Critical Thinking in 21st Century Nursing

[Team HPNI]

Hi AllNurses.com Friends,

Much is said and written about the importance of critical thinking and how it affects the quality of patient care.

Everyone has an opinion:

The National Patient Safety Foundation (NPSF) Discussion Forum:

Jo Ann Klein, MS, RN's commentary on "Critical Thinking in Nursing": "What is critical thinking in nursing? Ask a dozen nurses, and you'll get a dozen different answers. Primarily, critical thinking is a method of problem solving requiring reflective thinking. It is built on an individual's ideals and value system, and is purposeful and goal-directed with the intention of making decisions."

Academic medical center nursing director:

We have a tool to evaluate critical thinking in our new hires.

Competency training participant:

It's just common sense - doesn't everyone do that?

But . . . . in the last 12 months, two almost-identical tragic events occurred in the same ICU area . . . in both cases, 4-5 doctors and nurses made flawed assumptions (e.g., ok to ignore alarming equipment because it must be broken).

Sure, everyone knows that theory and reality are worlds apart. Okay - but surely there's a solution? Or, at least a workaround?

So, what do YOU think? I can use help! Thank you!

[Team HPNI]

Well, to answer my own question and raise a few more questions . . .

Today's NY Times (June 7, 2003) has an interesting article, "NASA's Failings Go Far Beyond Foam Hitting Shuttle, Panel Says."

A few key phrases.

"NASA's problems go far beyond falling foam, according to an early outline of the report by the independent panel investigating the accident that doomed the shuttle Columbia and its crew.

The failings include an institutional culture that plays down problems, as well as constraints from Washington that may have reduced the ability to reach space safely.

The outline portrays the fatal Columbia mission as the tip of an iceberg of problems that include communications breakdowns and an increasingly complacent attitude toward warning signs. Budget pressures and administrative shuffles add to the pressure on the National Aeronautics and Space Administration, the report suggests, and may have contributed to the troubles."

Based on this article, I guess "institutional culture," "communication breakdowns," and "complacent attitude" are contributing factors.

Hmmm.

Thoughts?

[harp]

Yes, all of the above are contributing factors, weather it's NASA or an ICU. Why did JCAHO come up with National Patient Safety Goals for 2003 that include improving effectiveness of communication and clinical alarm systems? Is it common sense or critical thinking? If it's ringing, fix it.. if it's broken, fix it.. don't allow fatal errors because we refuse to address the safety of patient care.

[olympiad27]

Team HPNI,

What exactly are you asking? It is unclear if you are needing ways to measure critical thinking, develop critical thinking skills, or a definition of it. Please elaborate.