Critical Thinking

1 January 2017

Strong critical thinking (CT) skills are necessary for every successful nurse manager. Giving them an edge at creating a positive work environment, that is conducive to job satisfaction and retention of staff RNs. This study is entitled, “Critical Thinking of Nurse Managers Related to Staff RNs’ Perceptions of the Practice Environment. ” The California Critical Thinking Disposition Inventory (CCTDI) was used to measure critical thinking in nurse managers in relation to their respective staff RNs.

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Enhancing critical thinking skills is important, staff RNs that work in an environment perceived to be positive are in a better position to deliver higher quality and safer patient care. As nurses we are responsible for helping a patient every way we can, being able to engage in critical thinking is a skill that must be obtained. This study was based off of twelve volunteering nurse managers and their respective one hundred and thirty-two staff RNs. Assessment of Nurse Manager’s Critical Thinking Skills

This study (Critical Thinking of Nurse Managers Related to Staff RNs’ Perceptions of the Practice Environment) used the California Critical Thinking Disposition Inventory (CCTDI) to measure CT skills in nurse managers in relation to their staff RNs. This study was conducted in a nonprofit, hospital in the northeast United States. This study was completely voluntary, only thirty-one percent of nurse managers chose to participate, leaving the pool of staff RNs slim. This article is about a study that took place in the northeast United States at a 490 bed nonprofit, tertiary care hospital.

The study explores,” the differences between nurse managers’ dispositions to use critical thinking skills and their respective staff RNs’ perceptions of the practice environment” (Zori, Nosek & Musil, 2010). This study was completely voluntary and with a limited number of nurse manager participants, the number of staff RNs was also very limited. Nurse Managers need to have good leadership skills and critical thinking skills; these skills are assed in comparison to those of their respective staff RNs.

Research Question & Hypothesis There is a correlation between the Critical thinking skills of Nurse Managers and their respective staff nurses perception of the practice environment. Nurse Managers skilled in the use of critical thinking, may be able to create a positive practice environment for staff RN’s. Positive practice environments means increased retention of staff RN’s and improved job satisfaction. Sample of the Study Twelve nurse managers and one hundred and thirty-two staff RN’s were sampled.

The study was conducted at a 490-bed voluntary, nonprofit, tertiary care hospital located in the northeastern United States. Only nurse managers who voluntarily chose to answer the CCTDI were included in the study (31. 6%). Sample size limited the ability to address how the difference in type of unit and full- or part-time work may influence the outcome. Descriptive Study In this descriptive study nurse managers were categorized as weak or strong in critical thinking dispositions based on scores achieved on the California Critical Thinking Disposition Inventory (CCTDI).

Then, staff RNs from the units of participating nurse managers completed the Practice Environment Scale (PES). Staff nurses’ Practice Environment Scale (PES) results were dichotomized based on the critical thinking disposition scores of their nurse managers. A two-tailed, independent sample t test was conducted to determine if there were significant differences in the Practice Environment Scale(PES) mean overall and subscale scores of the two groups of staff RNs (Zori, Nosek & Musil, 2010). CCDTI was created based on the APA Delphi Study.

Reliability testing was conducted, with an overall score of . 90. The CCDTI is therefore considered reliable. Practice Environment Scale PES was developed from Nursing Work Index (NWI). Reliability testing of the final 31 items was conducted on both individual nurse scores and on the aggregate of subscale scores. Individual nurse subscale scores (n = 1,610) were analyzed using Cronbach’s ? , with ? > . 80 for all subscales except the collegial nurse-physician relations (? = . 71). The nurse manager ability, leadership, and support of nurse’s subscale scored the highest.

The results are reliable. The PES has been endorsed by the National Quality Forum and is used by the ANA as part of the National Database of Nursing Quality Indicators to measure staff nurse job satisfaction (Lake, 2007). Enhancing critical thinking skills and dispositions of course managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care (Zori, Nosek & Musil, 2010).

Table One Table one, of the article is entitled, “Nurse Manager California Critical Thinking Disposition Inventory (CCTDI) Score Distribution and Standard Deviation by Subscale. ” This table breaks down the CCTDI Scale into seven subscales: truth-seeking, open-mindedness, analyticity, systematicity, CT confidence, inquisitiveness, and cognitive maturity (Zori, Nosek & Musil, 2010). The table also shows the minimum score, maximum score, mean score, median score, and standard deviation for the twelve sample nurse managers. Table Two

Table two of the study entitled, “RN Staff Nurses’ Practice Environment Scale scores by Nurse Managers’ Critical Thinking (CT) Dispositions. ” According to the study, “As this table indicates, there are significant differences in PES scores when they were compared based on their nurse managers’ strength or weakness on the CCTDI subscales of analyticity, systematicity, open-mindedness, and critical thinking confidence” (Zori, Nosek & Musil, 2010). The biggest difference between staff nurses and nurse managers scores were in the truth-seeking subscale (strength versus weakness), within the nurse-physician relationship.

Limitations This study was conducted in one medical facility in the northeast United States. This may not be a proper representation of the whole population of nurse managers and their respective staff nurses. Also the nurse managers who participated did so by choice and were not required to, therefore, the number of staff RNs were limited to those whose nurse manager participated. Out of thirty-eight nurse managers only twelve chose to participate, this limited the three hundred and twenty-seven possible staff RNs down to one hundred and thirty-two.

If there were more willing participants then the findings could be better generalized to the entire nurse manager population. My Findings and Improvements Nurse Managers skilled in critical thinking create a positive environment for staff RN’s resulting in increase in job satisfaction and retention of RN’s, decreasing job turnover. This study is extremely important because the World Health Organization (WHO) anticipates the RN shortage to reach 285,000 by the year 2020. If I was conducting this study, I would look at part-time vs. full-time employees, and areas of practice.

Is burn-out more noted in critical care areas? Statistical Procedure, Methodology & Measurement This was a voluntary survey conducted at one tertiary hospital. A t-test was conducted. Scores of 40 or above were considered strengths, and scores of 39 and below were weakness. Scores on inquisitiveness and cognitive maturity were all in the strength range. Final Analysis As nurses we must use critical thinking every day, nurse managers are no exception to this. This study shows that by having a nurse manager who has strong critical thinking skills, the staff RNs respond positively.

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