Critical Thinking to Facilitate Patient Care

Guidelines:

• Perioperative nurses’ decision making, based on their expert knowledge and experience, is essential to ensuring patient safety
• Critical thinking
  • Identifying a problem
  • Determining the best solution
  • Choosing the most effective method for reaching the solution
  • Implementing the solution
  • Reflecting on whether or not the chosen solution was effective
  • Sound familiar? Nursing process at work
  • Focuses on safety and quality nursing care

Considerations:

• Stages of critical thinking:
  • Unreflective thinker: fixed beliefs about current practice, unaccepting of ambiguity, unable to incorporate or adapt to new knowledge
  • Beginning critical thinker: Rarely asks for feedback but is receptive to feedback when provided
  • Practicing critical thinker: Demonstrates ability to acknowledge uncertainties, is open to thinking challenges, welcomes new approaches
  • Advanced critical thinker: seeks and accepts feedback, demonstrates an interest in alternative thinking
  • Accomplished critical thinker: Attempts to advance thinking, remains open-minded to alternate thinking, creates innovative problem-solving approaches to best practices

Nurse’s role:

• Determine and customize perioperative nursing care based on the patient’s changing situation
• Apply experiential and scientific knowledge to critical thinking
• Guide new nurses in developing critical thinking skills
• Always be open to feedback, improvement, and creative innovation

Pitfalls:

• Time and schedule pressures
• Situational stress
• Improper planning
• Closed mind
• Lack of motivation
• procrastination/complacency
• Resistance to change
• Self-focus, tunnel vision, face-saving
• Group norm conformity
• Stereotyping (previous experiences)
• Self-deception about lack of knowledge

Examples:

• N/A

Linchpins (Key Points):

• Perioperative RNs critical thinking skill is essential to patient safety
• Critical thinking = clinical judgment and decision making
• Grow others you grow your own critical thinking skills