CRITICAL_CARE_Trans_1_Critical_Thinking_and_Clinical_Judgment.pdf

CRITICAL THINKING AND CLINICAL JUDGMENT LESSON # 1 NCM 118 – Critical Care Nursing (Lec) Prof. Frances Carmi D. Gonzales │ August 15, 2024 │ Transcript by JABYNATION OUTLINE...

CRITICAL THINKING AND CLINICAL JUDGMENT LESSON # 1 NCM 118 – Critical Care Nursing (Lec) Prof. Frances Carmi D. Gonzales │ August 15, 2024 │ Transcript by JABYNATION OUTLINE LANGUAGE I. Critical Thinking A. Levels of Critical Thinking Precise, clear language demonstrating focused B. Components of Critical Thinking thinking and communicating unambiguous i. Knowledge messages and expectations to clients and other ii. Experience health care team members iii. Competence A nurse should ask the following: iv. Attitude o “Did I use language appropriate for the v. Standards client?” II. Critical Thinking and the Nursing Process o “Did I communicate the message clearly A. Assessment / Data Collection to the provider?” B. Analysis of Data C. Planning INTUITION D. Implementation E. Evaluation An inner sensing that facts do not currently support something MUST-KNOW 📌 Intuition should spark the nurse to search the Critical Thinking and Clinical Judgment for a: data to confirm or disprove the feeling SAFE & EFFECTIVE CARING ENVIRONMENT The nurse should ask the following: o “Did the vital signs reflect any changes I. CRITICAL THINKING that account for the client’s present status?” Critical thinking requires lifelong learning and o “When the client’s status changed in this the ability to acquire relevant experiences that way last month, there was a specific can be reflected on continuously to improve reason for it. Is that what is happening nursing judgment here?” COMPONENTS OF CRITICAL THINKING 1. Knowledge A. LEVELS OF CRITICAL THINKING 2. Experience 3. Critical Thinking Competencies 1) BASIC CRITICAL THINKING 4. Attitudes 5. Intellectual & Professional Standards A nurse trusts the experts and thinks Critical thinking incorporates: concretely based on the rules 1. Reflection Results from limited nursing knowledge and 2. Language and; experience, as well as inadequate critical 3. Intuition thinking experience It evolves through three distinct levels as a Example: nurse gains knowledge and experience while o A client reports pain an hour after maturing into a competent nursing professional receiving a pain medication. Instead of reassessing the client’s pain, the nurse REFLECTION tells the client he must wait two more hours before he can receive another Purposefully thinking back or recalling a dose situation to discover its meaning and gain insight into the event 2) COMPLEX CRITICAL THINKING A nurse should reflect on the following: o “Why did I say that or do this?” The nurse begins to express autonomy by o “Did the original plan of care achieve analyzing and examining data to determine the optimal client outcomes?” best alternative Ø If so: “Which interventions were Results from an increase in nursing knowledge, successful?” experience, intuition, and more flexible Ø If not: “Which interventions were attitudes unsuccessful?” Example: o A nurse realizes that a client is not ambulating as often as prescribed JABYNATION BUCN 3-A 1 CRITICAL THINKING AND CLINICAL JUDGMENT LESSON # 1 because of a fear of missing her GENERAL SPECIFIC daughter’s phone call. The nurse assures CRITICAL THINKING CRITICAL THINKING the client that the staff will listen for and Decision-making answer her phone when she is out of her Diagnostic reasoning & room inference Clinical decision-making 3) COMMITMENT Collaboration The nurse expects to make choices without help iv. ATTITUDE from others and fully assumes the responsibility for those choices Mindsets that affect how a nurse approaches a Commitment results from an expert level of problem knowledge, experience, developed intuition, and reflective, flexible attitudes ATTITUDE MEANING Example: 1. Confidence Feels sure of abilities o A nurse increases the rate of an IV fluid Analyzes ideas for logical 2. Independence infusion when a client’s blood pressure reasoning indicates hypovolemic shock 24 hrs after 3. Fairness Objective, nonjudgmental surgery Adheres to standards of 4. Responsibility practice B. COMPONENTS OF CRITICAL THINKING Takes calculated 5. Risk-taking chances in finding better 1. Knowledge solutions to problems 2. Experience Develops a systematic 3. Competence 6. Discipline approach to thinking 4. Attitude Continues to work at a 5. Standards 7. Perseverance problem until there is a resolution i. KNOWLEDGE Uses imagination to find 8. Creativity solutions to unique client Information that is specific to nursing problems Comes from: Requires more o Basic nursing education 9. Curiosity information about clients o Use of evidence-based practice and problems o Continuing education courses o Advanced degrees and certifications Practices truthfully and 10. Integrity ethically ii. EXPERIENCE Acknowledges 11. Humility weaknesses Decision-making ability derived from opportunities to observe, sense, and interact v. STANDARDS with clients followed by active reflection A nurse: Model for comparing care to determine o Demonstrates an understanding of acceptability, excellence, and appropriateness clinical situations Intellectual standards ensure the thorough o Recognizes and analyzes cues for application of critical thinking relevance Professional standards: o Incorporates experience into intuition o Nursing judgment based on ethical criteria iii. COMPETENCE o Evaluation that relies on evidence- based practice Cognitive processes a nurse uses to make o Demonstration of professional nursing judgments responsibility o Promotes maximal level of nursing care GENERAL SPECIFIC CRITICAL THINKING CRITICAL THINKING II. CRITICAL THINKING AND THE NURSING Scientific method The Nursing Process PROCESS Problem-solving JABYNATION BUCN 3-A 2 CRITICAL THINKING AND CLINICAL JUDGMENT LESSON # 1 A. ASSESSMENT / DATA COLLECTION D. IMPLEMENTATION Collect information about a client’s present Provide care based on assessment data, health status to identify needs, and to identify analyses, and the plan of care additional data to collect based on findings CRITICAL THINKING SKILLS CRITICAL THINKING SKILLS Use knowledge base Observe Use appropriate skills and teaching strategies Use correct techniques for collecting data Test theories Differentiate between relevant and irrelevant Delegate and supervise nursing care data, and between important and unimportant Communicate appropriately in response to a data situation Organize, categorize, and validate data Interpret assessment data and draw a E. EVALUATION conclusion Examine a client’s response to nursing B. ANALYSIS OF DATA interventions and form a clinical judgment about meeting goals and outcomes Interpret or monitor the collected database, reach an appropriate nursing judgment about a CRITICAL THINKING SKILLS client’s health status and coping mechanisms, and provide direction for nursing care Determine accuracy of theories While analysis helps the nurse establish Evaluate outcomes based on specific criteria diagnoses for the client, it occurs in an ongoing Determine understanding of teaching manner throughout the nursing process CRITICAL THINKING SKILLS Identify clusters and cues Detect inferences Recognize an actual or potential problem or risk Avoid making judgments C. PLANNING Establish priorities and optimal outcomes of care to measure and evaluate Then, select the nursing interventions to include in a client’s plan of care to promote, maintain, or restore health CRITICAL THINKING SKILLS Identify goals and outcomes for client care Set priorities Determine appropriate strategies and interventions for inclusion on a client’s plan of care or teaching plan Take knowledge and apply it to more than one situation Create outcome criteria Theorize Consider the consequences of implementation JABYNATION BUCN 3-A 3