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CRITICAL THINKING IN

NURSING PRACTICE

TITIH HURIAH

Critical Thinking and Nursing
Judgment

• How do we make
decisions?
• How do nurses
make decisions
about patient
care?
• What do we rely
on to help us in
decision making?

Critical Thinking and Nursing
Judgment

• Not a linear step by step process
• Process acquired through hard
work, commitment, and an active
curiosity toward learning
• Decision making is the skill that
separates the professional nurse
from technical or ancillary staff

Critical Thinking and Nursing Judgment • Good problem solving skills • Not always a clear textbook answer • Nurse must learn to question. look at alternatives .

How do nurse's accomplish this? • Learns to be flexible in clinical decision making • Reflect on past experiences and previous knowledge • Listen to others point of view • Identify the nature of the problem • Select the best solution for improving client’s health .

216) – Recognize that an issue exists – Analyzing information about the issue – Evaluating information – Making conclusions . cognitive process used to carefully examine one’s thinking and the thinking of others (Pg. organized. CRITICAL THINKING • Critical thinking is an active.

Critical Thinking • It involves the use of the mind in forming conclusions. making decisions. drawing inferences. and reflecting .

Critical Thinking Requires… • Cognitive skills • Ask questions • Remain well-informed • Be honest in facing personal biases • Be willing to reconsider and think clearly about issues .

Attributes of a Critical Thinker • Asks questions • Is able to admit a lack of understanding or information • Is interested in finding new solutions • Listens carefully to others and is able to give feedback • Examines problems closely .

Critical Thinking Can Lead To… • Sound clinical decisions • Using the Nursing Process to guide patient care • Evidence-Based Practice (EBP) .

Developing Critical Thinking Skills • Reflection = the process of purposefully thinking back or recalling a situation to discover its purpose or meaning • Concept mapping .

outcome-directed • Driven by patient. and community needs • Based on principles of nursing process and the scientific method • Requires specific knowledge.Critical Thinking in Nursing • Purposeful. family. and experience • New nurses must question . skills.

Critical Thinking in Nursing • Guided by professional standards and ethic codes • Requires strategies that maximize potential and compensate for problems • Constantly reevaluating. and striving to improve . self- correcting.

Formula for Critical Thinking • Start Thinking • Why Ask Why • Ask the Right Questions • Are you an expert? .

Aspects of Critical Thinking • Reflection • Language • Intuition .

Levels of Critical Thinking • Basic • Complex • Commitment .

Critical Thinking Competencies • Scientific method • Problem Solving • Decision Making • Diagnostic Reasoning and Inferences • Clinical Decision Making • Nursing Process .

open process • Learn to think and to ANTICIPATE • What. how questions • Look beyond the obvious • Reflect on past experience • New knowledge challenges the traditional way .Thinking and Learning • Lifelong process • Flexible. why.

Level 3 Commitment Level 2 Complex Level 1 Basic Specific Knowledge Base Experience Competencies Attitudes Standards .

Components Of Critical Thinking • Scientific Knowledge Base • Experience • Competencies • Attitudes • Standards .

institutional policy and procedure. ANA Standards of Professional Practice .Standards of care • Standards of professional responsibility that nurses strive to achieve are cited in Nurse Practice Acts.Professional Standards • Ethical criteria for Nursing judgment- Code of Ethics • Criteria for evaluation. Joint Commission guidelines.

Critical Thinking Synthesis • Reasoning process by which individuals reflect on and analyze their own thoughts. actions. & decisions and those of others • Not a step by step process .

dkk (1985)  The Six R • Rememberingmenggunakan pengalaman masa lalu • Repeating  semakin sering berfikir kritis semakin mudah mengambil keputusan • Reasoningkeputusan didasari atas berfikir kritis/pertimbangan akurat • Reorganizingmengorganisasikan fakta yg mendukung fenomena • Relatingmenemukan relasi antara fenomena • Reflectingmenganalisa kembali secara hati-hati. .Model berfikir kritis : Costa.

tetapi bgmn berfikir. • Berfikir dalam keperawatan sama dengan situasi pribadi. berfikir. . • Jangan hanya apa yang difikirkan. perasaan dan perbuatan sejalan.Asumsi berfikir : • Komponen dasar kep. • Mengembangkan upaya berfikir kritis adalah upaya yg disengaja.

Knowing how you think –sadar bahwa perawat sedang berfikir.Bentuk berfikir (THINK) 1.inquiry. Habits –suatu tindakan biasa dilakukan berulang akan secara spontan dilakukan. 4. Inquiry – keputusan akan lebh baik/akurat bila dg. 5. Total recall –fakta kep. . 3. New ideas and creativity –banyak belajar/peroleh info baru.datang dari berbagai sumber 2.

Penggunaan bahasa dalam keperawatan 2. Argumentasi dalam keperawatan 3.Penerapan Konsep Berfikir kritis dalam keperawatan : 1. Pengambilan keputusan 4. . Penerapan dalam proses keperawatan.

klien/sesama perawat/profesi lain.Penggunaan bahasa dalam kep. • Penggunaan bahasa : 1. Memberi info yg dapat diklarifikasi. mis. • Perawat menggunakan bahasa verbal dan non verbal  mengekspresikan ide/fikiran/info/fakta/perasaan/keyakinan dan sikap thd.info pentingnya kompres pada klien .

mengekspresikan keraguan dan keheranan. Mengekspresikan pengandaian. mis. Bila diberikan digitalis. 3. mis. 5.pengumuman jam besk efektif memberikan kesempatan klien istirahat. mis. .mengapa Tn.A tiba- tiba syok?. info makanan yang dianjurkan/dihindari. 4.2. Mengekspresikan perasaan dan sikap. gejala serangan jantung tidak muncul. Melaksanakan perencanaan kep/ide dalam tindakan kep. Mengajukan pertanyaan dalam rangka mencari info.info diet rendah kolesterol. mis.

.memberi penjelasan. menjelaskan kebenaran. mempertahankan thd tuntutan/tuduhan. mengklarifikasi isu.Argumentasi dalam keperawatan : Perawat dihadapkan untuk beradu argumentasi bersama anggota timnya menemukan.

Berhubungan dg. .situasi perdebatan/pertengkaran.Badman and Badman (1988) argumentasi terkait berfikir dalam kep. : a. b. Debat tentang suatu isuKepala Ruangan dg pimpinan RS tentang kebijakan yan kep bermutu.

c. . d.mis.bentuk penjelasan yg rasional yg memerlukan serangkaian alasan perlunya keyakinan dan pengambilan keputusan. Monitor kadar gula darah setiap hari pada klien A.iklan layanan kesehatan tentang pemberantasan sarang nyamuk u/mencegah demam berdarah. Berhubungan dg. Upaya mempengaruhi individu/kelompok untuk berbuat sesuatu dalam rangka merubah perilaku sehat. mis.

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TERIMA KASIH .