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CRITICAL THINKING in Nursing Practice:

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CRITICAL THINKING in Nursing Practice: active, organized, cognitive process used to carefully examine one s thinking and the thinking of others. – PowerPoint PPT presentation

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Title: CRITICAL THINKING in Nursing Practice:


1
CRITICAL THINKING in Nursing Practice
  • active, organized, cognitive process used to
    carefully examine ones thinking and the thinking
    of others.
  • Involves use of MIND
  • Form conclusions
  • Make decisions
  • Draw inferences
  • reflect

2
Critical Thinking and Nursing
  • The nurse identifies unique needs of each client
    and develops specific interventions to meet those
    needs.
  • Creative thinkers have the intellectual courage
    and capacity to think in a new and in a different
    way.
  • Without creative thinking, nursing would become
    routine and habitual.

2
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Critical Thinking Applied in Nursing
  • Application of critical thinking is vital to each
    step of the nursing process.
  • Critical thinkers develop a questioning attitude.
  • No action is performed without critical
    thinking.

3
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Activity
  • Its often said that medicine is curing and
    nursing is caring, do you agree ?
  • Discussion

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BEGIN WITH
  • Questions
  • What do I really know about this nursing care
    situation?
  • How do I know it?
  • What options are available to me?

6
THREE INPORTANT ASPECTS
  • REFLECTION purposefully thinking back
    /recalling. Requires honest review
  • LANGUAGE precise clear resulting in clear
    message
  • INTUITION inner sensing that something is so

7
THINKING AND LEARNING
  • LIFELONG PROCESS
  • NURSING PRACTICE ALWAYS CHANGING

8
LEVELS OF CRITICAL THINKING IN NURSING
  • BASIC CONCRETE, BASED ON SET OF RULES OR
    PRINCIPLES
  • COMPLEX IT DEPENDS
  • COMMITMENT CHOOSE AN ACTION STAND BY IT

9
CRITICAL THINKING COMPETENCIES
  • Scientific method
  • Problem solving
  • Decision making
  • Diagnostic reasoning and inference
  • Clinical decision making

10
Critical Thinking and Decision Making
  • Decision Making
  • Considering and selecting interventions to
    facilitate achievement of desired outcomes.
  • Based on reliable information and made with as
    much critical thought as possible

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Critical Thinking and Decision Making
  • Critical thinking for clinical decision-making is
    the ability to think in a systematic and logical
    manner with openness to ask questions and reflect
    on the reasoning process used to ensure safe
    clinical practice and quality care.

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Activity
  • You hear strange noise in the kitchen. Upon
    entering the kitchen you find that you left the
    water running and notice the kitchen floor is
    covered with water. Within your reach there are
    six (6) sponges, a mop and bucket and a covered
    floor drain. What do you do first?

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Critical Thinking and Problem Solving
  • The nurse uses the nursing process to identify
    and make decisions about client needs.
  • The nursing process is a systematic and
    scientifically-based process.
  • The process requires the use of many cognitive
    and psychomotor skills

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NURSES DO NOT MAKE MEDICAL DIAGNOSES, BUT THEY
DO ASSESS AND MONITOR CLIENTS CLOSELY AND COMPARE
THE CLIENTS SIGNS AND SYMPTOMS WITH THOSE THAT
ARE COMMON TO A MEDICAL DIAGNOSIS.
15
The Nursing Process
  • A process is a series of steps or acts that leads
    to accomplishment of some goal or purpose.
  • The purpose of the nursing process is to provide
    individualized, holistic, effective, and
    efficient care to clients.
  • Systematic framework for providing professional,
    quality nursing care.
  • Used in every practice setting and specialty.
  • Derived from the scientific method of problem
    solving.

15
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Nursing process as a competency
  • Five steps
  • Assessment
  • Diagnosis
  • Planning
  • Implementation
  • Evaluation

17
Components of the Nursing Process
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SYSTEMATIC APPROACH
  • GATHER DATA
  • CRITICALLY EXAMINE ANALYZE
  • IDENTIFY RESPONSE
  • DETERMINE PRIORITY
  • ESTABLISH GOALS EXPECTED OUTCOMES
  • TAKE ACTION
  • EVALUATE

19
Characteristics of Critical Thinking
  • Creativity
  • Logical and rational
  • Cautious and information-seeking
  • Systemic
  • intellectual

19
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Critical Thinkers Ask
  • What am I taking for granted?
  • Did I explore all points of view?
  • Do I understand the question?
  • What information do I need?

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The Four Critical Thinking Skills
  • Reading
  • Listening
  • Observing
  • Analyzing

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To Improve Critical Reading
  • Highlight the main ideas as you read. If most of
    the text is highlighted you are not reading
    critically.
  • Join a study group and see if your main idea is
    the same as fellow group members.
  • Dialogue with yourself to identify the main idea
    of your reading.
  • Try to state the main idea in your own words

22
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To Improve Critical Listening
  • Restate the points made in a discussion with
    others to see if you understand them.
  • Focus on what a speaker is saying and listen for
    key points.
  • While listening, make note of anything you find
    confusing, and ask about it later.

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To Improve Critical Observing
  • Remove any restrictions in your mind.
  • Eliminate or decrease any distraction.
  • Ask yourself if you understand the most important
    points?
  • Create new ways of looking at situations
  • Always look from outside the situation .

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To Improve Critical Analyzing
  • Maintain clear and accurate logic.
  • Take all details into consideration.
  • Use systematic and scientifically-based process.
  • Use both cognitive and psychomotor skills.

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Reasoning
  • The process of solving problems by using critical
    thinking skills.
  • An attempt to figure something out, solve a
    problem, or settle a question

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.Strategies that Promote Development
Application of Critical Thinking
  • Identify goals.
  • Determine what knowledge is required.
  • Assess the margin for error.
  • Determine the amount of time available for
    decision making.
  • Identify available resources.
  • Recognize factors that may influence decision
    making.

27
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Barriers to Creative Thinking
  • Resistance to change, rigid mind-set, practice
    guided by tradition, habit, routines
  • Stereotypical perceptions of clients
  • Fear of making mistakes
  • Unwillingness to take risks or look for
    alternative strategies
  • Decision making without sufficient data or
    supported by rationale
  • Failure to evaluate effectiveness of nursing
    actions

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Examples
  • A 6-year old girl is admitted to following
    lacrimal duct probing. She has a history of
    asthma and is receiving humidified oxygen through
    a nebulizer mask. Suddenly, her respiratory
    status changes. She is struggling for air and has
    sternal retraction. Her respirations become loud
    and crowing.
  • What would you do at this time? Why?

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Examples
  • On your second home visit with Mrs. B., she tells
    you , Being in this much pain isnt worth it
    anymore. I am just getting worse everyday. I can
    hardly do anything for myself. I would be better
    off dead!
  • Describe three possible responses you could make
    to Mrs. B. Provide a rationale for each.
  • Which response would you choose and why?
  • Mr. K., a patient with asthma, was admitted
    yesterday morning. He has an order for albuterol
    treatments to be given every 4 hours around the
    clock. You enter his room at 400 a.m. and find
    him sleeping soundly.
  • What would you do? Why?

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10 Key Questions that Promote Critical Thinking
  1. What major outcomes (observable results) will
    drive our thinking?
  2. Exactly what are the problems, issues, or risks
    that must be addressed to achieve the major
    outcomes?
  3. What are the circumstances?
  4. What knowledge is required?
  5. How much room is there for error?

32
10 Key Questions that Promote Critical Thinking
  • 6. How much time do I/we have?
  • What resources can help?
  • Whose perspectives must be considered?
  • Whats influencing thinking?
  • What must we do to prevent, control, or eliminate
    the problems or issues identified in question 2
    above?

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Designed with the Assumptions that
  • Critical thinking
  • has to happen in our own brains. 
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