Critical thinking and the Nursing Process

Critical Thinking and the Nursing
Process
Introduction
 Nursing process: the foundation of the nursing profession
 The nursing process requires the skill to clinically apply the knowledge and theory in
nursing practice
 Nurses interact with patients in a scientific manner
 Being scientific means to work systematically to address problems and to base decision
on scientific evidence (evidence-based practice)
 To develop and employ critical thinking skills
 It involves collaboration with the patient/client and the family
Definition of concepts
 Nursing process: an orderly, systematic way of planning and implementing nursing care
 Critical thinking: a purposeful process that is disciplined, active, multi-dimensional,
reasonable, rational and reflective to arrive at insight and to draw conclusions
 Patient contact: an incident of contact between a patient needing nursing care and a
nurse(s). It may be a clinic visit, a hospital admission or a telephone conversation
 Nursing history: essential background information about a patient at first contact,
including general and health information
 Nursing diagnosis: a formulation of what the problem is, based on the information
gathered, which should now be the focus of the nursing actions
 Observation: the act of noticing patient cues
 Interviewing: the interaction and communication process for gathering data by
questioning and information exchange
 Physical examination: the analysis of bodily functioning using techniques of inspection,
palpation, percussion and auscultation
 Inspection: visual examination of the patient done in a methodical/deliberate manner
 Palpation: the specialised use of touch for data collection that adds to and evidences the
inspection process
 Percussion: a technique in which 1 or both hands are used to strike the body surface in a
precise manner to produce a sound called a percussion note
 Auscultation: the technique of listening to body sounds with a stethoscope placed on
the body surface to amplify normal and abnormal sounds
 Nursing goals: the expected outcomes the nurse wants to achieve with a patient before
his/her discharge. The outcomes may be short term (achieved within days/less than a
week) or long term (achieved in several weeks/months)
 Nursing interventions: specific instructions to all the nurses who work with the patient
to solve a particular problem
 Implementation: the action phase of the nursing process where nursing care is provided
 Evaluation: defined as the judgement of the effectiveness of the nursing care so that the
patients goals can be met, based on the patients behavioural responses

, The nursing process
 The nursing process is an orderly and systematic way to:
 Make contact with the patient (MEET)
 Determine the patient’s problems (ASSESS)
 Make plans based on the information and knowledge to solve the problems
(PLAN & SET GOALS)
 Execute the plans (IMPLEMENT)
 Monitor to what degree the actions were effective in solving the identified problems
(EVALUATE)
 Record and report all actions (RECORD KEEPING)
 The nursing process is a problem-solving process that nurses use in every contact with a
patient and to plant nursing care for the whole duration of a patient’s care
 The nursing process has the following characteristics:
 It’s an orderly and systematic framework for providing specific nursing care to
individuals, families and communities
 It is interdependent
 It is patient orientated  it uses the patient’s strengths to its advantage
 It is appropriate for use throughout the lifespan
 It can be used in all settings
 Critical thinking underlies each step of the nursing process  problem solving and
decision making
The MADGIE model can be used to better understand the nursing process

M – meet
A – assess
D – diagnose
G – goal setting and planning
I – implementation
E – evaluation

Meet
 Greet the patient/client
 Introduce yourself
 State the purpose of the contact