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Learning Objective 1: describe a method to measure nurses' critical thinking ability during clinical practice.
Learning Objective 2: examine the critical thinking project implementation and results.
Objectives: To promote critical thinking in nursing practice, a northeast medical center’s administrative team utilized a tool developed for individualized critical-thinking assessment by the Nursing Executive Center of The Advisory Board Company. The instrument (Cronbach alpha = .976) assesses individual performance on 25 critical-thinking competencies with feedback on strengths and weaknesses, offers educational assignments, and templates for successful coaching. The goal was to promote a hospital-wide nursing practice environment that fosters critical-thinking and best practices to achieve strategic essentials: to understand protocol underpinnings, to recognize significant clinical patterns, and trigger early recognition and patient intervention.
Background: Clinical leaders realize that bedside nurses are caring for more acutely ill patients during shorter hospital stays, using more involved protocols. In this fast-paced, task-oriented atmosphere, frontline nurses are challenged to think critically about care delivery. Negative /life-threatening outcomes can occur as a result of not recognizing patients’ emerging clinical patterns.
Design: Quantitative pre-post intervention observational assessment study
Method: Medical-surgical nurses (n = 99) were assessed during bedside practice. Based on performance scores, individualized educational action plan was implemented. After completion, the participants discussed assignment results in small groups. The nurses were re-assessed individually to determine if the educational interventions made a difference in the nurses’ critical thinking abilities/scores.
Results: A t-test for independent samples analyzed the hypothesis of no difference in pre-post scores with significance level of 0.05. The findings shows a statistically significant improvement in critical thinking scores post educational intervention (critical t = 1.66; P-Value = 0.00).
Relevance: Nursing Executive Center’s critical-thinking educational interventions improved frontline nurses’ critical thinking and potentially improved patient outcomes.
Future project suggestions: to examine the use of this method with nurses of other specialties and settings; to verify the critical-thinking improvement maintenance; and to determine the effect on patient outcomes.