CRITICAL THINKING AND ADPIE

• Origins of nursing process

  • Lydia E. Hall (1955)
  • Dorothy Johnson (1959)
  • Ida Jean Orlando (1961)
  • Ernestine Wiedenbach (1963)
• Steps of the nursing process

  • Assessment
  • Diagnosis
  • Planning
  • Implementation
  • Evaluation
• - interpretation of a patient’s needs, concerns, or health problems - to make decision to take action or not

  CLINICAL JUDGMENT
• • Making accurate & appropriate decisions • Nurses must learn to question, wonder, and explore different perspectives and interpretations to find a solution that benefits the patient. • Separates nurses from technical personnel


  CLINICAL DECISION
• APPLICATION OF (COMPONENTS OF CRITICAL TTHINKING):

  • Knowledge • Attitude • Clinical experiences

  • Professional standards
• • exercising or involving careful judgment or judicious evaluation • Involving the objective analysis and evaluation of an issue in order to form a judgement.

  CRITICAL
• • The ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process • Recognizing that an issue exists, analyzing information, evaluating information, and drawing conclusions

  CRITICAL THINKING
• Components of Critical Thinking:

  • Specific Knowledge Base

  • Experience

  • Competencies

  • Attitudes

  • Standards
• levels of critical thinking:

  level 1 - Basic critical thinking

  level 2 - Complex critical thinking

  level 3 - Commitment critical thinking
• • a learner trusts that experts have the right answers for every problem.

  • Thinking is concrete and based on a set of rules or principles.

  • thinker learns to accept the diverse opinions and values of experts. •Negative components of Critical Thinking can restrict thinkers ability to move to nextlevel

  BASIC CRITICAL THINKING
• level 1 of critical thinking

  Basic critical thinking
• level 2 of critical thinking

  Complex critical thinking
• level 3 of critical thinking

  Commitment critical thinking
• • thinkers begin to separate themselves from experts and analyze the clinical situation and examine choices more independently.

  • each solution has benefits and risks that you weigh before making a final decision • Thinking becomes creative and innovative

  COMPLEX CRITICAL THINKING
• • Can anticipate when to make choices without assistance from others and accept accountability for decisions made • chooses an action or belief that is based on the available alternatives and support it

  COMMITMENT CRITICAL THINKING
• General critical thinking:

  • Scientific method • Problem solving • Decision making
• Specific critical thinking:

  • Diagnostic reasoning and inference

  • Clinical decision making
• • Used as a competency when delivering patient care • A five –step clinical decision making approach • Purpose: is to diagnose and treat human responses to actual or potential • Requires the nurse to use Gen. & specific critical thinking competencies

  NURSING PROCESS AS A COMPETENCY
• a systematic, rational method of planning and providing individualized nursing care

  NURSING PROCESS SYSTEM
• Originated the term nursing process in 1955

  Lydia E. Hall
• 1955

  Lydia E. Hall
• 1959

  Dorothy Johnson
• 1961

  Ida Jean Orlando
• 1963

  Ernestine Wiedenbach
• Purposes of Nursing Process System:

  • To identify a client’s health status and actual or potential health care

  • To establish plans to meet the identified needs

  • To deliver specific nursing interventions to meet those needs
• Characteristics of the Nursing Process:

  • CYCLICAL AND DYNAMIC NATURE

  • CLIENT CENTEREDNESS

  • FOCUS ON PROBLEM SOLVING AND DECISION MAKING

  • INTERPERSONAL AND COLLABORATIVE

  • UNIVERSAL APPLICABILITY

  • USE OF CRITICAL THINKING AND CLINICAL REASONING
• characteristic of nursing process that organizes the plan of care according to client problems rather than nursing goals.

  CLIENT CENTEREDNESS
• ▪ characteristics of nursing process that is involved in every phase ▪ characteristics of nursing process that is not bound by standard responses and may apply their repertoire of skills and knowledge

  FOCUS ON PROBLEM SOLVING AND DECISION MAKING
• • characteristic of nursing process that requires to communicate directly and consistently with clients family to meet their needs.

  • characteristic of nursing process that requires to collaborate, as members of the health care team

  INTERPERSONAL AND COLLABORATIVE
• characteristic of nursing process used as a framework for nursing care in all types of health care settings, with clients of all age groups

  UNIVERSAL APPLICABILITY
• characteristic of nursing process that utilize clinical reasoning throughout the delivery of nursing care

  USE OF CRITICAL THINKING AND CLINICAL REASONING
• • A Critical Thinking process that professional nurses use to apply the best available evidence to caregiving & promoting human functions and responses to health & illness • Dynamic and continuous

  NURSING PROCESS
• Deliberate & systematic collection of information about a patient to determine his/her current & past health and functional status & his/her present and past coping patterns

  ASSESSMENT
• types of Assessment:

  • PATIENT-CENTERED INTERVIEW

  • PHYSICAL EXAMINATION

  • PERIODIC ASSESSMENT
• 2 steps of Assessment:

  step 1 - COLLECTION AND VERIFICATION OF DATA

  step 2 - ANALYSIS OF DATA
• • collect and verify data from the patient (PRIMARY SOURCE)
  • collects data from family, health care providers, medical records (SECONDARY SOURCE)

  COLLECTION AND VERIFICATION OF DATA
• • data will be used to develop the nursing diagnosis

  ANALYSIS OF DATA
• sources of Data:

  • Patient (interview, observation, physical examination) —the best source of information • Family and significant others • Health care team • Medical records • Scientific literature • Nurse’s experience
• types of Data:

  • SUBJECTIVE

  • OBJECTIVE
• patient’s verbal descriptions of their health problems

  SUBJECTIVE