9781437727760

Table of Contents


Chapter 1	What are Critical Thinking, Clinical Reasoning, and Clinical Judgment?	1
	Critical Thinking: Behind Every Healed Patient	2
	Critical Thinking: Not Simply being Critical	2
	Rewards of Learning to Think Critically	3
	How this Book Helps You Improve Thinking	4
	Brain-Based Learning	4
	Organized for Novices and Experts	6
	What’s the Difference between Thinking and Critical Thinking?	7
	Critical Thinking: Some Different Descriptions	7
	A Synonym: Reasoning	7
	Common Critical Thinking Descriptions	7
	Critical Thinking, Clinical Reasoning, and Clinical Judgment	7
	Applied Definition	8
	Problem-Focused versus Outcome-Focused Thinking	10
	What about Common Sense?	10
	What do Critical Thinkers Look Like?	11
	Critical Thinking Indicators (CTIs)	11
	What’s Familiar and What’s New?	15
	What’s Familiar	15
	What’s New	15
	4-Circle CT Model: Get the Picture?	17
	Thinking Ahead, Thinking-In-Action, and Thinking Back (Reflecting)	17
	Putting it All Together	18
	Critical Thinking Exercises	21
	Key Points/Summary	22
Chapter 2	How to Develop Critical Thinking	24
	Gaining Insight and Self-Aware Ness	26
	How Your Personality Affects Thinking	26
	Connecting with Your Learning Style	31
	Self-Efficacy: Believe in Yourself	31
	Effects of Birth Order, Upbringing, and Culture	32
	Male versus Female Thinking	32
	Emotional Intelligence (El)	33
	Communicating Effectively	35
	Communication Strategies that Promote Critical Thinking	36
	Building Relationships	39
	Preceptors, Mentors, and Empowered Partnerships	39
	Factors Influencing Critical Thinking Ability	40
	Personal Factors Influencing Thinking	40
	Situational Factors Influencing Thinking	41
	Habit; Causing Barriers to Critical Thinking	42
	Habits that Promote Critical Thinking	43
	Critical Thinking Exercises	44
	Outcome-Focused (Results-Oriented) Thinking	46
	Goal (Intent) versus Outcome (Result)	46
	Critical Thinking Strategies	47
	10 Key Questions	47
	Using Logic, Intuition, and Trial and Error	49
	Focusing on Details and Big Picture	49
	Drawing Maps, Diagrams, and Decision Trees	50
	Clinical Simulation and Debriefing	50
	Other Useful Strategies	51
	Critical Thinking Indicators for Knowledge and Intellectual Skills	52
	Developing Character—Acquiring Knowledge and Skills	55
	Assessing and Evaluating Thinking	55
	Basic Principles of Evaluating Thinking	56
	Self-Assessment	57
	Peer Review	58
	Using Tests and Instruments	58
	Critical Thinking Exercises	62
	Key Points/Summary	63
Chapter 3	Clinical Reasoning and Clinical Judgment	66
	Nurses: The Glue and Conscience of Health Care	69
	Goals and Outcomes of Nursing	69
	Goals of Nursing	70
	Outcomes of Nursing	70
	What are the Implications?	70
	Critical Thinking, Clinical Reasoning, and Clinical Judgment	70
	Applied Definition	71
	What Other Nurses Say	72
	Mapping Critical Thinking	73
	Improving Practice and Performance	73
	Critical Thinking Indicators (CTIs) and the 4-Circle Model	75
	Novice versus Expert Thinking	75
	Paying Attention to Context	76
	Trends that Affect Thinking	78
	Institute of Medicine Competencies	78
	Quality and Safety Education for Nurses’ Competencies	78
	Safety is Top Priority	79
	Upholding Patients’ Rights and Privacy is Law	79
	Patient- and Family-Centered Care	80
	Population-Based Care: Meeting Diverse Needs	80
	Empowering Patients: Nurses as Stewards for Safe Passage	80
	Health Information Technology and Electronic Health Records	80
	Electronic and Printed Tools	81
	Standard Tools Prevent Miscommunication	82
	Time-Outs Promote Group Thinking and Prevent Errors	83
	Diagnose and Treat versus Predict, Prevent, Manage, and Promote	84
	Point of Care Testing Fine Tunes Care	86
	Rapid Response Teams and Code H (Help!	86
	Disease and Disability Management	87
	Outcome-Focused, Evidence-Based Care	87
	Clinical, Functional, and Other Outcomes	89
	Dynamic Relationship of Problems and Outcomes	90
	Critical Thinking Exercises	90
	Nursing Process: A Tool Clinical Reasoning Tool	92
	Proactive, Dynamic, and Outcome-Focused	94
	Interplay of Intuition and Logic	95
	Thinking Things Through	96
	What about Creativity?	97
	Collecting versus Analyzing Data	97
	Is the Care Plan Dead?	98
	Why Learn Care Planning When We Use Computers?	98
	Expanding Roles Related to Diagnosis and Management	98
	Growing Responsibilities	99
	Legal Implications of Diagnosis	100
	Scope of Practice and Clinical Decision-Making	100
	Using Standard or Recognized Terms	101
	Unique Nursing Role	101
	Nursing Surveillance: Monitoring Closely	103
	Activating the Chain of Command	106
	Monitoring for Dangerous Situations	107
	Failure to Rescue	107
	Additional Nursing Responsibilities	109
	Developing Clinical Judgment	110
	Decision-Making and Standards and Guidelines	110
	Delegating Safely and Effectively	111
	10 Strategies for Developing Clinical Judgment	112
	Charting that Shows Critical Thinking	116
	Critical Thinking Exercises	121
	Key Points/Summary	123
Chapter 4	Ethical Reasoning, Evidence-Based Practice, Teaching Others, Teaching Ourselves, and Test-Taking	128
	Reasoning in Five Major Nursing Contexts	130
	Moral and Ethical Reasoning	130
	Clarifying Values	130
	Moral versus Ethical Reasoning	131
	How do You Decide?	131
	Seven Ethical Principles	132
	Standards, Ethics Codes, and Patients’ Rights	132
	Steps for Moral and Ethical Reasoning	133
	Evidence-Based Practice	136
	Accessing, Analyzing, and Applying Information	136
	Relationship of Research to Evidence-Based Practice	138
	Transforming Knowledge to Evidence-Based Practice	138
	Clinical Summaries and Practice Alerts	139
	ACE Star Model of Knowledge Transformation	139
	Research: All Nurses Play a Part	141
	Scanning before Reading Research Articles	144
	Questioning Care Practices: Promoting Inquiry and Creativity	144
	Surveillance and Quality Improvement	145
	Critical Thinking Exercises	147
	Teaching Others: Promoting Independence	150
	10 Steps for Teaching Others	151
	Teaching Ourselves: Grab the Spoon	152
	Memorizing Effectively	152
	Strategies to Boost Your Memory	152
	Test-Taking: Improving Grades and Passing the First Time	153
	Strategies for Successful Test-Taking	154
	Strategies for the NCLEX^® and Other Standard Tests	157
	Critical Thinking Exercises	160
	Key Points/Summary	161
Chapter 5	Practicing Clinical Reasoning Skills: Applying the Nursing Process	164
	Chapter Overview	166
	Clinical Reasoning Skills: Dynamic and Interrelated	166
	Why Practice these Skills Separately?	166
	How to Get the Most Out of this Chapter	166
	1. Identifying Assumptions	168
	2. Assessing Systematically and Comprehensively	171
	3. Checking Accuracy and Reliability (Validating Data)	176
	4. Distinguishing Normal from Abnormal and Identifying Signs and Symptoms	177
	5. Making Inferences (Drawing Valid Conclusions)	179
	6. Clustering Related Cues (Data)	181
	7. Distinguishing Relevant from Irrelevant	182
	8. Recognizing Inconsistencies	184
	9. Identifying Patterns	186
	10. Identifying Missing Information	188
	11. Promoting Health by Identifying and Managing Risk Factors	189
	12. Diagnosing Actual and Potential Problems	191
	13. Setting Priorities	198
	14. Determining Patient-Centered (Client-Centered) Outcomes	202
	15. Determining Individualized Interventions	205
	16. Evaluating and Correcting Thinking (Self-Regulating)	210
	17. Determining a Comprehensive Plan/Evaluating and Updating the Plan	212
Chapter 6	Developing Interpersonal, Teamwork, and Self-Management Skills	216
	How to Use this Chapter	217
	How the Skills are Organized	217
	1. Communicating Bad News	217
	2. Dealing with Complaints Constructively	222
	3. Developing Empowered Partnerships	226
	4. Giving and Taking Constructive Criticism	230
	5. Managing Conflict Constructively	234
	6. Managing Your Time	240
	7. Navigating and Facilitating Change	245
	8. Preventing and Dealing with Mistakes Constructively	249
	9. Transforming a Group into a Team	259
	Response Key for Exercises in Chapters 1 to 5	266
	APPENDIXES
A	Concept Mapping: Getting in the “Right” State of Mind	279
B	Key Brain Parts Involved in Thinking	282
C	Patients’ Rights	283
D	ANA Standards of Practice and Professional Performance for Registered Nurses (RNs)	284
E	Comprehensive Patient Admission Tool	286
F	NCLEX^® Practice Questions	290
	Glossary	298
	Index	302