Based Learning (PBL) and the Nursing Process 💡 Problem-based learning (PBL) is a method used to enhance clinical judgment. The REFLECT model is one example that helps improve learning after providing patient care: REFLECT Model: This model can be used to improve learning after providing patient care. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 28/29 1/30/25, 7:11 PM Critical Thinking in Nursing Practice 💉 Applying Clinical Judgment: Case Examples 💉 Here are some examples of applying clinical judgment in nursing practice: Example 1: A nurse assesses a patient following a blood transfusion. This requires analyzing data (e.g., vital signs, patient report) and determining what information is relevant. Example 2: A nurse is preparing medications and checks the medication label against the healthcare provider's order at the bedside. This involves careful attention to detail and double-checking. Example 3: A nurse responds to a patient's call light and must determine the level of urgency of the situation. This depends on analyzing the patient’s stated problem and the nurse’s own knowledge. Example 4: A nurse uses the information found in electronic health records to inform their assessment of the patient at the beginning of a shift. 📝 Types of Critical Thinking Questions 📝 Nurses should ask three types of critical thinking questions: 1. Questions about evidence 2. Questions about assumptions 3. Questions about perspectives 🤝 Building Patient Relationships 🤝 Building a strong nurse-patient relationship is crucial for effective clinical decision-making. This involves understanding the patient’s psychosocial needs and engaging with them while experiencing illness. https://www.turbolearn.ai/notes/c68a91ef-7cbf-4eff-acdb-863bf018a9d1 29/29