Professional Documents
Culture Documents
CHAPTER 9 Problem Solving Process
CHAPTER 9 Problem Solving Process
> Analyze and examine choices more independently. The person’s thinking
abilities and initiative to look beyond expert opinion begin to change. In
complex critical thinking each solution has benefits and risks that decides
before making a final decision.
Example: While giving bed bath to a comatose patient, the nurse modifies the
procedure by washing the front part of the body before going to the back,
instead of the standards step by step procedure in the hospital Procedure
manual.
Commitment
A cognitive process in which nurse uses to make judgements about the clinical
care.
In clinical Situation
Diagnostic Reasoning
Clinical inference
Clinical decision making
3. Specific Critical Thinking
In nursing
Nursing Process
1. General Critical Thinking
a. Scientific Method
It is a methodical way to solve problems using reasoning.
It is a systematic approach to gathering data and solving problems.
Example:
Example:
The nurse used patient data that she gathered and analyzed logically to
recognize a problem.
Diagnostic conclusion, nurse make will help health care providers identify
the nature of the problem more quickly and select appropriate medical
therapies.
Examples:
The model defines the outcome of critical thinking: nursing judgement that
is relevant to nursing problems in a variety of settings. According to this
model, there are five components of critical thinking.
1. Knowledge base
2. Experience
3. Critical thinking competencies (with emphasis on the nursing process)
4. Attitudes
5. Standards
Confidence
Is the belief in oneself, one’s judgement and psychomotor skills, and
one’s possession of the knowledge and the ability to think critically and
draw appropriate conclusions.
Thinking Independently
The nurse learns to consider all the sides of a situation.
Critical thinker does nor accept another person’s ideas without question.
Examples:
Example:
1. Regardless of how the nurse feels about obesity, he/she does not allow
personal attitudes to influence the way he/she takes care of patient who
is overweight.
Responsibility and Accountability
The knowledge that one is accountable for his/her decisions, actions, and
critical thinking.
When the nurse is caring for patients, he/ she is responsible for
correctly performing nursing care activities on the basis of standards of
practice.
Example:
The nurse does not take shortcuts, e.g., failing to check identification of a
patient before administering medications; failing to check written informed
consent before transporting a patient to the operating room for surgery.
Risk Taking
When taking a risk, consider all options; follow safety guidelines; analyze
any potential dangerous to a patient; and act in a well-reasoned, logical,
and thoughtful manner.
Example:
Discipline
A discipline thinker is orderly or systematic when collecting information,
making decision or taking actions and misses few details.
Example:
A patient is in pain. Instead of asking only the patient, “how severe is your
pain on a scale of 0 to 10?” the nurse also ask more specific questions about
the character of pain, like.
Perseverance
Keep looking for more resources unit it successful approach is found.
Example:
A patient is unable to speak clearly after a stroke. Perseverance leads the
to be able to communicate effectively by trying different communication
approaches (e.g., picture board, message board, or alarm bells) until he or
she finds method that the patient is able to use.
Creativity
Involves original thinking. This means that nurse finds solutions outside
the standard routines of care while still following standard of practice,
Example:
Curiosity
A critical thinker’s favorite question is “Why.” In any clinical situation
the nurse learns a great deal of information about a patient.
Integrity
A person of integrity is honest and willing to admit to mistake or
inconsistence in his or own behavior, ideas, and beliefs.
Humility
Critical thinkers admit what they do not know and try to find the
knowledge needed to make proper decision.
a. Intellectual Standard
Paul (1993) identified 14 intellectual standards universal for critical
thinking.
A principle for rational though.
These standards applied by nurse during all steps of the nursing process.
The intellectual standards are as follows;
Precise- Exact and specific (e.g., focusing on one problem and possible
solution).
Accurate- True and free from error; getting to the facts (objective &
subjective)
b. Professional Standards
Critical thinking refers to ethical criteria for nursing judgements,
evidence- based criteria used for evaluation, and criteria for
professional responsibility.
Promote the highest level of quality nursing care.
Being ale to focus on a patient’s values and beliefs help the nurse make
clinical decisions that are just, faithful to a patient’s choices and
beneficial to a patient’s well-being.
Clinical Thinking System
Nursing process and critical thinking go hand in hand in making quality
decision about patient care.
Knowledge-underlying disease process, Normal growth and development,
Normal physiology and psychology, Normal assessment findings, health
promotion, Assessment skills, and Communication skills.
Reflect Journaling
The following are tips that may be used for reflecting on a clinical
experience to explore its meaning:
Concept Mapping
Managing Stress
Critical Thinking
Example: Nurse observe a patient has dry skin, poor skin turgor, sunken
eyes-dehydrated(premise).
Example: all kids love peanut butter sandwich, this conclusion may not
always be valid.
Creativity
Thinking that results in the development of new ideas and products.
Allow nurse to:
Generate many ideas rapidly.
Be generally flexible and natural.
Create original solutions to problems.
Be independent and self-confident, even when under pressure.
Demonstrate individually.
Critical Analysis
Application of a set of questions to a particular situation to discard
unimportant ideas.
Socratic Questioning
Techniques to search for inconsistencies, examine multiple points of
view, separate the known from beliefs.
Inductive reasoning
Generalization formed from a set of facts, observations.
Deductive reasoning
Reasoning from general premise to specific conclusion.
Making valid inferences.
Differentiating facts from opinions.
Evaluating the credibility of information sources.
Clarifying concepts.
Recognizing assumptions.
Problem Solving
Decision-making process
Prioritizing care when providing care to many clients.
Deciding whether client’s condition can be managed in the home or
requires hospitalization.
Consider client’s cultural, religious background.
Logical reasoning skills.
Commitment to lifelong learning.
Concept Mapping
Nursing Process
ASSESSMENT
Nursing Diagnosis