Exploring Critical Thinking Dispositions among Fourth Year BSc Nursing Students of Various Colleges of Nursing, Pakistan

Background: Critical Thinking (CT) dispositions in nursing are prominent predictors of competence in delivering high-quality care, and of professionalism, in newly graduated nurses. CT skills, in isolation of CT dispositions, do not guarantee success in the workplace, because Critical Thinking Dispositions (CTD) are important elements of intellectual reasoning that simulate a person towards using the CT skills. Therefore, nursing educational programs should promote lifelong learning rather than focusing on transferring the content of nursing knowledge only. And for this purpose, quality education is the key. Education should focus on teaching from diverse perspectives, incorporating various teaching learning strategies that are congruent with the modern era. Purpose: The purpose of this study is to explore critical thinking dispositions among final year Baccalaureate Nursing students of various military colleges of nursing, in Pakistan. Methodology: A descriptive qualitative exploratory study design was used to investigate the CTD of BSc final year nursing students. The study population included twelve willing nursing students, from six military colleges across the country. Demographic information and consent was taken from the participants of the study. In-depth interviews, through a semi structured interview guide, and probes were used to obtain data related to personal experiences of CTD amongst the nursing students. Results: Data analysis showed two broad themes: 1) Perceptions of CT, and 2) Experiences of CT dispositions. In theme one, the emerging category was: Clarity of CT;whereas in theme two, the categories that emerged were: a) Truth Seeking, b) Open Mindedness, c) Inquisitiveness, and d) Self Organization. Conclusion: The findings of the study revealed positive dispositions towards truth seeking, open mindedness, and self-organization, whereas disposition towards inquisitiveness was weak. Self-confidence and maturity also emerged as positive factors that the students possessed. This study recommends that faculty and learners should extend their concept of CTD, and emphasizes its application in daily routine. Additionally, faculty should modify their instructional strategies and focus on the cultivation of dispositions of inquisitiveness, curiosity, and allow questioning by students in the class.

Application and Satisfaction Analysis of Humanized Quality Nursing Intervention in the Care of Patients with Critical Respiratory Failure

Objective:To implement humanized quality care in critical respiratory failure nursing,observe the effect,and analyze the satisfaction.Methods:80 patients with severe respiratory failure were divided into 40 cases per group(admitted from February 2022 to December 2023)by double-blind method,the control group performed routine care,and the observation group was given humanized quality care.Results:After the nursing care,two respiratory function indexes of the observation group were lower than those of the control group,and two pulmonary function indexes were higher than those of the control group(P<0.05);regarding the complication situation,the incidence rate of the observation group was lower(P<0.05);regarding the nursing care satisfaction situation,the observation group had a higher level of total satisfaction(P<0.05).Conclusion:The application of a humanized quality nursing intervention model in the care of critical respiratory failure can actively improve patients’respiratory status and lung function,reduce complications,and satisfy patients.

The Role of Grid-Style Nursing Management Model in Critically Ill Patients

Objective:This study aims to gain insight into the effects and potential advantages of the grid-style nursing management model in the care of critically ill patients.Methods:Eighty critically ill patients admitted to our hospital between May 2020 and May 2021 were selected and randomly divided into the control group and the grid group,each with 40 patients.The control group implemented traditional nursing management,while the grid group adopted a grid-style nursing management model.The quality of care,quality of life,nursing satisfaction,and treatment adherence of the two groups were compared.Results:Compared with the control group,the grid group had significantly higher quality of care and quality of life(P<0.001);in terms of nursing satisfaction,the score of the grid group was 8.26±0.85,which was significantly higher than that of the control group(6.65±0.77)(P<0.001);90.00%(36 patients)of the grid group showed good treatment adherence,significantly higher than 70.00%(28 patients)of the control group(P<0.001).Conclusion:The implementation of the grid-style nursing management model in critically ill patients can significantly improve the quality of care,quality of life,and satisfaction of patients,and effectively promote patients’treatment adherence.These positive results provide strong support for the promotion and application of this model in clinical care.

Nursing Experience of Early Application of Nasoenteric Tube for Enteral Nutrition in Critically Ill ICU Patients

Objective:To investigate the effective nursing measures of early application of nasoenteric tube for enteral nutrition in critically ill patients in ICU,and to summarize the nursing experience.Methods:The study was carried out in June 2023–November 2023.62 samples of ICU critically ill patients were selected,all of whom used enteral nutrition by mesenteric tube and were grouped into an observation group(n=31)and a control group(n=31)by using the numerical table randomization method.The patients in the control group were basic nursing interventions,and the patients in the observation group were comprehensive quality care,comparing the nutritional indexes,complication rates,and nursing satisfaction between the two groups.Results:All nutritional indicators of the observation group were higher than those of the control group after nursing intervention(P<0.05);the complication rate of the observation group was lower than that of the control group(P<0.05);the nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Comprehensive quality nursing care during the early application of a gastroenteric tube for enteral nutrition in critically ill patients in the ICU can improve nutritional indexes,reduce the incidence of complications and improve nursing satisfaction.

Correlation between critical thinking and emotional intelligence:a national crosssectional study on operating room nursing students in Iran

Objective:According to the World Federation of Medical Education,critical thinking should be part of the training of medical and paramedical students.Professionals can improve the quality of care of patients after surgery by having or acquiring this skill in health care.Also,Emotional intelligence is introduced as an impor tant and effective factor on the professional performance and mental health of healthcare professionals.Thus,the present study was designed and implemented to determine the relationship between emotional intelligence and critical thinking among operating room nursing students of medical sciences universities in Iran.Methods:This cross-sectional study was done on 420 operating room students in 10 top medical sciences universities of Iran in 2022.The sampling method in this research was multistage sampling.The data collection instruments included demographic characteristics,Rickett's critical thinking,and Bradberry-Greaves'emotional intelligence questionnaires.After receiving the ethics code,data collection was done for 2 months.For data analysis,descriptive and inferential analyses including independent t-tests,analysis of variance,and Pearson correlation were used.The collected data were analyzed by SPSS 18(IBM Corporation,Armonk,New York,United States).P-value<0.05 was considered significant.Results:The mean age of the students participating in this study was 23.02±3.70 years,with women constituting 67.4%of them.The results of data analysis indicated that the mean total score of critical thinking and emotional intelligence was 124.10±37.52 and 114.12±43.63,respectively.A direct significant correlation between critical thinking and emotional intelligence(r=0.459,P-value<0.001)and a significant relationship between gender and emotional intelligence(P-value=0.028)were found.Conclusions:Based on the present study results,educational managers in the Ministry of Health are suggested to consider suitable educational programs for improving critical thinking and emotional intelligence to enhance the quality of care provided by students in operating rooms.

Facilitating and hindering factors of community nurses'emergency and critical care treatment abilities:A qualitative study

BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.

Nurses'critical thinking disposition and professional commitment:a cross-sectional study

Objective:High-quality and successful nursing care delivery in a variety of situations requires critical thinking training and professional commitment.The present study aimed to investigate critical thinking disposition,professional commitment,and the relationship between these 2 variables among nurses.Methods:As a result of stratified random sampling,201 nurses were enrolled in the present cross-sectional study.Data were gathered using a socio-demographic form,the Critical Thinking Disposition Inventory(CTDI),and the Nurses'Professional Commitment Scale(NPCS).Results:Although the critical thinking disposition scores were at a moderate level(115.70±13.55),the mean score for professional commitment was high(91.37±11.77).A positive correlation was found between critical thinking disposition and professional commitment(r=0.67,P=0.001).Conclusions:Nursing managers are urged to employ strategies to enhance nurses'critical thinking disposition and professional commitment.

Research on Nursing Effect of Individualized Nursing Intervention on Critically Ill Patients with Continuous Blood Purification

Objective:This paper aims to investigate the value of individualized care for critically ill patients receiving continuous blood purification therapy.Methods:89 cases of critically ill patients who were treated from June 2021 to June 2023 were randomly divided into groups,with individualized care in group A and routine care in group B.The differences in clinical indicators,purification effect,quality of life,and complications of blood purification were compared between the groups.Results:Heart rate,respiration,body temperature,and other indicators in group A were better than those in group B,P<0.05.C-reactive protein(CRP),β2-microglobulin(β2-MG),blood urea nitrogen(BUN),and phosphorus(P)in group A were lower than those in group B,P<0.05.Group A had higher quality of life than Group B,P<0.05.The complication rate of blood purification in Group A was lower than that in Group B,P<0.05.Conclusion:During continuous blood purification in critically ill patients,individualized nursing intervention can enhance the effect of blood purification,improve the physiological indicators of patients,and reduce the complications of blood purification,which is highly effective and feasible.

High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other characteristics.Patients with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate attention.AIM To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of delirium.METHODS General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU admission.Patients were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the patients.RESULTS Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU patients.The results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient origin.Multivariate logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU patients.CONCLUSION Patients with diabetes and/or smoking history,postoperative patients,patients with a high APACHE II score,and those with emergency ICU admission need emotional and pain care,flexible visiting modes,and early intervention to reduce delirium incidence.

The Value of Modern Information Technology in Nursing Emergencies

In first aid, traditional information interchange has numerous shortcomings. For example, delayed information and disorganized departmental communication cause patients to miss out on critical rescue time. Information technology is becoming more and more mature, and as a result, its use across numerous industries is now standard. China is still in the early stages of developing its integration of emergency medical services with modern information technology;despite our progress, there are still numerous obstacles and constraints to overcome. Our goal is to integrate information technology into every aspect of emergency patient care, offering robust assistance for both patient rescue and the efforts of medical personnel. Information may be communicated in a fast, multiple, and effective manner by utilizing modern information technology. This study aims to examine the current state of this field’s development, current issues, and the field’s future course of development.

Impacts of fighting against COVID-19 on critical care nurses'psychological and physical health:a literature review

Objective:To provide insight into the effects of the coronavirus disease(COVID-19)pandemic on the physical and psychological health of critical care nurses in adult units.Methods:A systematic search through the CINAHL,MEDLINE,and EMbase databases were performed.Studies that addressed“critical care nurses,”“COVID-19,”“physical effect,”and“psychological effect”from different perspectives were reviewed.Results:A total of 42 ar ticles were reviewed based on 2 aspects:critical care nurses'psychological and physical health.Negative emotions were the most common conditions:fear,anxiety,depression,and post-traumatic stress disorder(PTSD).Burnout,falling ill and having thoughts of self-harm,fatigue,physical burden,sleeping disorders,and chronic work overload also adversely affected the nurses'health.The nurses'health deteriorated because of the changes in the unfamiliar working environment and processes,colossal workload and chronic exhaustion,worries about themselves and their families,social response,and witnessing the death toll.Conclusions:Critical care nurses experienced adverse effects of the institutional reaction,social response,and individuals'reply to the COVID-19 pandemic upon their psychological and physical health.Suppor ting services and preparation for other unprecedented situations should be sustainably available.

Enhancing Evidence-Based Practice and Critical Thinking Skills of Nursing Students: Lessons from the Review of the Bachelor of Science in Nursing Curriculum of the University of Zambia

Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern’s six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally;2) Administration of the needs assessment questionnaire to key informants;3) Strengths, weakness, opportunities and threat analysis;4) Consultative meeting with major stakeholders;5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some “A” level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for team building and the development of leadership skills and a whole-of course perspective on the curriculum.

Predictors of critical care nurses’ intention to leave the unit, the hospital, and the nursing profession

Nursing turnover and shortage are acknowledged as worldwide issues: understanding the factors that foster nurses’ intention to leave (ITL) is essential in retaining them. The present study aims at providing insight into the factors influencing critical care and intensive care nurses’ ITL the unit, the hospital, and the nursing profession. The study was conducted in two hospitals, by a questionnaire administered to all nurses employed in critical and intensive care units. 512 questionnaires (89.4%) were returned. Results revealed that a low job satisfaction (JS) for interaction with physicians and nurses, seniority ≥20 years, and working in Emergency are related to higher ITL the unit. Low JS for work organization policies, seniority ≥11 years, working in a private hospital, and higher educational level are related to higher levels of ITL the hospital. Low JS for professional status, for pay, and for work organization policies, age ≥40 years, part-time schedule are related to higher ITL the nursing profession. The research permitted detection of various predictors of different kinds of ITL, enhancing the importance of regular monitoring of ITL. In order to limit ITL, it would be important to work on the relationship with physicians and colleagues, work demands, organizational policies, and acknowledgement of competence.

Observations on the Application of Nursing Risk Management in the Care of Critically Ill Patients in the Respiratory Unit

Objechive:Investigate the effectiveness of mursing risk management in the care of cntically ill patients in the respiratory umit.Methods:Among the cntically ill respiratory patients admitted to our hospital between May 2019 and April 2020,78 patients were randomly selected and divided into an observation group and a control group,each consisting of 39 patients.In the observation group.a mursing nisk management model was implemented,i.e,patients'clinical symptoms were observed at any time to monitor their treatment satisfaction and the effectiveness of their care and routine care was implemented for the control group.Results:The heart rate,respiratory rate,and pH of patients in the observation group were more stable than those in the control group,and their respiratory status was better,with differences in data.There was also sigmifcant statistical significance(P<0.05).The incidence of patient-provider disputes,unplanned extubation,and uplammed events were lower in the observation group conpared to the control group,and their data difference was satistically siguificant(P-0.05).The treatment satisfaction as well as the total effective rate of patients in the observation group was also much higher than that of the contol group,and there was also a statistically sigmificant difference in the data(P<0.05).Conclusion:The musing nisk management model has a significant therapeutic effect in the care of cnitically ill respiratory patients.Therefore,it is worth popularizing to use in the clinical mursing of respiratory cnitical patients.

Critical Thinking II: Teaching Strategies to Foster Critical Thinking in Undergraduate Nursing Students: A Case Analysis Approach

Due to increasingly complex issues,challenging and acutely ill patients,advancing technology and ethical dilemmas it is important that nurses are able to think critically to improve patient outcomes.Therefore,nurse educators continually seek to identify effective learning strategies that foster critical thinking in their undergraduate students to make theoretical and clinical teaching seamless.Therefore,the purpose of this article is to describe the role of the nurse educator in helping nursing students to think critically.We will examine a case analysis and describe various teaching strategies that support critical thinking,can increase student learning,and aid in the provision of nursing care.

The study of the situation of critical thinking emotional tendency of nursing teachers

Critical thinking （CT） is an important content of nursing education. It is also the important symbol of the improvementof overall quality of nursing teachers. In recent years, educational circles pay more and more attention to the cultivationof students’ CT ability, take CT and solve the problem as two basic skills of thinking. In the early 1980s, critical societytheory was led into the nursing field. After years of development, CT has become one of research hotspots in today’sinternational nursing. Numerous studies had confirmed that the CT played a significant role in nursing education, clinicalpractice and nursing scientific research. The paper studied the whole status and characteristics of CT emotional tendencyof college nursing teachers, and analyzed potential cause and discussed deeply on the corresponding factors of how toimprove college nursing teachers’ teaching ability and scientific ability. This research adopted random sampling method,in which questionnaires were distributed among some nursing teachers in six universities and 97 nursing teachers. Thestatistical results indicated that nursing teachers had a positive performance towards CT emotional tendency, but notstrong positive, and there were statistical significance among nursing teachers with different age, different length ofservice and reading habit （all P〈0.05）. In a conclusion, the managers of universities should lay stress on the importanceof critical thinking, and provide the development space to enhance the nursing teachers’ CT ability and offer betterservices for nursing student.

Critical Thinking Disposition among Nurses Working in Puplic Hospitals at Port-Said Governorate

Aim: This study aimed to investigate critical thinking disposition among nurses working in Public Hospitals in Port-Said Governorate.Methods: A descriptive research design was conducted in this study. Totally 196 respondents were chosen by systemic random sampling, to take part in the study as the sample. Data was collected from April to September in 2015. Tools of data collection: A personal and job characteristics data sheet and California Critical Thinking Disposition Inventory(CCTDI) were used. Results: The results revealed that the total critical thinking disposition score mean was 257.05 ± 20.16 and the highest score mean was 48.67 ± 6.28 for inquisitiveness subscale, while the lowest score mean was 21.36 ± 7.19 for the truth-seeking subscale. Also, none of the personal&job characteristics showed statistically significant relations with the total critical thinking disposition. Conclusion: More than three quarters of the nurses had an ambivalent disposition toward critical thinking, and most nurses' scores indicated a negative tendency towards truth-seeking. So the findings pointed for upgrading nurses' critical thinking through educational programs and a need for more problem-based learning with advanced teaching strategies in clinical areas.

Early mobilization implementation for critical ill patients:A cross-sectional multi-center survey about knowledge,attitudes,and perceptions of critical care nurses

Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to August 2020,ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge,attitudes and perceptions of ICU early mobilization.Results Totally 512 nurses completed the questionnaire.The respondents’mean score for knowledge of early mobilization was 6.89±2.91.The level of knowledge was good in 2.5%(13/512),fair in 52.3%(268/512).The attitudes toward early mobilization were positive in 31.4%(161/512).In terms of perceived implementation of ICU early mobilization,42.9%(220/512)of nurses did not believe that this should be a top priority in intensive care.The attitudes of nurses from different ICUs were significantly different(F=3.58,P<0.05).The knowledge(7.34±2.78 vs.6.49±2.97,t=3.37,P<0.001)and attitudes(3.82±0.58 vs.3.52±0.56,t=5.63,P<0.001)of nurses who had early mobilization related training were higher than those of nurses who had no training.Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers.However,there is still a gap in the knowledge,attitudes and perceptions of ICU early mobilization among nurses.In future studies,it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps.Meanwhile,more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

The purposes of this study were to describe the decision making process and decision activities of critical care nurses in natural clinical settings. An exploratory descriptive approach utilizing both interview and observation methods, was used for data collection. The study involved twenty four critical care nurses from three hospitals in Jordan. Participant observation was performed to understand the routine clinical decisions made by Intensive Care nurses. About 150 hours of observations were spent in the involved Intensive Care Units. Nurses were interviewed to elicit information about how they made decisions about patient’s care. The study revealed that the most common model nurses tend to use was intuitive model in order to observe the cues relating to the patient’s situation. Data revealed that the decision making process is continuous and that experience is one of the main factors that determine nurses’ ability to take decisions. Five themes were generated from the data: on-going process, autonomy, experience/power, joint/ethical decisions, and advocacy. Critical care nurses were seen to be sensitive to the patient’s verbal and non-verbal cues;they were able to respond to these evidences to ensure that the patient’s condition did not deteriorate. Critical care nurses are likely to be more confident and effective when dealing with patient’s changing situations with more experience.

The relationships among critical thinking disposition, caring behavior, and learning styles in student nurses

The purpose of this study was to identify the relationships among disposition toward critical thinking, learning styles, and caring behaviors in student nurses enrolled in three 5-year junior nursing colleges in Southern Taiwan. Methods: This cross-sectional study used a convenience sample that comprised 777 nursing students from two cities. The data were obtained through the Critical Thinking Disposition Inventory, Chinese Version (CTDI-CV), Index of Learning Styles (ILS), and the Caring Behavior Scale (CBS). The sample ranged in age from 16 to 22 years (M = 18.21). Results: Students scored highest on the inquisitiveness subscale and lowest on the truth-seeking subscale. Additionally, some dimensions of disposition toward critical thinking differed significantly by learning style. There was a positive relationship between overall critical thinking dispositions and caring behaviors (r = 0.23, p < 0.01). Finally, dimensions of caring behavior, with the exception of the maturity dimension, were significantly positively related to most dimensions of the disposition toward critical thinking (p < 0.05). Conclusion: The findings indicate that not only is learning style related to critical thinking disposition but also to caring behaviors. However, the cause of these relationships warrants further study.