Docstoc

DeLaunechapter 05

Document Sample
DeLaunechapter 05 Powered By Docstoc
					Fundamentals of Nursing:
Standards & Practices, 2E


        Chapter 5
        Critical Thinking
        and the Nursing
        Process
Critical Thinking
Critical thinking is “…reasonable
 reflective thinking that is focused on
 deciding what to believe or do”
 (Ennis, 1987).




 Copyright 2002 by Delmar, a division of Thomson Learning   5-2
Components of Critical
Thinking
Mental operations
Knowledge
Attitudes




 Copyright 2002 by Delmar, a division of Thomson Learning   5-3
Phases of Critical Thinking
Trigger event
Appraisal of the event
Exploration
Integration



 Copyright 2002 by Delmar, a division of Thomson Learning   5-4
Promoting 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
 Copyright 2002 by Delmar, a division of Thomson Learning   5-5
Critical Thinking Skills
Interpretation
Analysis
Influence
Explanation
Evaluation
Self-regulation

 Copyright 2002 by Delmar, a division of Thomson Learning   5-6
Critical Thinking and Creativity
Critical thinkers are also creative
 thinkers.
Creative thinking is the foundation for
 individualizing client care.
A major block to creativity is groupthink.
It takes intellectual courage to think
 something different from one’s peers and
 then act on those thoughts.

 Copyright 2002 by Delmar, a division of Thomson Learning   5-7
Critical Thinking and
Problem Solving
Critical thinkers avoid pitfalls of problem
 solving by defining a problem, analyzing
 the data, understanding the causes, and
 creating new ideas that will lead to
 problem resolution.




 Copyright 2002 by Delmar, a division of Thomson Learning   5-8
Critical Thinking and
Decision Making
Nurses exercise clinical judgment by making
 sound decisions.
Clinical judgment is viewed as critical thinking
 applied in clinical situations.
Nursing judgments are formed after collecting
 and examining assessment data.
Nursing judgments occur in every phase of the
 nursing process.


 Copyright 2002 by Delmar, a division of Thomson Learning   5-9
Nursing Process
The nursing process “…provides the
 basis for critical thinking in nursing”
 (Alfaro-LeFavre, 1998).




 Copyright 2002 by Delmar, a division of Thomson Learning   5-10
Historical Perspective
   Lydia Hall (1955) first referred to nursing
    as a “process”.
   Yura and Walsh (1967) identified four
    steps in the nursing process: assessing,
    planning, implementing, and evaluating.
   In 1974, Gebbin and Lavin added nursing
    diagnosis to the above steps.

Copyright 2002 by Delmar, a division of Thomson Learning   5-11
Overview of 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.



Copyright 2002 by Delmar, a division of Thomson Learning   5-12
Steps in the Nursing Process
Assessment
   • Collecting data from a variety of
     sources
   • Validating the data
   • Organizing data
   • Categorizing or identifying patterns in
     data

 Copyright 2002 by Delmar, a division of Thomson Learning   5-13
  • Making initial inferences or
    impressions
  • Recording or reporting data
  • Types of data
        Primary data source
        Secondary data source
        Subjective data
        Objective data

Copyright 2002 by Delmar, a division of Thomson Learning   5-14
Diagnosis
   • Diagnosis involves analysis and synthesis of
     the data that have been collected.
   • Formulation of the list of nursing diagnoses
     is the outcome of this process.
   • Nursing diagnoses provide the basis for
     client care delivered through the remaining
     steps of the nursing process.

 Copyright 2002 by Delmar, a division of Thomson Learning   5-15
  • Types of nursing diagnoses
        Actual nursing diagnosis
        Risk nursing diagnosis
        Possible nursing diagnosis
        Wellness nursing diagnosis




Copyright 2002 by Delmar, a division of Thomson Learning   5-16
Outcome Identification and Planning
   • Formulate guidelines that establish the
     proposed course of nursing action in the
     resolution of nursing diagnoses
   • Develop the client’s plan of care
   • Planning can begin once the nursing
     diagnoses have been developed and client
     strengths have been identified.

 Copyright 2002 by Delmar, a division of Thomson Learning   5-17
  • The planning phase involves several
    tasks
        The list of nursing diagnoses is prioritized.
        Client-centered long- and short-term
         goals are written.
        Specific interventions are developed.
        The entire plan of care is recorded in the
         client’s record.

Copyright 2002 by Delmar, a division of Thomson Learning   5-18
  • Goals are broad statements that describe
    the intended change in the client’s behavior.
  • Expected outcomes are specific objectives
    related to the goals and are used to evaluate
    the nursing interventions.
  • Nursing interventions are activities that the
    nurse will execute to enable accomplishment
    of the goals.


Copyright 2002 by Delmar, a division of Thomson Learning   5-19
Implementation includes
   • the execution of the nursing plan of care
   • nursing activities that have been planned to
     meet the goals set with the client
   • assessment skills, psychomotor skills, and
     interpersonal skills
   • reporting and documentation


 Copyright 2002 by Delmar, a division of Thomson Learning   5-20
Evaluation
   • determines if the client goals have
     been met, partially met, or not met
   • is an ongoing process
   • Nurses continually evaluate data in
     order to make informed decisions
     during other phases of the nursing
     process.

 Copyright 2002 by Delmar, a division of Thomson Learning   5-21

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:1
posted:10/26/2011
language:English
pages:21
xiaohuicaicai xiaohuicaicai
About