BERFIKIR KRITIS DALAM

PRAKTEK KEPERAWATAN

By
Tri Prabowo
BERFIKIR KRITIS ?

MERUPAKAN SEBUAH
KOMPONEN ESENSIAL
DLM TANGGUNG
GUGAT PROFESIONAL &
ASKEP YG BERMUTU
 MENGAPA HARUS
BERFIKIR KRITIS ?
• Penggunaan berfikir kritis dlm keperawatan
menunjukkan kpd perawat untuk
memberikan perawatan yg aman, efektif &
penuh kasih
• Mampu mengembangkan daya nalar shg
mampu mengambil keputusan yg tepat
berdasarkan pertimbangan akal sehat dari
berbagai sumber
• Menjadikan pola pikir kita: reasonable,
rational, reflective, autonomous, creative ,
fair thinking
• Make judgements based on facts, concepts,
Logic
 PREFACE
 The need for critical thinking in nursing has
been accentuated in response to the rapidly
changing health care environment.
 Nurses must think critically to provide
effective care whilst coping with the
expansion in role associated with the
complexities of current health care systems.
 critical thinking is vital in examining simple
and complex situations in nurses’ day-to-
day responsibilities.
 CRITICAL THINKING
 The art of thinking about your thinking
while you are in order to make your
thinking better : more clear, more
accurate, or more defensible” (paul cit
smith, 1999)
 Is a multifaceted and complex concept
based on reason and reflection,
knowledge and instinct derived from
experience.
 CRITICAL THINKING
 Critical thinking is a cognitive or mental
process that involves conscious,
systematic, reflective, rational, and goal-
oriented examination and analysis of all
available information and ideas, and the
formulation of conclusions and the most
appropriate, often creative, decision.
 Critical thinking in nursing
 Purposeful, informed, outcomes-
focused (results oriented) thinking that
requires identifying key problems,
issues, risks
 Is driven by Patient, family,
community needs
 Based on the nursing process and
scientific method
 Requires specific knowledge, skills,
and experience
 Critical thinking in nursing
 Guided by professional standards and
ethics codes*
 Requires strategies that make the
most of human potential*
 Constantly re-evaluating, self-
correcting, and striving to improve
Critical Thinking in Clinical Practice
 Is an intellectual process of applying skillful
reasoning as a guide to belief or action.

 Is a purposeful, goal-directed thinking

process that strives to solve problems

 Critical thinking is an essential competency

of a professional health care provider, and it
is the most distinguishing attributes of an
expert practitioner.
Critical Thinking in Clinical Practice
 Critical thinking when developed in the
practitioner includes adherence to
intellectual standards, proficiency in using
reasoning
and the competent use of thinking skills and
abilities for sound
clinical judgments
and safe decision-making.
 Why…..Critical thinking?

 Our thinking pattern will be: reasonable,

systematic, rational, reflective, autonomous,
creative , fair thinking, cautious & informational-
seeking

Make judgment based on facts,

concepts, Logic
 Aspect: Critical Thinking and
Nursing
 The nurse identifies unique needs of each
client and develops specific interventions
to meet those needs.
 Creative thinkers have the intellectual
courage and capacity to think in a new
and in a different way.
 Without creative thinking, nursing would
become routine and habitual.
Characteristics of critical thinker

Rationality and insight

Cognitive maturity and
analytic nature
Purposeful and intentional
Truth-seeker with open-
mindedness
CHARACTERISTICS OF CRITICAL
THINKERS
ATTITUDES
• INDEPENDENT THINKING
• HUMILITY(memandang penting)
• COURAGE (semangat)
• INTEGRITY (keteguhan)
• PERSEVERANCE (gigih/tekun)
• EMPATHY
• FAIRNESS. (pantas,patut)
• SELF-AWARENESS (kesadaran diri)
CHARACTERISTICS OF CRITICAL
THINKERS

COGNITIVE
• ANALYZES
• MAKES INFERENCES
• DIFFERENTIATES FACTS VS OPINION
• EVALUATES CREDIBILITY
• USES REASONING
• CLARIFIES CONCEPTS
• RECOGNIZES ASSUMPTIONS
Critical Thinkers Ask

What am I taking for

granted?
Did I explore all points of
view?
Do I understand the
question?
What information do I need?
 Critical Thinking Ability
 CT Characteristics

 Technical Skills/ Competencies  Theoretical & Experiential Knowledge

 intellectual skills, competencies

 Interpersonal Skills/ Competencies

 MODEL BERPIKIR KRITIS
 T :
Total recall (ingatan total)
 H :
Habits (kebiasaan)
 I :
Inquiry (penyelidikan)
 N :
New Ideas & Creativity (ide
baru & kreatifitas)
 K : Knowing How You Think (
mengetahui bgmn anda berfikir)
Affective CTI’s

 Self–aware
 Genuine
 Self-disciplined
 Healthy
 Autonomous and responsible
 Careful, prudent
 Honest, curious, inquisitive
 Analytical, insightful
 Knowledge CTI’s

– Nursing and medical terminology

– Nursing vs medical and other models, roles,
responsibilities
– S&S of common problems and complications
– Related anatomy, physiology,
pathophysiology
– Related pharmacology
– Normal and abnormal function (bio-psycho-
social-cultural-spiritual)
Intellectual CTI’ s

 Applies standards and principles when providing care

 Assesses systematically and comprehensively using
a nursing framework to identify nursing concerns and
a body systems framework when identifying medical
concerns
 Detects bias, determines credibility of information
sources
Characteristics of Critical Thinking in
Clinical Practice

 Action-oriented, goal directed

 Pro-active: takes initiative, anticipatory
 Expertise based on experience and knowledge
 Blends logic and intuitive feelings
 More than gathering facts and figures
 Searching for the best answer, not just any
answer.
 Able to work collaboratively
Strategies that Promote Development &
Application of Critical Thinking

 Identify goals.
 Determine what knowledge is required.
 Assess the margin for error.
 Determine the amount of time available for
decision making.
 Identify available resources.
 Recognize factors that may influence
decision making.
Barriers to Creative Thinking

 Resistance to change, rigid mind-set, practice

guided by tradition, habit, routines
 Stereotypical perceptions of clients
 Fear of making mistakes
 Unwillingness to take risks or look for alternative
strategies
 Decision making without sufficient data or
supported by rationale
 Failure to evaluate effectiveness of nursing
actions
The Four Critical Thinking
Skills:

• Reading
• Listening
• Observing
• Analyzing
 To Improve Critical Reading
• Highlight the main ideas as you read. If most
of the text is highlighted you are not reading
critically.
• Join a study group and see if your main idea
is the same as fellow group member’s.
• Dialogue with yourself to identify the main
idea of your reading.
• Try to state the main idea in your own words
 To Improve Critical Listening
• Restate the points made in a
discussion with others to see if you
understand them.
• Focus on what a speaker is saying and
listen for key points.
• While listening, make note of anything
you find confusing, and ask about it
later.
 To Improve Critical Observing
• Remove any restrictions in your mind.
• Eliminate or decrease any distraction.
• Ask yourself if you understand the most
important points?
• Create new ways of looking at situations
• Always look from outside the situation .
 To Improve Critical Analyzing
• Maintain clear and accurate logic.
• Take all details into consideration.
• Use systematic and scientifically-
based process.
• Use both cognitive and psychomotor
skills.
Activity

 Its often said that medicine is

curing and nursing is caring , do
you agree ?
 Discussion
Activity

 Mr. K., a patient with asthma,

was admitted yesterday
morning. He has an order for
albuterol treatments to be given
every 4 hours around the clock.
You enter his room at 4:00 a.m.
and find him sleeping soundly.
 What would you do? Why?
Activity
 Mr. G. was admitted 2 weeks ago with right lower
lobe pneumonia. With severe chronic obstructive
pulmonary disease (COPD) as his underlying
disease, he has been deteriorating since admission.
Although he is given albuterol breathing treatments
every 3 hours around the clock, his respiratory rate
is 30/min., and he is constantly using his accessory
muscles to breathe. His latest blood gases indicate
his CO2 IS UP TO 75. The physician orders a
morphine drip. The nurse expresses her concern
about the order and refuses to give the medication.
 Do you agree or disagree with the
nurse’s decision? Why?
 What would have done in this situation?
Provide a rationale for your answer