Clinical Nursing Judgements Based On Quality And Safety

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Clinical Nursing Judgements Based On Quality And Safety

Clinical Nursing Judgements Based On Quality And Safety

Change is part of our daily healthcare environment. Clinical nursing judgements based on quality and safety, as well as protocols and standards, reflect our patient-centered care values.

1. What steps could you take to develop more resilience in your practice setting?   2. How might you communicate a change in practice to patients and nursing peers? 2 references please. 2 pages.

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 1, “Introduction to Nursing Research in an Evidence-Based Practice Environment”

This chapter provides an introduction to nursing research, its history, and the evolution of evidence-based practice. It includes an overview of credible sources of evidences and a description of the different paradigms used in nursing research.

Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice”

The focus of this chapter includes an overview of the key aspects of evidence-based practice, a review of how to identify credible research and appraise its value, and, finally, a discussion on how to take the identified evidence and convert it into a practice.

For more than 50 years, nursing education has stressed critical thinking as an important nursing skill. 
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Over time, definitions of critical thinking have changed. 
There are various critical thinking definitions to examine. 
The American Philosophical Association (APA) defines critical thinking as “purposeful, self-regulatory judgment based on evidential, conceptual, methodological, criteriological, or contextual considerations using cognitive tools such as interpretation, analysis, evaluation, inference, and explanation.” 
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The term “critical thinking” has a broader definition.

 

Self-directed, self-disciplined, self-monitored, and self-corrective thinking, in a nutshell. 
It necessitates agreement with strict criteria of excellence and a conscious command of their application. 
It necessitates strong communication and problem-solving skills, as well as a commitment to overcoming our natural egocentrism and sociocentrism. 
Every clinician must cultivate rigorous critical thinking habits, but they cannot totally escape the situatedness and frameworks of clinical traditions and practices in which they must make quick decisions and respond in specific clinical settings. 
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There are three main definitions for nursing, each of which is slightly different. 
Critical thinking, according to Bittner and Tobin, is “affected by knowledge and experience, using tools like reflective thinking as a part of learning to identify difficulties and opportunities, and comprehensively synthesize the information in nursing practice”4 (p. 268). 
Through a consensus procedure, Scheffer and Rubenfeld5 elaborated on the APA definition for nurses, resulting in the following definition:

 

In nursing, critical thinking is a necessary component of professional accountability and high-quality nursing care. 
Confidence, contextual perspective, inventiveness, adaptability, inquisitiveness, intellectual integrity, intuition, openmindedness, perseverance, and introspection are all traits of critical thinkers in nursing. 
In nursing, critical thinkers use cognitive skills such as evaluating, applying standards, discriminating, obtaining information, logical reasoning, anticipating, and changing knowledge6 (Scheffer & Rubenfeld, p. 357).

 

Critical thinking is defined by the National League for Nursing Accreditation Commission (NLNAC) as:

 

the deliberate nonlinear process of gathering, interpreting, analyzing, deriving conclusions from, presenting, and evaluating both factual and belief-based information. 
Clinical judgment, which encompasses ethical, diagnostic, and therapeutic elements as well as research7, demonstrates this in nursing (p. 8).

 

The definition of critical thinking provided by the American Association of Colleges of Nurses in their Essentials of Baccalaureate Nursing:

 

Independent and interdependent decision-making are based on critical thinking. 
Questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity8 are all examples of critical thinking (p. 9).

 

Graduates should have the knowledge and skills to:

 

Use nursing and other applicable theories and models, as well as an ethical framework that is appropriate;

 

Apply nursing and science research-based knowledge as the foundation for practice;

 

Apply clinical judgment and decision-making techniques;

 

Participate in a self-reflective and collegial discussion about professional practice;

 

Evaluate nursing care results by collecting data and questioning inconsistencies, which allows for the adjustment of activities and goals.

 

Participate in problem-solving activities that are creative8 (p. 10).

 

The extent and major features of cognitive processes required in providing clinical care are defined by these definitions of critical thinking when taken together. 
Critical thinking will be taught differently depending on how it is defined, and nurses will be held to a higher standard of care.

 

Professional and regulatory authorities in nursing education have mandated that critical thinking be a part of all nursing curricula, but they have failed to distinguish critical reflection from ethical, clinical, or even creative thinking when it comes to clinical decision-making or acts. 
Clinical reasoning, evidence evaluation, creative thinking, and the application of well-established norms of practice—all separate from critical reflection—have been grouped together under the critical thinking umbrella. 
Clinical reasoning and judgment are frequently confused with critical thinking in nursing education literature. 
Decisionmaking and action-oriented, practical, ethical, and clinical reasoning have been included under the rubric of critical reflection and thought by accrediting agencies and nursing researchers. 
One could argue that actual practices correct this harmless semantic ambiguity, but students must understand the differences between critical reflection and clinical reasoning and learn to recognize when each is more appropriate, just as they must engage in applying standards, evidence-based practices, and creative thinking.

 

Higher-order thinking skills are required due to the rising body of research, patient acuity, and the complexity of care. 
The application of knowledge and experience to detect patient problems and drive clinical judgements and actions that result in positive patient outcomes is known as critical thinking. 
Educators who model critical thinking values such as independence of thought, intellectual curiosity, courage, humility, empathy, honesty, perseverance, and fairness can help students develop these talents. 
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