Hemşirelik Sürecinde Klinik Akıl Yürütme
Özet
Günümüzde gelişmeler ve durmadan artan bilgi ile karakterize sağlık sistemi içinde profesyonel hemşirelerden esnek, bireyselleştirilmiş, duruma özgü problem çözme konusunda kendilerine öncülük edecek olan klinik akıl yürütme, problem çözme ve eleştirel düşünme becerilerini geliştirmeleri beklenmektedir. Çağdaş hemşirelik uygulamaları, yeni mezunların bile karmaşık durumdaki hastalar için zor kararlar almaya hazırlıklı olmalarını gerektirdiği için klinik akıl yürütme becerisi önemlidir. Klinik akıl yürütme, değerlendirmeyi, hemşirelik tanılarını, müdahaleyi ve en iyi bilimsel kanıtların kullanımıyla, sonuçları içeren hemşirelik sürecinin tüm aşamalarında önemli bir unsurdur. Bu bilgiler ışığında bu bölümde, hemşirelik sürecinde önemli yeri olan klinik akıl yürütme, problem çözme, eleştirel düşünme becerileri ve kavram haritası stratejisi güncel literatüre dayalı olarak ele alınmıştır.
Referanslar
Banning M. Clinical reasoning and its application to nursing: concepts and research studies. Nurse Education in Practice 2008; 8, 177–183.
Schooley AM. Concept-mapping proficiency and reasoning skills in baccalaureate nursing students (Doctoral dissertation, Capella University). 2015.
Simmons B. Clinical reasoning: Concept analysis. J Adv Nurs 2010;66(5):1151–8.
Levett-Jones T. Clinical Reasoning: Learning to Think Like a Nurse. Pearson, Frenchs Forest, Australia. 2013.
Higgs, J., Burn, A., & Jones, M. (2001). Integrating clinical reasoning and evidence-based practice. AACN Advanced Critical Care, 12(4), 482-490.
Leoni‐Scheiber, C., Mayer, H., & Müller‐Staub, M. (2019). Measuring the effects of guided clinical reasoning on the Advanced Nursing Process quality, on nurses’ knowledge and attitude: Study protocol. Nursing open, 6(3), 1269-1280.
Carvalho DP, Azevedo IC, Cruz GK, Mafra, GA, Rego AL, Vitor AF, Ferreira MA. Strategies used for the promotion of critical thinking in nursing undergraduate education: a systematic review. Nurse Educ. Today 2017;57:103–107. https://doi.org/10.1016/j.nedt.2017.07.010.
Griffits S, Hines S, Moloney C, Ralph N. Characteristics and processes of clinical reasoning in nurses and factors related to its use: a scoping review protocol. JBI Evid. Synth. 2017;15 (12):2832–2836. https://doi.org/10.1097/ JXX.0000000000000355.
Gummesson C, Sund´en A, Fex AClinical reasoning as a conceptual framework for interprofessional learning: a literature review and a case study. Phys. Ther. Rev. 2018;23 (1):29–34. https://doi.org/10.1080/10833196.2018.1450327.
Tanner C. Thinking like a nurse: a research-based model of clinical judgment in nursing. Journal of Nursing Education 2006;45 (6): 204–211.
Lapkin, S., Levett-Jones, T., Bellchambers, H., & Fernandez, R. (2010). Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: A systematic review. Clinical simulation in nursing, 6(6), e207-e222.
Dawson TE. Can Script Concordance Testing be Utilized in Nursing Education to Accurately Assess Clinical Reasoning Skills? (Doctoral dissertation, Western Carolina University). 2012.
Jensen R. Clinical reasoning during simulation: Comparison of student and faculty ratings. Nurse education in practice, 2013;13(1): 23-28.
Corcoran-Perry S. Narayan S. Teaching clinical reasoning in nursing education. Clinical reasoning in the heaÏth profession (2 Ilded), 2000; 249-254.
Alfaro-LeFevre R. Critical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach. fifth ed. Elsevier, St. Louis. 2013.
Mohammadi‐Shahboulaghi F. Khankeh H. HosseinZadeh T. Clinical reasoning in nursing students: A concept analysis. In Nursing Forum 2021; 56(4): 1008-1014.
Levett-Jones, T., Hoffman, K., Dempsey, J., Jeong, S. Y. S., Noble, D., Norton, C. A., ... & Hickey, N. (2010). The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’patients. Nurse education today, 30(6), 515-520.
Thompson C. Cullum N. McCaughan D. Sheldon T. Raynor P. Nurses, information use, and clinical decision making: the real world potential for evidence-based decisions in nursing. Evidence-Based Nursing 2004;7(3):68–72.
Bucknall T. Critical care nurses’ decision-making activities in the natural clinical setting. Journal of Clinical Nursing 2000;9 (1):25–35.
TDK (2023) Güncel Türkçe Sözlük. https://sozluk.gov.tr/ (Erişim Tarihi: 12.12.2023).
Gelbal, S. Problem çözme. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi,1991; 6, 167- 173.
Kaya, E. (2005). Hemşirelerin problem çözme becerilerinin ve etkileyen bazı faktörlerin belirlenmesi. Hemşirelik Programı Yayınlanmamış Yüksek Lisans Tezi, Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü. Sivas, Türkiye.
Abaan S, Altıntoprak A. Hemşirelerde problem çözme becerileri: öz değerlendirme sonuçlarının analizi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 2005;12(1):62-76.
Marquis BL, Huston CJ. Leadership roles and management function in nursing. Theory and application, 7. 2012.
Sullıvan, EJ. Effective leadership and management in nursing. Eighth Edition, Boston: Pearson. 2013.
Kantek F, Yıldırım N. Sorun Çözme ve Karar Verme, In Hemşirelikte Yönetim , İstanbul: Akademi Basın ve Yayıncılık, 2022, pp.184-208.
Ulupınar S. Hemşirelik eğitiminin öğrencilerin sorun çözme becerilerine etkisi (Yayınlanmamış Doktora Tezi). İstanbul Üniversitesi, Sağlık Bilimleri Enstitüsü, İstanbul. 1997.
Taşçı S. Hemşirelikte problem çözme süreci. Sağlık Bilimleri Dergisi, 14 (Ek sayı: Hemşirelik Özel Sayısı),2005;73-78.
Sönmez B. Sorun Çözme ve Karar Verme, In Hemşirelikte Yönetim , İstanbul: Akademi Basın ve Yayıncılık, 2014, pp.257-273.
Kanbay Y, Okanlı A. The effect of critical thinking education on nursing students’ problem-solving skills. Contemporary nurse, 2017;53(3): 313-321.
Scheffer BK, Rubenfeld MG. A consensus statement on critical thinking. Journal of Nursing Education, 2000;39:52–359.
Griffits S, Hines S, Moloney C, Ralph N. Characteristics and processes of clinical reasoning in nurses and factors related to its use: a scoping review protocol. JBI Evidence Synthesis, 2017; 15(12):2832-2836.
Facione NC. Facione PA. Sánchez CA Critical thinking disposition as a mesure of component critical judgment: The development of the California Critical Thinking Disposition Inventory. Journal of Nursing Education, 1994;33(8):345–350.
Falcó‐Pegueroles A, Rodríguez‐Martín D, Ramos‐Pozón S, Zuriguel‐Pérez ECritical thinking in nursing clinical practice, education and research: From attitudes to virtue. Nursing Philosophy, . 2021;22(1): e12332.
Kotzee B. Ignatowicz A. Measuring ‘virtue’ in medicine. Medicine, Health Care and Philosophy, 2016;19: 149–161. https://doi.org/10.1007/s11019-015-9653-6
Alfaro-Lefevre, R. Critical thinking, clinical reasoning and clinical judgment. A practical approach, 7th ed. Elsevier. 2019.
Ravert, P. (2008). Patient simulator sessions and critical thinking. The Journal of Nursing Education, 47(12), 557–562.
Raymond-Seniuk C, Profetto-McGrath J. Can one learn to think critically?—A philosophical exploration. The Open Nursing Journal, 2011;5:45–51. https://doi.org/10.2174/1874434601105010045
Zuriguel-Pérez E, Lluch-Canut MT, Falcó Pegueroles A, Puig-Llobet M, Moreno- Arroyo C, Roldán-Merino J. Critical thinking in nursing: Scoping review of the literature. International Journal of Nursing Practice, 2015;21(6):820–830. https://doi.org/10.1111/ijn.12347
Dwyer CP, Hogan MJ, Stewart I. An integrated critical thinking framework for the 21st century. Thinking Skills and Creativity, 2014;12, 43–52.
Dunne G. Beyond critical thinking to critical being: Criticality in higher education and life. International Journal of Education Research, 2015;71, 86–99.
Kataoka-Yahiro, M, Saylor C. A critical thinking model for nursing judgment. J. Nurs. Educ. 1994;33 (8): 351–356.
Paul R, Elder L. (2019). The miniature guide to critical thinking-concepts & tools, 8th ed. The Foundation for Critical Thinking.
Profetto-McGrath, J., Hesketh, K. L., Lang, S., & Estabrooks, C. A. (2003). A study of critical thinking and research utilization among nurses. Western Journal of Nursing Research, 25(3), 322–333
Wilkinson J M. Nursing process and critical thinking, 5th ed. Pearson. 2012.
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal of Nursing Terminologies and Classifications, 21(2), 82–88. https://doi.org/10.1111/j.1744-618X.2010.01150.x
Yue M, Zhang M, Zhang C, Jin, CThe effectiveness of concept mapping on development of critical thinking in nursing education: A systematic review and meta-analysis. Nurse education today, 2017;52, 87-94.
Senemoğlu N. Gelişim Öğrenme ve Öğretim, 12. baskı, Ağustos. 2005.
Schuster, PM. Concept Mapping: a Critical-thinking Approach to Care Planning, third ed. F.A. Davis, Philadelphia, PA. 2012.
Carr-Lopez S, Galal SM, Vyas D, Patel RA, Gnesa EH. The utility of concept maps to facilitate higher-level learning in a large classroom setting. American Journal of Pharmaceutical Education, 2014;78(9):1-7. https://doi.org/10.5688/ajpe789170
Adema-Hannes R, Parzen M. Concept Mapping: Does It Promote Meaningful Learning in the Clinical Setting?. College Quarterly, 2005;8(3):n3.
Hıcks-Moore, Sandee L. Clinical concept maps in nursing education: An effective way to link theory and practice. Nurse education in practice, 2005;5.6: 348-352.
Chen, Shiah-Lian, et al. Effects of concept map teaching on students’ critical thinking and approach to learning and studying. Journal of Nursing Education, 2011; 50.8: 466-469.
Sınatra-Wılhelm, Tina. Nursing care plans versus concept maps in the enhancement of critical thinking skills in nursing students enrolled in a baccalaureate nursing program. Creative Nursing, 2012, 18.2: 78-84.
Black P, Green N, Chapin B, Owens C. Concept mapping: An alternative teaching strategy. Pelican News, 2000;56(4):23-6.
Castellıno AR, Schuster PM. Evaluation of outcomes in nursing students using clinical concept map care plans. Nurse Educator, 2002, 27.4: 149-150.
Wheeler LA, Collıns SKR. The influence of concept mapping on critical thinking in baccalaureate nursing students. Journal of professional Nursing, 2003, 19.6: 339-346.
Abel WM, Martha Freeze MSN. Evaluation of concept mapping in an associate degree nursing program. Journal of nursing education, 2006, 45.9: 356.
Maneval RE, Filburn MJ, Deringer SO, Lum GD. Concept mapping: Does it improve critical thinking ability in practical nursing students?. Nursing Education Perspectives, 2011;32(4):229-233.
Sinatra-Wilhelm T. Nursing care plans versus concept maps in the enhancement of critical thinking skills in nursing students enrolled in a baccalaureate nursing program. Creative Nursing, 2012;18(2):78-84.
Atay S, Karabacak Ü. Care plans using concept maps and their effects on the critical thinking dispositions of nursing students. International Journal of Nursing Practice, 2012;18.3: 233-239.
Garwood JK, Ahmed AH, McComb SA. The effect of concept maps on undergraduate nursing students’ critical thinking. Nursing education perspectives, 2018;39(4): 208-214.
Schuelke SM, Barnason S. Interventions used by nurse preceptors to develop critical thinking of new graduate nurses: A systematic review. Journal for Nurses in Professional Development, 2017;31(1). https://doi.org/10.1097/NND.0000000000000318
Schooley AM. Concept-mapping proficiency and reasoning skills in baccalaureate nursing students. 2015. PhD Thesis. Capella University.
Referanslar
Banning M. Clinical reasoning and its application to nursing: concepts and research studies. Nurse Education in Practice 2008; 8, 177–183.
Schooley AM. Concept-mapping proficiency and reasoning skills in baccalaureate nursing students (Doctoral dissertation, Capella University). 2015.
Simmons B. Clinical reasoning: Concept analysis. J Adv Nurs 2010;66(5):1151–8.
Levett-Jones T. Clinical Reasoning: Learning to Think Like a Nurse. Pearson, Frenchs Forest, Australia. 2013.
Higgs, J., Burn, A., & Jones, M. (2001). Integrating clinical reasoning and evidence-based practice. AACN Advanced Critical Care, 12(4), 482-490.
Leoni‐Scheiber, C., Mayer, H., & Müller‐Staub, M. (2019). Measuring the effects of guided clinical reasoning on the Advanced Nursing Process quality, on nurses’ knowledge and attitude: Study protocol. Nursing open, 6(3), 1269-1280.
Carvalho DP, Azevedo IC, Cruz GK, Mafra, GA, Rego AL, Vitor AF, Ferreira MA. Strategies used for the promotion of critical thinking in nursing undergraduate education: a systematic review. Nurse Educ. Today 2017;57:103–107. https://doi.org/10.1016/j.nedt.2017.07.010.
Griffits S, Hines S, Moloney C, Ralph N. Characteristics and processes of clinical reasoning in nurses and factors related to its use: a scoping review protocol. JBI Evid. Synth. 2017;15 (12):2832–2836. https://doi.org/10.1097/ JXX.0000000000000355.
Gummesson C, Sund´en A, Fex AClinical reasoning as a conceptual framework for interprofessional learning: a literature review and a case study. Phys. Ther. Rev. 2018;23 (1):29–34. https://doi.org/10.1080/10833196.2018.1450327.
Tanner C. Thinking like a nurse: a research-based model of clinical judgment in nursing. Journal of Nursing Education 2006;45 (6): 204–211.
Lapkin, S., Levett-Jones, T., Bellchambers, H., & Fernandez, R. (2010). Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: A systematic review. Clinical simulation in nursing, 6(6), e207-e222.
Dawson TE. Can Script Concordance Testing be Utilized in Nursing Education to Accurately Assess Clinical Reasoning Skills? (Doctoral dissertation, Western Carolina University). 2012.
Jensen R. Clinical reasoning during simulation: Comparison of student and faculty ratings. Nurse education in practice, 2013;13(1): 23-28.
Corcoran-Perry S. Narayan S. Teaching clinical reasoning in nursing education. Clinical reasoning in the heaÏth profession (2 Ilded), 2000; 249-254.
Alfaro-LeFevre R. Critical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach. fifth ed. Elsevier, St. Louis. 2013.
Mohammadi‐Shahboulaghi F. Khankeh H. HosseinZadeh T. Clinical reasoning in nursing students: A concept analysis. In Nursing Forum 2021; 56(4): 1008-1014.
Levett-Jones, T., Hoffman, K., Dempsey, J., Jeong, S. Y. S., Noble, D., Norton, C. A., ... & Hickey, N. (2010). The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’patients. Nurse education today, 30(6), 515-520.
Thompson C. Cullum N. McCaughan D. Sheldon T. Raynor P. Nurses, information use, and clinical decision making: the real world potential for evidence-based decisions in nursing. Evidence-Based Nursing 2004;7(3):68–72.
Bucknall T. Critical care nurses’ decision-making activities in the natural clinical setting. Journal of Clinical Nursing 2000;9 (1):25–35.
TDK (2023) Güncel Türkçe Sözlük. https://sozluk.gov.tr/ (Erişim Tarihi: 12.12.2023).
Gelbal, S. Problem çözme. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi,1991; 6, 167- 173.
Kaya, E. (2005). Hemşirelerin problem çözme becerilerinin ve etkileyen bazı faktörlerin belirlenmesi. Hemşirelik Programı Yayınlanmamış Yüksek Lisans Tezi, Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü. Sivas, Türkiye.
Abaan S, Altıntoprak A. Hemşirelerde problem çözme becerileri: öz değerlendirme sonuçlarının analizi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 2005;12(1):62-76.
Marquis BL, Huston CJ. Leadership roles and management function in nursing. Theory and application, 7. 2012.
Sullıvan, EJ. Effective leadership and management in nursing. Eighth Edition, Boston: Pearson. 2013.
Kantek F, Yıldırım N. Sorun Çözme ve Karar Verme, In Hemşirelikte Yönetim , İstanbul: Akademi Basın ve Yayıncılık, 2022, pp.184-208.
Ulupınar S. Hemşirelik eğitiminin öğrencilerin sorun çözme becerilerine etkisi (Yayınlanmamış Doktora Tezi). İstanbul Üniversitesi, Sağlık Bilimleri Enstitüsü, İstanbul. 1997.
Taşçı S. Hemşirelikte problem çözme süreci. Sağlık Bilimleri Dergisi, 14 (Ek sayı: Hemşirelik Özel Sayısı),2005;73-78.
Sönmez B. Sorun Çözme ve Karar Verme, In Hemşirelikte Yönetim , İstanbul: Akademi Basın ve Yayıncılık, 2014, pp.257-273.
Kanbay Y, Okanlı A. The effect of critical thinking education on nursing students’ problem-solving skills. Contemporary nurse, 2017;53(3): 313-321.
Scheffer BK, Rubenfeld MG. A consensus statement on critical thinking. Journal of Nursing Education, 2000;39:52–359.
Griffits S, Hines S, Moloney C, Ralph N. Characteristics and processes of clinical reasoning in nurses and factors related to its use: a scoping review protocol. JBI Evidence Synthesis, 2017; 15(12):2832-2836.
Facione NC. Facione PA. Sánchez CA Critical thinking disposition as a mesure of component critical judgment: The development of the California Critical Thinking Disposition Inventory. Journal of Nursing Education, 1994;33(8):345–350.
Falcó‐Pegueroles A, Rodríguez‐Martín D, Ramos‐Pozón S, Zuriguel‐Pérez ECritical thinking in nursing clinical practice, education and research: From attitudes to virtue. Nursing Philosophy, . 2021;22(1): e12332.
Kotzee B. Ignatowicz A. Measuring ‘virtue’ in medicine. Medicine, Health Care and Philosophy, 2016;19: 149–161. https://doi.org/10.1007/s11019-015-9653-6
Alfaro-Lefevre, R. Critical thinking, clinical reasoning and clinical judgment. A practical approach, 7th ed. Elsevier. 2019.
Ravert, P. (2008). Patient simulator sessions and critical thinking. The Journal of Nursing Education, 47(12), 557–562.
Raymond-Seniuk C, Profetto-McGrath J. Can one learn to think critically?—A philosophical exploration. The Open Nursing Journal, 2011;5:45–51. https://doi.org/10.2174/1874434601105010045
Zuriguel-Pérez E, Lluch-Canut MT, Falcó Pegueroles A, Puig-Llobet M, Moreno- Arroyo C, Roldán-Merino J. Critical thinking in nursing: Scoping review of the literature. International Journal of Nursing Practice, 2015;21(6):820–830. https://doi.org/10.1111/ijn.12347
Dwyer CP, Hogan MJ, Stewart I. An integrated critical thinking framework for the 21st century. Thinking Skills and Creativity, 2014;12, 43–52.
Dunne G. Beyond critical thinking to critical being: Criticality in higher education and life. International Journal of Education Research, 2015;71, 86–99.
Kataoka-Yahiro, M, Saylor C. A critical thinking model for nursing judgment. J. Nurs. Educ. 1994;33 (8): 351–356.
Paul R, Elder L. (2019). The miniature guide to critical thinking-concepts & tools, 8th ed. The Foundation for Critical Thinking.
Profetto-McGrath, J., Hesketh, K. L., Lang, S., & Estabrooks, C. A. (2003). A study of critical thinking and research utilization among nurses. Western Journal of Nursing Research, 25(3), 322–333
Wilkinson J M. Nursing process and critical thinking, 5th ed. Pearson. 2012.
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal of Nursing Terminologies and Classifications, 21(2), 82–88. https://doi.org/10.1111/j.1744-618X.2010.01150.x
Yue M, Zhang M, Zhang C, Jin, CThe effectiveness of concept mapping on development of critical thinking in nursing education: A systematic review and meta-analysis. Nurse education today, 2017;52, 87-94.
Senemoğlu N. Gelişim Öğrenme ve Öğretim, 12. baskı, Ağustos. 2005.
Schuster, PM. Concept Mapping: a Critical-thinking Approach to Care Planning, third ed. F.A. Davis, Philadelphia, PA. 2012.
Carr-Lopez S, Galal SM, Vyas D, Patel RA, Gnesa EH. The utility of concept maps to facilitate higher-level learning in a large classroom setting. American Journal of Pharmaceutical Education, 2014;78(9):1-7. https://doi.org/10.5688/ajpe789170
Adema-Hannes R, Parzen M. Concept Mapping: Does It Promote Meaningful Learning in the Clinical Setting?. College Quarterly, 2005;8(3):n3.
Hıcks-Moore, Sandee L. Clinical concept maps in nursing education: An effective way to link theory and practice. Nurse education in practice, 2005;5.6: 348-352.
Chen, Shiah-Lian, et al. Effects of concept map teaching on students’ critical thinking and approach to learning and studying. Journal of Nursing Education, 2011; 50.8: 466-469.
Sınatra-Wılhelm, Tina. Nursing care plans versus concept maps in the enhancement of critical thinking skills in nursing students enrolled in a baccalaureate nursing program. Creative Nursing, 2012, 18.2: 78-84.
Black P, Green N, Chapin B, Owens C. Concept mapping: An alternative teaching strategy. Pelican News, 2000;56(4):23-6.
Castellıno AR, Schuster PM. Evaluation of outcomes in nursing students using clinical concept map care plans. Nurse Educator, 2002, 27.4: 149-150.
Wheeler LA, Collıns SKR. The influence of concept mapping on critical thinking in baccalaureate nursing students. Journal of professional Nursing, 2003, 19.6: 339-346.
Abel WM, Martha Freeze MSN. Evaluation of concept mapping in an associate degree nursing program. Journal of nursing education, 2006, 45.9: 356.
Maneval RE, Filburn MJ, Deringer SO, Lum GD. Concept mapping: Does it improve critical thinking ability in practical nursing students?. Nursing Education Perspectives, 2011;32(4):229-233.
Sinatra-Wilhelm T. Nursing care plans versus concept maps in the enhancement of critical thinking skills in nursing students enrolled in a baccalaureate nursing program. Creative Nursing, 2012;18(2):78-84.
Atay S, Karabacak Ü. Care plans using concept maps and their effects on the critical thinking dispositions of nursing students. International Journal of Nursing Practice, 2012;18.3: 233-239.
Garwood JK, Ahmed AH, McComb SA. The effect of concept maps on undergraduate nursing students’ critical thinking. Nursing education perspectives, 2018;39(4): 208-214.
Schuelke SM, Barnason S. Interventions used by nurse preceptors to develop critical thinking of new graduate nurses: A systematic review. Journal for Nurses in Professional Development, 2017;31(1). https://doi.org/10.1097/NND.0000000000000318
Schooley AM. Concept-mapping proficiency and reasoning skills in baccalaureate nursing students. 2015. PhD Thesis. Capella University.
