The ability to think in a systematic and logical manner with openness to question and
reflect on the reasoning process.
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 relevant.
Recognizing that an issue exists, analyzing information, evaluating information, and
drawing conclusions
Clinical Reasoning
a way of thinking about patient care issues (determining, preventing, managing patient
problems).
Clinical Judgment
,Result of clinical reasoning and/or critical thinking
Levels of Critical Thinking in Nursing
level 1: Basic
Level 2: Complex
Level 3: Commitment
The Basic level of critical thinking
A learner trusts their experts have the answer for everything. Thinking is concrete and
based on a set of rules and principles. Basic thinkers learn to accept diverse opinions
and values of experts. However, inexperience, weak competencies, and inflexible
attitudes can restrict a person's ability to move to the next level.
Complex critical thinkers
Separate themselves for the experts and analyze situations more independently. Each
solution has benefits and risks that you weigh before making a final decision. Thinking
becomes more creative and innovative. You learn to take consider new options for
complex situation and different approaches for the same therapy.
Commitment Level
Nurses anticipate choices and act without assistance and accept accountability for their
decisions. A nurse chooses an action or belief based on the available alternatives and
support it.
General Critical Thinking
Scientific Method
Problem solving
Decision Making
, Specific Critical Thinking
Diagnostic reasoning and inference
Clinical decision making
How to Develop Critical Thinking Skills
1.) Reflective Journaling (define and express clinical experiences in your own words)
2.) Meet with colleagues (Discuss and examine exp and validate decisions)
3.)concept Mapping (Visual representation of patient problems and interventions that
show their relationship to one another)
Levels of critical Thinking
The Framework for Nursing Process
When does the Nursing Framework end?
Continuous until clients health is improved, restored or maintained (or deteriorates)
ADPIE
A: Assessing - Gathering Data
D: Diagnosis - Analyzing for nursing dx
P: Planning - Write Care Plan to Meet Goals
I: Implementing - Carry Out Plan
E: Evaluating - Collect Objective Data to determine the extent to which goals were
achieved. Revise and plan as needed.
Assessment
Sources of Data: Patient, family, health team, medical records, literature.
Methods of Data Collection: Interview, physical assessment, ongoing
nursing Health History: Interview initiaes nurse-client relationship, use open-ended
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