Nursing 100 Critical Thinking and Evidence Based Practice
Nursing 100 Critical Thinking and Evidence Based Practice Nsg 100
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This 7 page Class Notes was uploaded by Alyssa Risi on Wednesday September 14, 2016. The Class Notes belongs to Nsg 100 at West Virginia University taught by Kathy Linkous in Fall 2016. Since its upload, it has received 10 views. For similar materials see Introduction to Nursing in NURSING at West Virginia University.
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Date Created: 09/14/16
Nursing 100 Critical Thinking and Evidence Based Practice 9/14/16 EBP= evidence based practice Thinking vs. Critical Thinking -thinking- short term answers without any real plan to come to a resolution -critical thinking- applying information you've learned to solve a problem; having a plan to fix something Critical Thinking in Nursing -apply what you've been taught to current situations -not necessarily what you're doing but rather what steps you should take to come to an end -kind of thinking about any subject, content, or domain, that improves itself through disciplined analysis and assessment -analysis- required knowledge of the elements of thought -assessment- requires knowledge of the standard of thought Elements of Thought -intellectual humility- understand that you're view or belief is not always correct; knowing what you do and don't know; awareness of biases, prejudice, self- deceptive tendencies, and limitations -intellectual courage- expresses views even if they are unpopular ; ability to question beliefs that you feel strongly about; question the beliefs of your culture -intellectual empathy- to understand and try to relate with others; awareness of the need to entertain views different from your own; listening to how other people might perceive a situation -intellectual integrity- holding yourself to the same intellectual standards you expect of others; being honest with what you do -intellectual perseverance- working through intellectual complexities instead of walking away; frustration or uncomfortable situations should be welcomed because you can work through them and learn from them -confidence in reasoning- using standards of reasonability to judge whether to accept or reject any belief or position; listen to other peoples points of views and reason with them to come to a decision instead of just accepting things that you think should be a certain way -intellectual autonomy- thinking for yourself while adhering to the standards of rationality Standard of Thought -clarity- teach-back method to ensure the patient understands his instructions for home care -accuracy-verify information -precision- make sure you're giving the right amount of medicine -relevance- how does that relate to the problem; how does that help us with the issue -depth-what factors make this a difficult problem; what are some of the difficulties we need to deal with -breadth-do we need to look at this from another perspective; so we need to consider another point of view -logic-does all this make sense together; does what you say follow the evidence -significance- what is the most important problem to consider -fairness- are my own biases keeping me from being fair to others; am I considering the viewpoint of others; am I putting views I oppose in their strongest form Applying Critical Thinking in the Nursing Profession Medical Focus Nursing Focus Diagnose and treat disease Diagnose, treat human response Cure disease, prevent disease Promote disease prevention Focus on pathophysiology, biological, Care for patient physical effects Teach about treatment for disease or Holistic approach, consider the effects injury on the whole person ---------------------------------------------Teach self-care strategies to increase -------- independence in daily activities ---------------------------------------------Promote wellness activities -------- Critical thinking and the nursing process -involves creativity and intuition, specific way of thinking and acting, systematic problem solving approach used to identify, prevent, and treat health problems and promote wellness -the framework in which nurses use their knowledge and skills to express human caring Listen to the patient's story -ask what their goals are and how you can help them -give the person their control back by asking them what they want to accomplish for that day Nursing Process -Assessment- assess the situation; -Diagnosis- what's the problem -Planning- what goals and interventions do you need -Implementation- applying your goals -Evaluation- what your interventions and goals successful Assessment - collect, organize, validate, and record data such as interviews, physical exams, and medical records; introduce yourself and verify that they patient is the correct person you are caring for -body language is extremely important (try to make the patient comfortable) Organize data- not an official step in the nursing process but it should come after Assessment -objective- nurse perceives with own senses -if the patient says their pain is a 9 out of 10, its objective because it's on a validated scale -subjective- patient states -primary- from the patient -secondary- from the family or medical record Ensure that data is complete, accurate, and factual Diagnosis - a nurse can't make a medical diagnosis -can make a diagnosis of human response or reaction to an event or stressor such as an event or injury -human reactions occur in the physical, emotional, intellectual, social, and spiritual domains -physical: cardiac output decreased; impaired skin integrity -emotional: ineffective coping; anxiety -intellectual: knowledge deficit; acute confusion -social: dysfunctional family processes; risk of loneliness -spiritual: moral distress; spiritual distress Planning -plan goals contain what the patient will do -goals must be observable, specific, precise, measurable, and time oriented -plan interventions include what the nurse has to do to aid the patient Interventions -actions that support the goal -must be evidence based Implementation -making sure the goals get achieved Evaluation -progress towards goal -effectiveness of interventions -appropriateness of goal -consider patient non-adherence -consider nurse role performance Why is the nursing process important?? 1. Promotes collaboration: patient, all disciplines 2. Is cost-effective 3. Helps people understand what nurses do 4. Is required by professional standards of practice 5. Increases patient participation in care 6. Promotes patient autonomy Evidence Based Practice -combines best research evidence, clinical expertise, patient values and needs, and cost effective care -ultimate goal of EBP is to improve patient outcomes -many things that are done in the hospital are based on tradition but they might not be the best solution Why is EBP used in nursing? -nurses are constantly with the patients and can monitor changes -implement and evaluate -experts on caring for patients EBP is our map in directing change in the way care is delivered OR confirming the direction we are going is the best for our patients Consumers vs. Producers -consumers- those who need the information to further their career -producers- those who find the facts for the consumers Expectation of BSN student consumers -read and summarize evidence -apply evidence in clinical practice -read and critique evidence Expectations of RN consumers -provide care based on best evidence -constantly evaluate care -ALWAYS question: why am I doing this and is there a better way What is the best evidence? -intuition- not based on actual facts -tradition- not up to date -trial and error- unsafe - expert opinion- not always accurate -research-Test, refine, advance the knowledge on which improved education, clinical judgment, safe, cost effective, ethical nursing rests Two types of Research -Quantitative- seeks to verify data through prescriptive testing, correlation, and sometimes description; numbers -qualitative- gains understanding how individuals construct meaning in their world, visualize a situation, and make sense of that situation; words and descriptions Levels of Evidence from strongest to weakest 1. clinical practice guidelines and meta-analysis 2. experimental study 3. Quasi- experimental study 4. Non-experimental study 5. Case reports and clinical examples- news reports and the media Reliable Internet Sources -.gov -.edu (more reliable) -clinical practice guidelines found at www.guideline.gov -look for a webmaster and a date professional associations websites like American heart association Six parts of Research Article -abstract -introduction -methods -results -discussion -references Benefits of Evidence- Based practice -Improve patient outcomes -increase nurse autonomy -professional development -continuing education Barriers of EBP -Lack of completed research for many clinical problems -Educational background of nurses -Attitude of nurses -Lack of organizational support -Limited library resources -Poor collaboration between academia and practice -Lack of time -Nurses not empowered to implement change
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