N108: Transition to the Registered Professional Nurse Role Study Guide Critical/clinical pathways are used in quality assurance and quality improvement programs with outcome measurement. They use graphics and text to illustrate the normal sequence of critical activities and care processes for a specific type of patient. Care can be described by diagnosis or by describing care and outcomes expected for patients experiencing a usual procedure. Pathways also use written statements describing what should happen to the average patient during the day and allows for the clinician to document modifications and reasons for the modifications, as well as guiding the direct health care team in daily care by organizing and sequencing care using a multidisciplinary approach. They are reevaluated on a regular basis and used to deliver care more effectively and track outcome data. Concept mapping is a visual representation of the thinking processes as nursing care is planned and implemented. Concept mapping uses all elements of the nursing process and helps others to see the big picture by applying care planning using a holistic view of individual clients. It encourages “whole- brain” thinking by critically thinking about interconnections between data associated with client problems. Concept mapping allows the nurse to work on critical thinking skills by determining the priority needs of the patient and the relationship of the data documented on the concept map. Concept mapping improves a nurse’s ability to organize his/her bank of knowledge for application in the nursing profession and allows the nurse to assimilate previously learned knowledge with newly acquired knowledge. Concept mapping increases the nurse’s critical thinking and clinical reasoning skills. Concept mapping links nursing theory with nursing practice and allows the nurse to identify what he or she knows about the patient and also identifies what he or she must learn in order to care for the patient. Concept mapping interconnects data from various sources to include signs and symptoms/assessment data, past medical history, laboratory and diagnostic data, medications and medical interventions, and family/psychosocial data. Types of concept maps: • Spider map: This is easy to read and configure. All data is organized around a central theme (diagnosis). However, it is difficult to show the relationship without making the map messy and hard to read and doesn’t allow for integration of data and the relationships among data. • Hierarchal/chronological: This follows a definite pattern with most general data being located at the top and moves to the more specific data below. It is easy to read and shows no inter-relationship between data, but does not allow for critical thinking and thus has limited problem solving. • Flowchart: This is easy to read and information is organized in a logical, ordered fashion with minimal data noted on the concept map. Because of this, it is usually very incomplete and a lack of critical thinking and clinical reasoning skills are used. • Systems map: This is complete and includes all data on the map. It shows many relationships between the data and uses critical thinking skills along with problem solving skills and links theory and practice well. It does take more time to complete, and when using with a critical client, the map can get very involved and sometimes difficult to read due to the number of relationships noted.