CHAPTER 4 Overview of the Nursing Process and Critical Thinking

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CHAPTER 4 Overview of theNursing Process and
Critical Thinking
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The Nursing Process

• A way of thinking and acting based on the
  scientific process, with observable results used
  to solve problems
• Five components
• Assessment
• Nursing Diagnosis
• Planning
• Implementation
• Evaluation

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Assessment

• The process of collecting, organizing,
  documenting, and validating a patients health
  data
• Data are gathered from the patient (physical
  assessment and interview) and the family, as well
  as from the physician and the patients medical
  record
• Data from other health professionals and
  diagnostic test are included in assessment.

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Nursing Diagnosis

• The process of sorting and analyzing the
  assessment data to identify potential health
  problems
• Problems identified during the process are
  specific nursing diagnoses.
• Nursing diagnoses are prioritized and entered
  into the nursing plan of care.

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Planning

• A series of steps in which the nurse and the
  patient set priorities and goals to eliminate,
  diminish or control identified problems
• Goals should be stated with specific outcomes.
• The nurse and the patient collaborate to choose
  specific interventions to enable the patient to
  meet the specific outcomes listed in the plan of
  care.

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Implementation

• The process of carrying out nursing interventions
  prioritized during the planning process
• Some interventions may be delegated or carried
  out by other members of the health care team.

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Evaluation

• Assessing the patient to evaluate his or her
  response to the nursing interventions
• Responses are compared with the expected outcomes
  to evaluate whether the outcomes have been
  achieved.
• Based on results from the evaluation process, the
  nursing plan of care may need to be changed.

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Critical Thinking

• Critical thinking is required to use the nursing
  process successfully.
• Critical thinking means requiring careful
  judgment.
• Critical thinking is directed purposeful mental
  activity by which ideas are evaluated, plans are
  constructed, and desired outcomes are decided.

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Problem Solving and Decision Making

• The problem-solving process has several steps
  beginning with defining the problem
• Consider all possible alternatives.
• Consider the possible outcomes for each
  alternative.
• Predict the likelihood of the alternative
  occurring.
• Choose alternatives with the best chanceof
  success and the fewest undesirable outcomes.

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Critical Thinking in Nursing

• Nursing Diagnosis The process by which the
• assessment data are sorted and analyzed so that
• specific actual and potential health problems are
  
• identified
• Factors contributing to the problems are
  considered, and specific nursing diagnoses are
  chosen for the patients care plan.
• (Contd)

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Critical Thinking in Nursing

• (Contd)
• Assessment/Data Collection Collecting,
  organizing,
• documenting, and validating data about a
  patients
• health status
• Assessment data are obtained from the patient,
  the family, the physician, diagnostic tests, and
  information from other health professionals.
• (Contd)

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Critical Thinking in Nursing

• (Contd)
• Planning A series of steps in which the nurse
  and
• the patient set priorities and goals to eliminate
  or
• diminish the identified problems
• The goals are stated as specific expected
  outcomes.
• The expected outcomes and nursing interventions
  are listed in the nursing care plan.
• (Contd)

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Critical Thinking in Nursing

• (Contd)
• Implementation Carrying out nursing
  interventions
• in a systematic way
• The nurse carries out the interventions or
  delegates them to an appropriate person.
• The patients response is documented in the
  patients chart.
• (Contd)

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Critical Thinking in Nursing

• (Contd)
• Evaluation Assessing the patients response to
  the
• nursing interventions
• Responses are compared with the expected outcomes
  to assess to what extent the outcomes have been
  achieved.
• The entire care plan is reassessed in this phase,
  and any changes needed are made.

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Priority Setting

• Priority setting involves placing nursing
  diagnoses or nursing interventions in the order
  of importance
• Life-threatening problems take priority
• Problems that threaten health or coping ability
  are medium priority
• Problems that do not have a major effect if not
  attended to that day or week are low priority.

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Organizing Workload

• Priorities change constantly as patient
  conditions change
• To maintain an organized workload you must
• Write out a worksheet and list major tasks to
  accomplish
• Be flexible and frequently reorder your tasks
• Evaluate and reprioritize your work plan at least
  every 2 hours
• Know when to ask for help and when to delegate a
  tasks to others