Critical Thinking, Decision Making, and the Nursing Process Chapter 5 Critical Thinking, Decision Making, and the Nursing Process

Critical Thinking “…reasonable reflective thinking that is focused on deciding what to believe or do” (Ennis, 1987) Process through which nurses analyze and make sense of situations to make sound clinical decisions

Components of Critical Thinking Mental operations Knowledge Attitudes

Development of Critical Thinking Skills Identify goals Determine knowledge Assess margin for error Determine time available for decision making Identify resources Recognize influencing factors

Critical Thinking Skills Interpretation Analysis Influence Explanation Evaluation Self-regulation

Critical Thinking and Creativity Barriers: Habit Comfort with status quo Fear of making mistakes Tradition Use of meaningless routines and rituals Rigid mind-set

Critical Thinking and Problem Solving Critical thinkers avoid pitfalls of problem solving by: Defining problem Analyzing data Understanding causes Creating new ideas that lead to problem resolution

Critical Thinking and Decision Making Critical thinking used to develop and support sound clinical decisions Implement safe, effective nursing interventions only after: Reflection Reasoning

Nursing Process Historical perspective Framework for providing professional, quality nursing care Assessment Planning Implementation Evaluation (continued)

Nursing Process Overview: Assessment Diagnosis Outcome identification and planning Implementation Evaluation

Assessment Collect data Validate data Organize data Identify pattern Devise initial inferences Record or report data

Diagnosis Analyze and synthesize data Types: Actual problems Potential problems Wellness conditions Collaborative problems

Outcome Identification and Planning Prioritize nursing diagnoses Identify and write outcomes and goals Develop specific interventions Record plan

Implementation Execute plan Necessary skills: Continual assessment Psychomotor Interpersonal Critical thinking (continued)

Implementation Necessary skills: Communication Writing Reporting

Evaluation Evaluate goals Reassess Make necessary changes Met Not met Partially met Reassess Make necessary changes Continual process

Critical Thinking Applied to Nursing Learned skill Vital tool Nurses need to have questioning attitude in every phase of nursing process