Fundamental of Nursing

Summaries
Chapter 15 and 16
By: Temitope Faleye
 We use criticallythinkingeverydayand we dont even know it.
Critical thinking is important to a nurses job. Critical thinking is
not simple a step by step process you learn overnight.
You can only learn it throughexperience. Clinical decision
making separate professional nurses fromtechnical personnel.
Each patient have a unique problem they are going through
and as a nurse the answers may not be right in front of you. As
a nurse you need to be able to think Critically.
Critical thinking competencies was described as a cognitive
process a nurse uses to make judgement about critical care of
patient.
 Withexperienceyou are able to seek new knowledge and
act on them. Critical thinking is more than a question that
asked yes or no, it a question that ask for reasoning.
Critical thinking is learnt early in your practice.
Learning to think critically helpscarefor patients as their
supporter. Learning is alifelongprocess. In order to learn,
you have to be flexible and always open to new
information.
You have to learn beyond the obvious in any clinical
situation.
Levels of Critical Thinking in Nursing
Basic Critical Thinking
1. Learner trust that expert has the right answers to every problem.
2. Concentrating on a set of rules.
.Complex Critical thinking
1. Thinkers starts separatingthemselvesfrom experts, and become
more independent.
2. Thinking becomes more creative and innovative.
.Commitment
1. A person can make their own decision, but also is held responsible
for what happens.
General Critical Thinking
Scientific Method (5 Steps):
1. Identify the problem
2. Collecting data
3. Formulating a question or hypothesis
4. Testing question or hypothesis
5. Evaluating result of the day.
.Problem Solving
1. When problem arises, you will obtain information, and use it to find a solution.
You have to be able to evaluate the solution overtime to see how effective it
is.
.Decision Making is aproduct of critical thinking that focuses on problem
resolution.
 Diagnostic reasoning is the analytical process for determining
a patients health problem.
An expert nurse see the background of the patients situation,
observes a pattern or theme and make quick decisions.
Clinical interference is making conclusions from related
pieces of evidence and previous experience.
Its alright to be wrong, you will communicate with nurses
experts and give you feedback on building future clinical
situation.
At times, you may not have enough information to diagnosis.
 Clinical decision making is choosing the best option for the
patient outcomes on the basis of the patient's condition
and their problem. Improvement in Clinical decision
making is possible.
The selection of nurse therapy is built on clinical
knowledge and specific patients data.
Always focus on the patient and try to solve their problem.
Critical thinking and critical decision making are
complicated because nurses care for multiple patients in
fast-paced and unpredictable environment.
Nursing Process (5 steps clinical
decision making approach):
Assessment- gathering information about patients
Diagnosis identifying the patients problem
Planning set goals of desired outcome and nurses action
Implementation-Performing the nurses problem.
Evaluation- determine of goal and expected outcome are
achieved.

The nursing process allows you to be flexible, by identifying a

patients health care needs by collecting useful information.
Assessment includes 2 steps:
Step 1: Collection of information from primary source
(patient) and/or secondary source (family members,
health professionals and medical records)
Step 2: The interpretation and validation of data to
ensure a complete database.
 Question and Observation are used to collect data.
Patient-centered interview, allows patient to set initial
focusedand important discussion about their own
health.
Success interviews required preparation, reviewingall
available information about the patient,preparing the
environment of the interview and timing
toavoidinterruption.
Interview encourage patient to tell their stories about
about their illnesses or healthcare problems.
Assessment interviews involve:
Setting the stage
Gathering information about the patient's problems and
settings an agenda
Collecting the assessment or a nursing health history
Terminating the interview