An
important component of the assessment process is reassessment.
After any intervention, it is paramount that a reassessment
be performed. This formula of assessment-intervention-reassessment
is a primary component of critical thinking.
The
following examples demonstrate application of the concepts
and approaches of critical thinking as it relates to patient
assessment. Strategies and attributes of critical thinking
during patient assessments include the following abilities:
Thinker:
- Identifies
and initiates appropriate standing orders.
Evaluates evidence and facts:
- A
patient states he did not receive any pain medication from
the previous nurse. However, all records indicate that medication
was delivered appropriately.
Evaluates policy:
- The
nurse recognizes that although the physician has written
an order that it is OK to use a new subclavian central catheter,
no chest x-ray was done after catheter insertion. The physician
is contacted to request a chest x-ray and have it read before
the new catheter is utilized.
Confident in decisions:
- A
physician challenges the nurse about a life-saving medication
that was given while the patient was on transport for a
procedure. The nurse refers the provider to the written
protocols that were followed to come to the decision of
administering these medications.
Effective communication:
- Communicates
to other members of the healthcare team using a concise,
organized process of verbalizing the situation, background,
assessment, recommendations, and requests for further actions.
Understands that no assumptions should be made.
Displays critical analysis:
- At
the end of the shift, reviews patient outcomes and determines
if delivered therapies or decisions were appropriate.
Editor's
Note: This excerpt was adapted from the book Critical Thinking
in the Intensive Care Unit, published by HCPro and written
by Shelley Cohen, RN, BSN. For more information on this book
(and others!), click
here and be connected to HCPro's new online resource,
www.StrategiesForNurseManagers.com.
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