clinical judgment/critical thinking

clinical reasoning

combine knowledge, experience, values, data, to make decisions

clinical judgment

using patient needs/concerns to serve the patient

critical thinking

used to help nurses make smart, smart + effective decisions

critical thinking = knowledge + experience + best practice

what a nurse brings to a situation

• experiential knowledge

• clinical knowledge

• contextualized theoretical knowledge

• engagement and curiosity

assessment

• gathering info - psychological, physiological, sociological, spiritual

• collect subjective/objective data

• identify current/future needs

• identify assessment parameters and responsibilities for care plan

problems you might face

related to:

• uncertain diagnosis

• new findings related to previous diagnosis

• new findings of unknown cause

• unusual findings

• personal/emotional difficulties

c

clinical judgment model

• recognize cues

• analyze cues

• prioritize hypothesis

• generation solutions

• take action

• evaluate outcomes

recognize cues

what info is important and relevant

what is of immediate concern

analyze cues

what conditions are consistent with these cues

do these cues support or go against a particular condition

prioritize hypotheses

what is most likely

what is more important to keeping them alive

generation solutions

what are the desired outcomes

what do we need to get the desired outcomes

what should not happen

is it SMART?

SMART

Specific

Measurable

Attainable

Realistic

Time frame

take action

implement the solutions

how should they be accomplished (communicated, taught, performed, administered etc)

evaluate outcomes

compare observed outcomes with expected outcomes

questions to ask yourself

what do I already know that will help me

what am I concerned about

Do I have knowledge on this diagnosis

What’s standing out

EBP

uses best available evidence to make decisions

EBP combines

• own clinical expertise

• patient preferences/values

• relevant evidence