BERFIKIR KRITIS DALAM

PRAKTEK KEPERAWATAN

By
Tri Prabowo

BERFIKIR
KRITIS

MERUPAKAN SEBUAH
KOMPONEN ESENSIAL
DLM TANGGUNG GUGAT
PROFESIONAL & ASKEP
YG BERMUTU

MENGAPA HARUS
BERFIKIR KRITIS ?
Penggunaan berfikir kritis dlm keperawatan
menunjukkan kpd perawat untuk memberikan
perawatan yg aman, efektif & penuh kasih
Mampu mengembangkan daya nalar shg mampu
mengambil keputusan yg tepat berdasarkan
pertimbangan akal sehat dari berbagai sumber
Menjadikan pola pikir kita: reasonable, rational,
reflective, autonomous, creative , fair thinking
Make judgements based on facts, concepts,
Logic

PREFACE
The need for critical thinking in nursing has
been accentuated in response to the rapidly
changing health care environment.
Nurses must think critically to provide
effective care whilst coping with the
expansion in role associated with the
complexities of current health care systems.
critical thinking is vital in examining simple
and complex situations in nurses day-to-day
responsibilities.

CRITICAL THINKING

The art of thinking about your

thinking while you are in order to
make your thinking better : more
clear, more accurate, or more
defensible (paul cit smith, 1999)
Is a multifaceted and complex
concept based on reason and
reflection, knowledge and instinct
derived from experience.

CRITICAL THINKING

Critical thinking is a cognitive or

mental process that involves
conscious, systematic, reflective,
rational, and goal-oriented
examination and analysis of all
available information and ideas, and
the formulation of conclusions and
the most appropriate, often creative,
decision.

Critical thinking in nursing

Purposeful, informed, outcomesfocused (results oriented) thinking

that requires identifying key
problems, issues, risks
Is driven by Patient, family,
community needs
Based on the nursing process and
scientific method
Requires specific knowledge, skills,
and experience

Critical thinking in nursing

Guided by professional standards

and ethics codes*
Requires strategies that make
the most of human potential*
Constantly re-evaluating, selfcorrecting, and striving to
improve

Critical Thinking in Clinical Practice

Is an intellectual process of applying skillful
reasoning as a guide to belief or action.

Is a purposeful, goal-directed thinking

process that strives to solve problems

Critical thinking is an essential competency

of a professional health care provider, and
it is the most distinguishing attributes of an
expert practitioner.

Critical Thinking in Clinical Practice

Critical thinking when developed in the
practitioner includes adherence to
intellectual standards, proficiency in using
reasoning
and the competent use of thinking skills and
abilities for sound
clinical judgments
and safe decision-making.

Why..Critical thinking?

Our thinking pattern will be: reasonable,

systematic, rational, reflective,
autonomous, creative , fair thinking,
cautious & informational-seeking

Make judgment based on facts,

concepts, Logic

Aspect: Critical Thinking and

Nursing

The nurse identifies unique needs of

each client and develops specific
interventions to meet those needs.
Creative thinkers have the
intellectual courage and capacity to
think in a new and in a different way.
Without creative thinking, nursing
would become routine and habitual.

Characteristics of critical thinker

Rationality and insight
Cognitive maturity and
analytic nature
Purposeful and intentional
Truth-seeker with openmindedness

CHARACTERISTICS OF CRITICAL
THINKERS
ATTITUDES
INDEPENDENT THINKING
HUMILITY(memandang penting)
COURAGE (semangat)
INTEGRITY (keteguhan)
PERSEVERANCE (gigih/tekun)
EMPATHY
FAIRNESS. (pantas,patut)
SELF-AWARENESS (kesadaran diri)

CHARACTERISTICS OF CRITICAL
THINKERS
COGNITIVE
ANALYZES
MAKES INFERENCES
DIFFERENTIATES FACTS VS OPINION
EVALUATES CREDIBILITY
USES REASONING
CLARIFIES CONCEPTS
RECOGNIZES ASSUMPTIONS

Critical Thinkers Ask

What am I taking for granted?
Did I explore all points of
view?
Do I understand the question?
What information do I need?

Critical Thinking Ability

Technical Skills/ Competencies

CT Characteristics

Interpersonal Skills/ Competencies

Theoretical & Experiential Knowledge

intellectual skills, competencies

MODEL BERPIKIR KRITIS

T
H
I
N

:
:
:
:

Total recall (ingatan total)

Habits (kebiasaan)
Inquiry (penyelidikan)
New Ideas & Creativity (ide
baru & kreatifitas)
K : Knowing How You Think (
mengetahui bgmn anda
berfikir)

Affective CTIs
Selfaware
Genuine
Self-disciplined
Healthy
Autonomous

and responsible
Careful, prudent
Honest, curious, inquisitive
Analytical, insightful

Knowledge CTIs

Nursing and medical terminology

Nursing vs medical and other models, roles,
responsibilities
S&S of common problems and complications
Related anatomy, physiology, pathophysiology
Related pharmacology
Normal and abnormal function (bio-psychosocial-cultural-spiritual)

Intellectual CTI s

Applies standards and principles when providing care

Assesses systematically and comprehensively using
a nursing framework to identify nursing concerns and
a body systems framework when identifying medical
concerns
Detects bias, determines credibility of information
sources

Characteristics of Critical Thinking in

Clinical Practice

Action-oriented, goal directed

Pro-active: takes initiative, anticipatory
Expertise based on experience and knowledge
Blends logic and intuitive feelings
More than gathering facts and figures
Searching for the best answer, not just any
answer.
Able to work collaboratively

Strategies that Promote Development &

Application of Critical Thinking
Identify goals.
Determine what knowledge is required.
Assess the margin for error.
Determine the amount of time available for
decision making.
Identify available resources.
Recognize factors that may influence decision
making.

Barriers to Creative Thinking

Resistance to change, rigid mind-set, practice

guided by tradition, habit, routines
Stereotypical perceptions of clients
Fear of making mistakes
Unwillingness to take risks or look for alternative
strategies
Decision making without sufficient data or
supported by rationale
Failure to evaluate effectiveness of nursing actions

The Four Critical Thinking

Skills:
Reading
Listening
Observing
Analyzing

To Improve Critical Reading

Highlight the main ideas as you read. If most
of the text is highlighted you are not reading
critically.
Join a study group and see if your main idea
is the same as fellow group members.
Dialogue with yourself to identify the main
idea of your reading.
Try to state the main idea in your own words

To Improve Critical Listening

Restate the points made in a
discussion with others to see if you
understand them.
Focus on what a speaker is saying and
listen for key points.
While listening, make note of anything
you find confusing, and ask about it
later.

To Improve Critical Observing

Remove any restrictions in your mind.
Eliminate or decrease any distraction.
Ask yourself if you understand the most
important points?
Create new ways of looking at situations
Always look from outside the situation .

To Improve Critical Analyzing

Maintain clear and accurate logic.
Take all details into consideration.
Use systematic and scientificallybased process.
Use both cognitive and psychomotor
skills.

Activity

Its often said that medicine is

curing and nursing is caring , do
you agree ?
Discussion

Activity

Mr. K., a patient with asthma,

was admitted yesterday
morning. He has an order for
albuterol treatments to be given
every 4 hours around the clock.
You enter his room at 4:00 a.m.
and find him sleeping soundly.
What

would you do? Why?

Activity

Mr. G. was admitted 2 weeks ago with right lower

lobe pneumonia. With severe chronic obstructive
pulmonary disease (COPD) as his underlying
disease, he has been deteriorating since admission.
Although he is given albuterol breathing treatments
every 3 hours around the clock, his respiratory rate
is 30/min., and he is constantly using his accessory
muscles to breathe. His latest blood gases indicate
his CO2 IS UP TO 75. The physician orders a
morphine drip. The nurse expresses her concern
about the order and refuses to give the medication.

Do you agree or disagree with the

nurses decision? Why?
What would have done in this situation?
Provide a rationale for your answer