1. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 5 Critical Thinking, Decision Making, and the Nursing Process

2. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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

3. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Components of Critical Thinking Mental operations Knowledge Attitudes

4. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Development of Critical Thinking Skills Identify goals Determine knowledge Assess margin for error Determine time available for decision making Identify resources Recognize influencing factors

5. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Critical Thinking Skills Interpretation Analysis Influence Explanation Evaluation Self-regulation

6. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Critical Thinking and Creativity Barriers: –Habit –Comfort with status quo –Fear of making mistakes –Tradition –Use of meaningless routines and rituals –Rigid mind-set

7. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. 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

8. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Critical Thinking and Decision Making Critical thinking used to develop and support sound clinical decisions Implement safe, effective nursing interventions only after: –Reflection –Reasoning

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Process Historical perspective –Framework for providing professional, quality nursing care Assessment Planning Implementation Evaluation (continued)

10. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Process Overview: –Assessment –Diagnosis –Outcome identification and planning –Implementation –Evaluation

11. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Assessment Collect data Validate data Organize data Identify pattern Devise initial inferences Record or report data

12. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnosis Analyze and synthesize data Types: –Actual problems –Potential problems “Risk for” –Wellness conditions –Collaborative problems

13. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Outcome Identification and Planning Prioritize nursing diagnoses Identify and write outcomes and goals Develop specific interventions Record plan

14. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Implementation Execute plan Necessary skills: –Continual assessment –Psychomotor –Interpersonal –Critical thinking (continued)

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Implementation Necessary skills: –Communication Writing Reporting

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Evaluation Evaluate goals –Met –Not met –Partially met/Ongoing Reassess Make necessary changes Continual process

17. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Critical Thinking Applied to Nursing Learned skill Vital tool Nurses need to have questioning attitude in every phase of nursing process