Applying Nursing Process: A Tool for Critical Thinking

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  • Edition: 7th
  • Format: Paperback
  • Copyright: 2009-01-28
  • Publisher: LWW
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This trusted resource combines the practical guidance students need to understand each phase of the nursing process with an emphasis on critical thinking, focusing on both independent and collaborative responsibilities facing today's nurses. Using straightforward language, abundant examples, and real case scenarios, the book addresses the nurse's role as a caregiver and decision-maker in a range of settings--from clinic to the home, community, research, and acute care arenas. "Doody's Core Titles 2009."

Table of Contents

Nursing Process Overview
What Is the Nursing Process and Why Learn About It?p. 5
What Is It?p. 5
Why Learn About It?p. 6
Steps of the Nursing Processp. 7
Relationships Among the Steps of the Nursing Processp. 9
Assessment and Diagnosisp. 10
Diagnosis and Planningp. 10
Planning and Implementationp. 11
Implementation and Evaluationp. 11
Evaluation and the Other Nursing Process Stepsp. 11
What Are the Benefits of Using the Nursing Process?p. 13
Nursing Process in Context of Today's Clinical Settingp. 15
Patient Safety Is Top Priorityp. 25
Ethics: Advocating for Patients' Rightsp. 26
Seven Ethical Principlesp. 26
Following Ana Ethics Codep. 27
Including Patient Partners While Following Hipaa Rulesp. 27
What's the Difference Between Nursing Process and Critical Thinking?p. 32
How to Become a Critical Thinkerp. 32
Using the Four-Circle CT Modelp. 35
Willingness and Ability to Carep. 38
Willingness to Carep. 38
Being Able to Carep. 38
Assessment: The First Step to Determining Health Statusp. 47
Characteristics of an Assessment That Promotes Critical Thinkingp. 47
Standard Assessment Tools and Evidence-Based Practicep. 48
Six Phases of Assessmentp. 48
Collecting Datap. 50
What Resources Do You Use?p. 50
How to Ensure Comprehensive Data Collectionp. 51
Data Base, Focus, and Quick Priority Assessmentsp. 51
Data Base (Start of Care) Assessmentp. 57
Focus Assessmentp. 57
Quick Priority Assessments (QPAs)p. 60
Assessing Disease and Disability Managementp. 61
Health Promotion: Screening for Risk Management and Early Diagnosisp. 62
Partnering With Patients to Make Informed Decisionsp. 63
The Interview and Physical Assessmentp. 63
Ethical, Cultural, and Spiritual Concernsp. 63
Developing Your Interviewing Skillsp. 64
Guidelines: Promoting a Caring Interviewp. 64
How to Establish Rapportp. 64
How to Listenp. 65
How to Ask Questionsp. 66
How to Observep. 66
How to Terminate the Interviewp. 68
Developing Your Physical Assessment Skillsp. 68
Guidelines: Performing a Physical Assessmentp. 70
Checking Diagnostic Studiesp. 70
Identifying Subjective and Objective Datap. 73
Identifying Cues and Making Inferencesp. 74
Validating (Verifying) Datap. 74
Guidelines: Validating (Verifying) Datap. 75
Clustering Related Datap. 77
Clustering Data According to Purposep. 77
Identifying Patterns/Testing First Impressionsp. 81
Reporting and Recordingp. 82
Reporting Abnormal Findingsp. 82
Deciding What's Abnormalp. 82
Guidelines: Reporting and Recordingp. 83
General Guidelinesp. 83
Guidelines: Verbal and Phone Communicationsp. 84
Guidelines: Recording the Nursing Data Basep. 84
Guidelines: Charting on Electronic Recordsp. 85
From Assessment to Diagnosis: A Pivotal Pointp. 93
Diagnosis: What ANA Standards Sayp. 94
Nurses' Growing Responsibilities as Diagnosticiansp. 94
Diagnose and Treat (DT) Versus Predict, Prevent, Manage, and Promote (PPMP)p. 96
Multidisciplinary Practicep. 97
Disease and Disability Managementp. 97
Point-of-Care Testingp. 97
Critical Pathways (Care Maps)p. 98
Advantages of Critical Pathsp. 98
Disadvantages of Critical Pathsp. 98
Informatics and Computer-Assisted Diagnosisp. 99
Using Standard or Recognized Termsp. 99
How to Use Standard Languagesp. 101
Computer-Assisted Diagnosisp. 102
Limitations of Computer-Assisted Diagnosisp. 103
Becoming a Competent Diagnosticianp. 103
Key Terms Related to Diagnosisp. 104
Recognizing Risk Factors: The Key to Proactive Approachesp. 110
Critical Thinking Indicators (CTIs) Related to Diagnosisp. 110
Learning How to Make Definitive Diagnosesp. 114
Fundamental Principles and Rules of Diagnostic Reasoningp. 114
Patients as Partners in Diagnosisp. 118
Clarifying Causes and Contributing (Risk) Factorsp. 123
Identifying Nursing Diagnosesp. 124
Guidelines: Identifying Nursing Diagnosesp. 125
Mapping Diagnosesp. 127
Writing Diagnostic Summary Statements Using the PES or PRS Formatp. 128
Identifying Potential Complicationsp. 134
Guidelines: Identifying Potential Complicationsp. 134
Identifying Problems Requiring Multidisciplinary Approachesp. 135
Thinking Critically During Planningp. 143
Four Main Purposes of the Plan of Carep. 143
Initial Versus Ongoing Planningp. 143
Applying Standardsp. 144
Clinical Decision Makingp. 145
Pain Management, Restraint Management, and Patient Safety Standardsp. 146
Standard and Electronic Plansp. 146
Attending to Urgent Prioritiesp. 146
Clarifying Expected Outcomes (Results)p. 147
Outcomes Versus Indicatorsp. 148
Principles of Patient-Centered Outcomesp. 151
Guidelines: Determining Patient-Centered Outcomesp. 153
Relationship of Outcomes to Accountabilityp. 154
Clinical, Functional, and Quality-of-Life Outcomesp. 154
Discharge Outcomes and Discharge Planningp. 155
Case Managementp. 157
Deciding Which Problems Must Be Recordedp. 157
Determining Nursing Interventionsp. 160
Assessment-Monitoring Health Status and Responses to Carep. 160
Teaching-Empowering Patients and Familiesp. 161
Guidelines: Planning Teachingp. 161
Counseling and Coaching: Helping People Make Informed Choicesp. 162
Consulting and Referring: Key to Multidisciplinary Carep. 162
Individualizing Interventionsp. 163
Evidence-Based Practice: Weigh Risks and Benefits-Be Proactivep. 164
Guidelines: Individualizing Nursing Ordersp. 165
Making Sure the Plan Is Adequately Recordedp. 167
Multidisciplinary Plansp. 168
Implementation: Putting the Plan into Actionp. 183
Critical Thinking Indicators (CTIs) Related to Implementationp. 184
Preparing for Report and Getting Report (Shift Hand-off)p. 184
Preparing for Report (Shift Hand-off)p. 184
Getting Report (Shift Hand-off)p. 184
Setting Daily Prioritiesp. 185
Strategies: Prioritizing Care for Several Patientsp. 185
Delegating Care, Not Accountabilityp. 188
Coordinating Carep. 190
Monitoring Responses: Assessing and Reassessingp. 190
Performing Nursing Interventionsp. 191
Be Proactive-Promote Safety, Comfort, and Efficiencyp. 191
Implementation and Evidence-Based Practicep. 191
Guidelines: Preparing to Actp. 192
Thinking Critically: What to Do If Things Go Wrongp. 192
Case Management: Critical Paths and Care Variancesp. 193
Ethical/Legal Concernsp. 194
Chartingp. 195
Six Purposes of Chartingp. 195
Various Ways of Chartingp. 196
Principles of Effective Chartingp. 197
Avoiding Dumping Syndrome With Electronic Chartingp. 198
Learning to Chart Effectivelyp. 198
Guidelines: Charting During Implementationp. 198
Memory-Jogs for Chartingp. 199
Giving Report (Shift Hand-Off)p. 200
Guidelines: Giving Report (Shift Hand-off)p. 201
Keeping the Plan Up-to-Data and Evaluating Your Dayp. 201
Critical Evaluation: Key to Excellence in Nursingp. 212
Evaluation and the Other Steps in the Nursing Processp. 212
Evaluating an Individual Plan of Carep. 212
Guidelines: Determining Outcome Achievementp. 213
Identifying Variables (Factors) Affecting Outcome Achievementp. 213
Deciding Whether to Discharge the Patientp. 214
Quality Improvement (QI)p. 215
Evidence-Based Practicep. 215
Consumer Satisfaction: Maximizing Valuep. 216
Health Care Systems Interest and Affect Outcomesp. 216
Three Types of Evaluation: Outcome, Process, and Structurep. 217
Staff Nurses' Responsibilitiesp. 217
Preventing Mistakes and Infection Transmissionp. 219
Quick Reference To Nursing Diagnosesp. 223
Example Responses To Critical Thinking Exercisesp. 241
Four Roles Of Advanced Practice Nurses (Apns)p. 247
Dead On!! A Game To Promote Critical Thinkingp. 249
Commonly Used Nanda Diagnoses Organized According To Gordon's Functional Health Patternsp. 250
Good Learning Environments, Healthy Workplace Standards, And Establishing A Culture of Safetyp. 252
Nursing Interventions Classification (NIC) And Nursing Outcomes Classification (NOC) Examplesp. 253
Glossaryp. 254
Indexp. 257
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