NRS 430 Topic 2 DQ 1 Discuss the role of critical thinking and evidence-based practice as they relate to patient outcomes

NRS 430 Topic 2 DQ 1 Discuss the role of critical thinking and evidence-based practice as they relate to patient outcomes

Topic 2 DQ 1

Apr 11-13, 2022

Define critical thinking and evidence-based practice. Discuss what critical thinking in nursing practice entails and explain why it is important. Discuss the role of critical thinking and evidence-based practice as they relate to patient outcomes.

REPLY TO DISCUSSION

CAT: Critical Thinking about Critical Thinking

Nurses must be able to think critically to provide effective care and to problem solve. In your opinion, is one born with critical thinking or develop these skills overtime?

Hello

In my opinion, critical thinking is developed over time . It takes knowledge, constant practice and experience to develop critical thinking skills. Everyone is born with a thinking ability and capable of logical reasoning. However, critical thinkers learn the ability to judge and solve issues as the need arises.

It could be a skill learnt after several and repeated practice or years of experience.

For instance, a new RN working in a psychiatric unit the first time might get frightened when the patient becomes disruptive or aggressive. It might be tough to deal with such a situation the first time. However, with constant practice in the unit, the nurse would learn and understand the proper way to deescalate while keeping self and others safe.

Therefore, I believe critical thinking skills offer the judgement and reasoning required to act in any given situation. It goes beyond the four walls of the classroom.

Thank you, Chioma. You provided a great example of how first exposure to an experience may result in uncertainty but has knowledge, skill, and experience are gained, one thinking about a situation change.

I agree with you Chioma. I think critical thinking is skill that takes time to learn and apply. Knowledge and experience play huge role in critical thinking. Something as simple as starting and IV requires some level of critical thinking. We all learned in nursing school the steps to starting an IV, but until we were able to actually touch the patient and see the vein then we could critically think through the process. Why wasn’t there a flash? Am I in the vein? Advance? Make minor adjustments? Learning through practice and knowledge, we can think through and apply that knowledge and experience to the situation at hand.

I feel it is a skill that one develops over time. It is also greatly dependent on your environment whether you learn it soon rather than later. We all grow up in different cultures, economic statuses, and lifestyles, which could affect when you start to grasp advanced thinking beyond the rudimentary level later in life.

I feel some people have an inherent trait or are more talented in critical thinking. When Im moving around the hospital on IV team, I witnessed many new grad nurses going through the motions and being task-oriented/task-driven. We have all been victims of this at one point. But as mentioned before, when one obtains knowledge through experience, one starts to bring more overall care to the table, which has better outcomes for the patient.

Great point that we all have innate individual thinking abilities, but we know that we can build our thinking (unless there is a cognitive or other defect) through education, experience, and desire to seek solutions.

I think that most people are born with a certain level of critical thinking. But, with experience, knowledge and creativity, most people are able to improve their critical thinking skills. Handling stressful situations and independent problem-solving can aid in improving critical decision-making skills. Critical thinking can be enhanced by independent thought, personal and social factors, spirituality and curiosity among others (Papathanasiou et al, 2014).

Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K., & Kourkouta, L. (2014). Critical thinking: the development of an essential skill for nursing students. Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH, 22(4), 283–286.

Well-stated. Although we do not like to be in stressful situations, your point is well taken. We explore how to avoid or minimize stress in future situations.

Billie, in my opinion, critical thinking is a skill that must be practiced and developed. But in the same token, I truly believe that some people are just inherently better at it! I guess I’m trying to say that some people have the natural ability to critically think and just have to practice it to become better but anyone can be taught…to a degree.

Thank you, Stephanie. Your post made me think of a time a few students approached me after they overheard their classmates discussing how they had critical thinking skills. The student who approached me were so upset that they did not believe they had been taught these skills. That was quite the conversation to be had. Critical thinking does develop at different levels and at a different pace for each individual.

In my opinion I believe that critical thinking is instilled in childhood and early years and is a learned aspect of ones personality. I think that critical thinking is something that is taught and can be worked on in different ways throughout ones education. Critical thinking entails many different levels of thinking making it something that is learned, in my opinion. A person can be born with character traits such as resiliency or determined that can assist in better critical thinking but overall I would say that critical thinking is a learned aspect of who someone is.

According to The Foundation for Critical Thinking (2019), “Critical thinking is, in short, self-directed, self-disciplined, self-monitored, and self-corrective thinking.” I think of critical thinking as all inclusive. One must incorporate knowledge/research, skills, attitude and experience. Putting the puzzle pieces together to come to a conclusion. One should be able to perform an assessment, interpret those findings and apply them to the situation at hand. Critical thinking enables someone to combine all off the “tools in their tool shed” and think outside of the box to come up with a solution. I feel that in my department, labor and delivery, this applies in many aspects. Critically thinking is important by adding up all the signs and symptoms and knowing when to speak to a physician. Knowing how to properly care for not only mom, but an unborn human who you cannot physically see or touch, requires evidence based knowledge, critical thinking and experience. Critical thinking is important in order keep or patients safe and alive. “Evidence-based practice (EBP), is a process used to review, analyze, and translate the latest scientific evidence”. (2022). I think that critical thinking and EBP give us the fundamental skills for the nursing process and practice which directly impacts patient care. The nursing process includes assessment, diagnosis, outcomes/planning, implementation and evaluation (American Nurses Association 2022). I think nurses go through this process multiple times a day, continuously evaluating and reevaluating. We use our knowledge of EBP and combine that with our critical thinking skills, effective communication and problem-solving skills to formulate the best plan of care for our patients for optimal health. I think by having good critical thinking skills and foundation for EBP allows the nurse to detect and act early; which then, improves patient outcomes.

American Nurses Association. (2022). The Nursing Process. https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/the-nursing-process/

 

John Hopkins Medicine (2022). Evidence-Based Practice. https://www.hopkinsmedicine.org/nursing/center-nursing-inquiry/nursing-inquiry/evidence-based-practice.html

 

The Foundation for Critical Thinking. (2019). Defining Critical Thinking. 

Edit: I did not fully cite my source and would like to note  “Evidence-based practice (EBP), is a process used to review, analyze, and translate the latest scientific evidence”. (John Hopkins Medicine, 2022).

Note to self: Re-read again and again.

That is so cool that you work on Labor and Delivery, I transferred to that department 2 weeks ago and I am absolutely loving it. Critical thinking is utilized so much on this floor when it comes to educating new parents about breastfeeding, necessary vaccines, baby health, etc. I love being able to critically think at work and be able to grow my skill either by learning from fellow coworkers or even myself. Educating patients about evidence based research requires a certain level of critical thinking because you have to be aware of how your patients learn and receive information (Falkner, A., 2018).

Falkner, A. (2018). Effective Writing and Research. CCC web books by AWS & CDD. https://lc.gcumedia.com/nrs430v/dynamics-in-nursing-art-and-science-of-professional-practice/v1.1/#/chapter/1

Critical thinking (CT) can be defined in many ways. One definition is that “critical thinking has been described as an ability to question; to acknowledge and test previously held assumptions; to recognize ambiguity; to examine, interpret, evaluate, reason, and reflect; to make informed judgements and decisions; and to clarify, articulate, and justify positions (https://louisville.edu). Critical thinking can also be defined as “that mode of thinking – about any subject, content, or problem – in which the thinker improves the quality of his or her thinking by skillfully taking charge of the structures inherent in thinking and imposing intellectual standards upon them.” (). So what does that mean to me? To me, critical thinking is the ability to look at or read information, ask questions, make assessments, and interpret findings. It also means to be open minded to new information as it becomes available.

Evidence-based practice (EVP) is described as “a conscientious, problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values and preferences, and a clinician’s expertise in making decisions about a patient’s care” (). Evidence-based practice (EBP) can also be defined as “integrating the best available research evidence with clinical expertise and the patient’s unique values and circumstances” ().

Another way to look at what EBP is the ability to look at scientific studies and apply findings that are proven most effective. Interventions that have been studied and are shown to be successful.

According to Makhene (2022), “There is a need in nursing practice for graduates with critical thinking skills to enable them to make informed clinical decisions that will benefit patients”. Nurses must be able to analyze situations that occur with their patients and also with their environment in order to decide the best pathway to take for the best possible outcome. For this reason, it is important to entail critical thinking into nursing practice. Situations can change quickly and the ability to critically think is vital to assist in providing appropriate care.

This can also be said for evidence-based practice. The foundations we have as nurses can be greatly enhanced by thinking critically in the analysis of a situation and then by using EVP to integrate “the best available research evidence with clinical expertise and the patient’s unique values and circumstance” (). Critical thinking is vital in order to properly put evidence-based practice to use. The situation must be evaluated with different possible outcomes considered, dependent on the intervention that is required. According to Brunt (2005), nurses should “develop critical thinking (CT) skills that will provide them with expertise in flexible, individualized, situation-specific problem-solving” in order to provide quality care. The nurse who has the ability to utilize critical thinking and implement EBP can have a profound impact on patient outcomes by being able to assess the situation and apply the best possible practice that has been shown effective.

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