CP 11, Blended Skills and Critical Thinking throughout the Nursing Process

What characteristic of the nursing process is defined as a great deal of overlapping interaction among the five steps, with each step being fluid and flowing into the next step?

Dynamic.

How is the nursing process systematic?

Each nursing task is a part of an ordered sequence of activities, and each activity depends on the accuracy of the activity that precedes it and influences the actions that follow it.

Expected Outcomes

Specific, measurable criteria used to evaluate whether the patient goal has been met.

The steps of the nursing process were legitimized in 1793 when the ANA Congress for Nursing Practice Developed what to guide nursing performance?

Standards of Practice.

What is the second step in developing a method of critical thinking?

Adequacy of Knowledge - Judgment if you have accurate, complete, factual, timely, and relevant information.

Nursing Diagnoses

Actual or potential health problem that an independent nursing intervention can prevent or resolve. Actual problem is present, Possible problem may be present, but more data are needed to confirm or disconfirm the problem. Potential problem may occur; defining characteristics are present as risk factors.

Which group legitimized the steps of the nursing process in 1973 by developing standards of practice to guide nursing practice?

American Nurses Association Congress for Nursing Practice.

Systematic

An ordered sequence of activities. Each activity depends on the accuracy of the previous activity, and influences the actions that follow it.

What is the purpose of Implementing in the Nursing Process?

Assist patient to achieve desired outcomes--promote wellness, prevent disease and illness, restore health, and facilitate coping with altered functioning.

Critical Thinking Indicators

CTIs - evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics, and skills that promote critical thinking in clinical practice.

Implement

Carry out the plan of care.

Standards for Critical Thinking

Clear, precise, specific, accurate, relevant, plausible, consistent, logical, deep, broad, complete, significant, adequate (for the purpose), and fair.

What is the instructional strategy that requires learners to identify, graphically display and link key concepts?

Concept mapping.

What are the benefits of Nursing Process?

Continuity, collaboration, and enhanced patient outcomes.

What is the purpose of Diagnosing in the Nursing Process?

Develop a prioritized list of the nursing diagnoses.

What is the purpose of Planning in the Nursing Process?

Develop an individualized plan of nursing care. Identify patient strenghts that can be tapped to facilitate achievement of desired outcomes.

What interpersonal skill is displayed by a nurse who is attentive and responsive to the healthcare needs of individual patients and ensures the continuity of care when leaving the patient?

Developing Accountability.

Intuitive Problem Solving

Direct understanding of a situation based on a background of experience, knowledge and skill that makes expert decision making possible.

What are four areas a nurse should consider when seeking to develop a sense of legal and ethical accountability to a patient?

Do I know my legal boundaries of my practice? Do I own my personal strengths and weaknesses and seek assistance as needed? Am I knowledgeable about, and respectful of patient rights? Does my documentation provide a legally defensible account of my practice?

What are Activities with Planning in the Nursing Process?

Establish priorities. Write outcomes, and develop an evaluative strategy. Select nursing interventions. Communicate plan of nursing care.

Plan

Established patient goals to prevent, reduce, or resolve the problems identified in the nursing diagnoses and determination of related nursing interventions.

What are Activities with Assessing in the Nursing Process?

Established the Database: Nursing History, Physical Assessment, Review of patient record and nursing literature, consultation with patients support people and healthcare professionals. Continuously update the Database. Validate Data. Communicate Data.

Nursing Process

Five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing and evaluating. A systematic, client-centered, goal oriented method of delivering care.

When a nurse assists a patient to achieve desired goals such as promoting wellness, preventing disease and illness, restoring health, or facilitating coping with altered functioning, he/she is using which part of the nursing process?

Implementation.

Concept Mapping

Instructional strategy that requires learners to identify, graphicallly display and link key concepts.

What are the skills necessary to use the nursing process?

Intellectual, technical, interpersonal, and ethical/legal skills as well as the willingness to use these skills creatively when working with patients.

What are Activities with Diagnosing in the Nursing Process?

Interpret and analyze patient data, Identify patient strengths and health problems. Formulate and validate nursing diagnoses. Develop prioritized list of nursing diagnoses.

How is the adequacy of knowledge relevant to the successful use of critical thinking competencies?

It is important to judge whether the knowledge available to you is accurate, complete, and relevant. If you reason with false information or lack important data, it is impossible to draw a sound conclusion.

What is the purpose of Assessing in the Nursing Process?

Make a judgment about the patients health status, ability to manage his or her own healthcare, and need for nursing. Plan individualized holistic care that draws on patient strengths and is responsive to changes in the patients conditions.

What are obstacles to Critical Thinking?

Making assumptions, personal biases, habits and routines, anxiety, pressure and deadlines, lack of confidence, pride.

What are Activities with Implementing in the Nursing Process?

Measure how well the patient has achieved desired outcomes. Identify factors that contribute to the patients success or failure. Modify the plan of care (if indicated).

Evaluate

Measurement of the extent to which the patient has achieved the goals specified in the plan of care; factors that positively or negatively influence goal achievement are identified, and the plan of care is terminated or revised.

The three important ideas that must be linked together during clinical planning are:

Medical diagnosis, nursing diagnosis, and all pertinent clinical data.

Trial-and-Error Problem Solving

Method of problem solving that involves testing any number of solutions until one is found that works for that particular problems.

Dynamic

No one step in the nursing process is a one-time phenomenon; each step flows into the next step. All five stages can occur almost simultaneously.

How is the nursing process universally applicable?

Once nurses have a working knowledge of the nursing process, they can apply it to well or ill patients, young or old patients, in any type of practice setting.

What is the purpose of the Nursing Process?

Organize data, formal statement of strategies, efficient, aides in delivery of care that is holistic, goal oriented and individualized.

What is the third step in developing a method of critical thinking?

Potential Problems - Identifying and flagging, remedy the pitfalls to sound reasoning.

What are four good habits nurses should develop to help them master the manual competencies essential to quality nursing process?

Practice a necessary skill until you feel confident in its execution before performing it on a patient. Take time to familiarize yourself with new equipment before using it in a clinical procedure. Identify nurses who are technical experts and ask them to share their secrets. Never be ashamed to seek assistance if you feel unsure of how to perform a procedure or manage equipment.

What is the first step in developing a method of critical thinking?

Purpose of thinking - Identify the purpose or goal of your thinking.

Decision Making

Purposeful, goal-directed effort applied in a systematic way to make a choice among alternatives.

Scientific Problem Solving

Systematic problem-solving process that involves 1. Problem Identification. 2. Data collection. 3. Hypothesis formulation. 4. Plan of Action. 5. Hypothesis testing. 6. Interpretation of Results, and 7. Evaluation resulting in conclusion or revision of the study.

The Nursing Process provides a framework that enables the nurse and patient to accomplish:

Systematically collect patient data (assessing), clearly identify patient strengths and actual and potential problems (diagnosing), develop a holistic plan of individualized care that specifies the desired patient goals and related outcomes and the nursing interventions most likely to assist the patient to meet those expected outcomes (planning), Execute the plan of care (implementation), Evaluate the effectiveness of the plan of care in terms of patient goal achievement (evaluating).

How is the nursing process interpersonal?

The human being is always at the heart of nursing. The nursing process ensures that nurses are patient centered rather than task centered.

How is the nursing process goal oriented?

The nursing process offers a means for nurses and patients to work together to identify specific goals related to wellness promotion, disease and illness prevention, health restoration, and coping with altered functioning that are most important to the patient and match them with appropriate nursing actions.

How is the nursing process dynamic?

There is a great interaction and overlapping among the five steps; no one step in the process is a one-time phenomenon; each step is fluid and flows into the next step.

What traits help nurses develop the attitudes and dispositions to think critically?

Thinking independently, being intellectually humble, and being curious and persevering.

How is the purpose of thinking relevant to the successful use of critical thinking competencies?

This helps to discipline thinking by keeping all thoughts directed to the goal.

Critical Thinking

Thought that is disciplined, comprehensive, based on intellectual standards, and, as a result, well reasoned; a systematic way to form and shape ones thinking that functions purposefully and exactingly.

What are the goals of the nursing process?

To help the nurse manage each patient's care scientifically, holistically, and creatively to promote wellness, prevent disease or illness, restore health, and facilitate coping with altered function.

Assess

To systematically and continuously collect, validate, and communicate patient data.

How is critique of judgments/decisions relevant to the successful use of critical thinking competencies?

Ultimately you must identify alternative judgments or decisions, weigh their merits, and reach a conclusion.

What are the characteristics of the Nursing Process?

Universally applicable, outcome oriented, interpersonal, systematic, and dynamic.

What do Advocates or Intuition recommend?

Welcoming flashes of intuition as additions to logical reasoning, rather than as disruptions. Validating intuitions: When an intuition cannot be valid (when a nurse senses something is wrong with her patient although no signs), careful monitoring of the patient should be initiated. Furthering nursing research to help find ways to cultivate intuition and its typical results (accurate and early diagnosis, vigilant monitoring, better patient care), and document the information it supplies.

A nurse who reports his/her employer's violation of law to law enforcement agencies outside the employers facilities is termed a:

Whistle-blower.

How are helpful resources relevant to the successful use of critical thinking competencies?

Wise professionals are quick to recognize their limits and seek help in remedying their deficiencies.