Chapter 15 Critical Thinking in Nursing Practice

1
Chapter 15Critical
Thinking in Nursing Practice
2
Critical Thinking

• Critical thinking is not a simple step-by-step
  linear process that is learned in a short period
  of time.
• Critical thinking is acquired through experience,
  commitment, and active curiosity.
• Critical thinking and the nursing process are
  interwoven. One does not exist without the other.

3
Clinical Decision in Nursing Practice

• Clinical decision-making skills separate
  professional nurses from technical and ancillary
  staff.
• Clients have problems for which no textbook
  answers exist.
• Nurses need to seek knowledge, act quickly, and
  make sound clinical decisions.

4
Critical Thinking Defined

• Chaffee (2002)
• An active, organized, cognitive process used to
  carefully examine ones thinking and the thinking
  of others
• Settersten and Lauer (2004)
• Recognizing an issue exists, analyzing
  information, evaluating information, and making
  conclusions

5
Thinking and Learning

• Learning is a lifelong process.
• Intellectual and emotional growth involves
  learning new knowledge, as well as refining the
  ability to think, solve problems, and make
  judgments.

The science of nursing continues to grow, Nurses
need to be flexible and open to new information.
6
Levels of Critical Thinking

• Kataoka-Yahiro and Saylor (1994) Critical
  Thinking Model
• Basic critical thinking - think concretely on the
  basis of a set of rules or principles, following
  a step-by-step process without deviation from the
  plan.
• Complex critical thinking -analyzes and examines
  choices independently. Students learn to think
  beyond and synthesize knowledge.
• Commitment- anticipate needs and make choices
  without assistance from others.

7
Critical Thinking Competencies
7
Scientific method Solve problem using reasoning. General critical thinking Problem solving General critical thinking
Decision making General critical thinking Diagnostic reasoning and inference
Clinical decision making Nursing process as a competency

1. Identify the problem
2. Collect data
3. Formulate questions/hypothesis
4. Testing hypothesis
5. Evaluating results

Specific clinical thinking
Specific clinical thinking
Specific clinical thinking
8
Critical Thinking Model for Decision Making

• Models serve to explain concepts and help nurses
  make decisions and judgments about patients.
• Kataoka-Yahiro and Saylor (1994)
• Define the outcome of critical
• thinking as nursing judgment that is
• relevant to nursing problems in a
• variety of settings.

9
Five Components of Critical Thinking

• Knowledge base
• Experience
• Nursing process competencies
• Attitudes for critical thinking (Confidence,
  independence, Fairness, Responsibility,
  Creativity)
• Standards Intellectual standard (Clear,
  Precise,
• Specific, Accurate,
  Relevant)
• -Professional standards
  (Ethical criteria
• for nursing judgment,
  criteria for
• evaluation,
  professional responsibility)

10
Developing Critical Thinking Skills

• Reflective journaling
• A tool used to clarify concepts through
  reflection by thinking back or recalling
  situations
• Concept mapping
• A visual representation of client problems and
  interventions that illustrates an
  interrelationship
• Meeting with Colleagues
• Clinical pre and post conferences, Staff
  meetings, Grand rounds

11
CRITICAL THINKING SYNTHESIS

• A reasoning process used to reflect on and
  analyze thoughts, actions, and knowledge
• Requires a desire to grow intellectually
• Requires the use of nursing process to make
  nursing care decisions

12
SUMMARY

• Nurses use critical thinking skills to identify
  priority client problems
• Critical thinking is to develop appropriate
  individualized care plans
• Critical thinking is used to reflect on
• implemented care and evaluation of
• client responses to care

13
SUMMARY

• The nursing process involves the general and
  specific thinking competencies
• These competencies are used in a way to focus on
  particular clients needs

14
Questions?