Fundamentals

A continuous process characterized by open-mindedness, continual inquiry, and perseverance, combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevantRecognizing that an issue exists, analyzing information, evaluating information, and making conclusions

Clinical decision making requires critical thinking.

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

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.

Interpretation InferenceExplanationAnalysisEvaluationSelf regulation

Be orderly in data collection. Look for patterns to categorize data, (nursing diagnosis). Clarify any data you are uncertain about.

Look at the meaning and significance of findings. Are there relationships between findings? Do the data about the patient help you see that a problem exists?

Support your findings and conclusions. Use knowledge and experience to choose strategies to use in the care of patients.

Be open minded as you look at information about a patient. Do not make careless assumptions.

Do the data reveal what you believe is true, or are there other options?

Looking at all situations objectively. Use criteria (expected outcomes, pain characteristics, learning objectives) to determine results of nursing actions. Reflect on your own behavior.

Reflect on your experiences. Identify the ways you can improve you own performance.

What will make you believe that you have been professional.

Truth seeking Open-mindednessAnalytic approachSystematic approachSelf-confidenceInquisitivenessMaturity

Seeking the true meaning of a situation, be courageous hones and objective about asking questions.

be tolerant of different views, be sensitive, to the possibility of you own prejudices, respect the right of others to have different opinions.

analyze potentially problematic situations,anticipate possible results or consequences, value reason, use evidence based knowledge.

be organized, focused, work hard in any inquiry

trust in your own reasoning processes.

be eager to acquire knowledge and learn explanations even when applications of the knowledge are not immediately clear.

Value learning for learning's sake.

multiple solutions are acceptable, reflect on your own judgments, have cognitive maturity.

1.Basic2.

Complex3.Commitment

early step in developing reason. one right or wrong, need to learn to accept diverse opinions and advise of experts

Begin to separate themselves from experts. analyze choices and realize there is other opinions and options

a person anticipates when to make choices without assistance from others and accepts accountability for decisions made. make choice base on available alternatives and support it.

Scientific methodproblem solvingdecision makingdiagnostic reasoning and inferenceclinical decision makingnursing process as a competency

A series of steps followed to solve problems using reasoning. Identifying the problem, collecting data, formulating a question or hypothesis, testing the question or hypothesis, and evaluating results of the test or study.

involves evaluating the solution over time to make sure that it is effective.

a product of critical thinking that focuses on problem resolution.

the analytical process for determining a patient's health problems. necessary before a solution.

making a decision to improve a patient's health or maintain wellness. This means reducing the severity of the problem or resolving the problem completely.

a competency when delivering patient care. the nursing process is a five step clinical decision making approach, assesment, diagnosis, planning, impelmentation, and evaluation.

StandardsAttitudesCompetenciesExperienceSpecific knowledge base

refer to ethical criteria for nursing judgements, evidence based criteria used for evaluation, and criteria for professional responsibility. Use critical thinking for the good of individuals.

guideline for how to approach a problem or decision making situation.

third component, applying critical thinking components.

Nursing is a practice discipline, clinical learning experiences are necessary to acquire clinical decision making skills.

prepares you to better anticipate and identify patients problems by understanding their origin and nature, varies by educational experience.

AssessmentDiagnosisPlanningImplementationEvaluation

When nurses have a formal means to discuss their experiences such as a staff meeting or a unit practice council, the dialogue allows for questions, differing viewpoints, and sharing of experiences.When nurses are able to discuss their practices, the process validates good practice and offers challenges and constructive criticism.

Identify the nursing diagnoses and collaborative problems of each patient.Decide which are most urgent.Consider the time it will take to care for those patients. Consider the resources that you have to manage each problem.Consider how to involve the patients as participants in care.Decide how to combine activities.Decide which nursing care procedures to delegate.Discuss complex cases with the health care team

The Circle of Meaning model adapted to nursing encourages concept clarification and a search for meaning in nursing practice.The Circle of Meaning model uses a series of questions to help you through a clinical experience and to find meaning.

Effective communication is needed between registered nurses (RNs) and nursing assistive personnel (NAP) for giving feedback and clarifying tasks and patient status.When patients' clinical conditions change, warranting attention by RNs, clear directions are necessary to avoid missed care.Applying critical thinking can help an RN make the decision about when to appropriately delegate care.

A reasoning process used to reflect on and analyze thoughts, actions, and knowledgeRequires a desire to grow intellectuallyRequires the use of nursing process to make nursing care decisions