1. NUR 568
Master program 2013
Presented by :
AlJuhara AlMarzoog
Reem Alshehry
Critical thinking
skills in the advanced
nursing practice

2. outlines
Definition
Critical thinking skills
Critical thinking in nursing
Pitfalls in critical thinking
Closed - mindedness
Holistic approach
Formula for , aspect and levels of critical
thinking
 Case study

3. Introduction
To become a professional nurse
require that to learn how to think .
So, what makes the thinking of a
nurse different from a doctor , a
dentist or an engineer ?

4. Introduction
To think like a professional nurse
requires that we learn the content
of nursing ; the ideas , concepts
and theories of nursing and
develop our intellectual capacities
and skills so that we become
disciplined , self-directed , critical
thinkers .

5. Definition
 Critical thinking for clinical
decision-making is the ability to
think in a systemic and logical
manner with openness to question
and reflect on the reasoning
process used to ensure safe nursing
practice and quality care .

6. Definition
 An
active , organized , cognitive
process used to carefully examine
one’s thinking and thinking of
others :
* recognize that an issue exist
* analyzing information about
issue

7. Critical thinking skills
 skills
are applied to patient care
through the framework called the
Nursing Process
1- Interpretation : the ability to
understand and explain the
meaning of information or an
event .
2- Analysis : the investigation of a

8. Critical thinking skills
3- Evaluation : the process of
assessing the value of the
information obtained . Is it
credible , reliable , and relevant ?
This skill is also applied in
determining if desired outcome
have been reached .

9. Critical thinking skills
4- Explanation : The ability to
clearly and concisely explain
one’s conclusions . The nurse
should be able to provide sound
rational for his/her answer .

10. Critical thinking skills
5- Self – regulation : Involves
monitoring one’s own thinking .
This means reflecting on the
process leading to the
conclusions . The individual
should self-correct the thinking
process as needed , being alert
for biases and incorrect

11. Critical thinking in nursing
Critical thinking are essential in
nursing because they are basis
for learning to prioritize and make
decisions .
 Because nurses provide care for
patients 24/7 , a nurse’s critical
thinking skills can literally mean

12. Critical thinking in nursing
 Critical thinkers strive to be
clear , accurate , precise , logical ,
complete , and fair when they
listen , speak and act .
 Nurses use language to clearly
communicate in-depth information
that is significant to nursing care .

13. Pitfalls in critical thinking
 Errors
in the critical thinking
process may result in illogical or
biased thinking and incorrect
conclusions .
 In nursing , the incorrect
conclusion can lead to an
incorrect action .

14. Closed – mindedness
1- the closed – minded individuals
ignores alternative of view .
2- Input from experts , patients ,
and significant others ignored .
3- This results in limited options
and the decreased use of
innovative ideas .

15. Holistic approach
1- Disciplined, self-directed thinking which
implies the perfection of thinking appropriate
to a particular mode or domain of thinking.
2- Thinking that displays master of
intellectual skills and abilities.
 3- The art of thinking about your thinking
while you are thinking in order to make your
thinking better: more clear, more accurate,
or more defensible

16. FORMULA OF CRITICAL
THINKING
Start Thinking
Why Ask Why
Ask the Right Questions
Are you an expert?

17. ASPECT OF
CRITICALTHINKING
Reflection
Language
Intuition

18. LEVELS OF CRITICAL
THINKING
Basic
Complex
Commitment

19. CASE STUDY
 Mrs. Lutz is a 78 yr old woman who has
undergone radiation therapy and three surgeries
for cancer. She is not responding well, cannot
eat, and is losing weight. The physician has
decided to place a subclavian catheter to
administer total parenteral nutrition. The nurse
takes the informed consent form to the patient to
sign and explains to her that “the doctor will
place a small tube in your vein to give you more
nutrients to help you regain your strength and
heal”. Mrs. Lutz says, “I’m so tired of all this
pain. I’m not sure I want anything else done,
and I surely don’t want to be hurt again .”

20. CASE STUDY
What factors does the nurse need to
assess that might affect Mrs. Lutz’s ability
to consent?
Before she signs the consent form, how
can the nurse be certain that her consent
was truly “informed”?

21. CASE STUDY
The nurse replies to Mrs. Lutz:
“Now, now, your doctor has
ordered this to make you well.
Don’t worry, we’ll make sure you
don’t feel a thing. Your doctor will
be here soon and he will expect
this consent to be signed. Won’t
you please sign it now?”