Description

3 references needed for original post and response posts).

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To Prepare:

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  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course. 

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By Day 3 of Week 4 : 3/24/21

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Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.

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Fatiatu Jobi 

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RE: Discussion – Week 4

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COLLAPSE

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Discussion: Searching Databases

The word PICOT is a derivation from the components of clinical research question: patient issues, intervention required for the correction of medical issues in a patient, comparison of medical cases, the outcome from the patient’s diagnosis, and time for medication and recovery (Aldinger et al., 2017). The PICOT process commences with a case scenario that is, assessing the mental health of an adolescent child and the question related to the complexities frames to elicit the answers regarding the disorder. Therefore, the adolescent kid’s research question is; In patients undertaking diagnosis of trauma disorder, is there evidence that suggests external factors contributing to the slow recovery, internal elements that affect cognitive behaviour?

According to the PICOT mnemonic, the keywords, according to the disorder, are the patient recovering from mental trauma. It is a result of the experience that disoriented the child’s cognitive function. The loss of his parents contributed to the destructive emotions that the teenager is experiencing. The intervention is mental therapy exercises that raise the good feeling within the child (Mysliwiec et al., 2018). Comparing the trauma disorder with attention deficit hyper reaction disorder shows the latter is more server than the trauma complication and requires much therapy to correct when compared to trauma (Spinazzola et al., 2018). The expected outcome is to observe the patient recover from the trauma complexity and respond positively to the environmental factors.

The search strategy is to find out the relevant journals containing information about trauma disorder among young children. The articles are available in the library and, in this case, use the developmental trauma disorder, which aims towards efficient diagnosis for children with complex trauma histories. It is an assessment by Van der Kolk in the approaches of the psychiatric approach in helping young people overcome trauma-related problems. Executing the search will be finding the information related to trauma among young children (Van der Kolk, 2017). It will offer a narrow scope to get information. The research meets the needed standards since Van der Kolk meets every basic psychiatric procedure to develop research to help diagnose children with trauma. 

References

Aldinger, F., & Schulze, T. G. (2017). Environmental factors, life events, and trauma in the course of bipolar disorder. Psychiatry and Clinical Neurosciences.

https://scholar.google.com/scholar?output=instlink&q=info:JIKljdNi5f8J:scholar.google.com/&hl=en&as_sdt=0,5&as_ylo=2017&as_yhi=2021&scillfp=18258360975160392301&oi=lle

Mysliwiec, V., Brock, M. S., Creamer, J. L., O’Reilly, B. M., Germain, A., & Roth, B. J. (2018). Trauma associated sleep disorder: a parasomnia induced by trauma. Sleep Medicine Reviews, 37, 94-104.

https://www.sciencedirect.com/science/article/abs/pii/S1087079217300199

Spinazzola, J., Van der Kolk, B., & Ford, J. D. (2018). When nowhere is safe: Interpersonal trauma and attachment adversity as antecedents of posttraumatic stress disorder and developmental trauma disorder? Journal of Traumatic Stress, 31(5), 631-642.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/jts.22320

Van der Kolk, B. A. (2017). Developmental trauma disorder: toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.

https://www.academia.edu/download/31046864/050105DevelopmentalTraumaDisorder.pdf

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Adam Gears 

Main post week 4 – Gears

COLLAPSE

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Searching Databases

My clinical area of interest is treating treatment-resistant depression. Working in behavioral health has given me an introduction to this topic, and the treatments that have recently been introduced are fascinating.  Some of these current methods are trauma-focused therapies, eye movement desensitization and reprocessing (EMDR), transcranial magnetic stimulation (TMS), ketamine infusions, and psilocybin. A psychiatrist I work with has recently opened a ketamine clinic and is doing clinical research on psilocybin at the University of Arizona. I recently found a podcast on psychotherapy and listened to a two-part, four-hour episode on the efficacy and research on using psilocybin to treat treatment-resistant depression. With my interest in this area of study, it seemed like a logical choice for my topic.

I first went to Psychology Databases Combined Search through the Walden Library and searched “treatment-resistant depression.” I came up with nearly 4,000 results. I then narrowed down the years of publication from 2016-2021, which brought up roughly 1200 articles. Perhaps I was too generic in my search. According to Walden University Library (n.d. -a), I needed to use Boolean phrases to aid in my search.

On this suggestion, I noticed that the Walden Library automatically suggests some Boolean operators. I tried this by searching for “treatment-resistant depression or trd or chronic depression or non remission depression or treatment refractory depression.” This brought up a ton of articles pertinent to my topic, but I also wanted to be sure they were the correct type of articles.

Using our class resources, I found through Walden University Library (n.d.- b) that I could use increase the rigor and effectiveness of my search using advanced search options to select “systematic review” and/or “randomized control trials” within the search databases. There were also options to select quantitative versus qualitative amongst many other options. This led me to a wealth of interesting and relevant articles on my chosen topic.

Walden University Library (n.d.- c) also gave me a framework for developing a PICOT (patient, intervention, comparison, outcome, and time) question. The format is: “In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)? In the aged population, what is the effect of exercise programs on accidental falls, as compared with no exercise?” My PICOT question became: In patients with treatment-resistant depression, what is the effect of treatment (TMS, ketamine, psilocybin etc.) on depression remission or lowered rates of suicidality compared with standard depression treatment within 3-6 months.

I am excited to explore this topic more throughout this course and through my future career as a Psychiatric Mental Health Nurse Practitioner.

References

Walden University Library. (n.d.- a). Keyword searching: Finding articles on your topic: Connect keywords. Retrieved March 21, 2021 from https://academicguides.waldenu.edu/library/keyword…

Walden University Library. (n.d.- b). Keyword searching: Finding articles on your topic: Connect keywords. Retrieved March 21, 2021 from https://academicguides.waldenu.edu/library/keyword…

Walden University Library. (n.d.- c). Evidence-Based practice research: Clinical question anatomy. Retrieved March 21, 2021 from https://academicguides.waldenu.edu/library/healthe…

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Assignment due : 3/29/21

To Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
  • Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
  • Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project) due 3/29/21

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

NURS 6053: By Day 3 of : 3/24/21

To Prepare:

  • Review the Resources and examine the leadership theories and behaviors introduced.
  • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
  • Reflect on the leadership behaviors presented in the three resources that you selected for review.

By Day 3 

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

RE: Discussion – Week 3

COLLAPSE

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According to Jimenez and his associates (2017), leadership behavior in a firm affect that general success of the workplace. Leadership provides the direction to workers on the most appropriate ways to attain organizational objectives. Leaders have a number of roles which include, but are not limited to tasks which include planning, creating and implementing techniques, motivating workers, enhancing a competitive advantage and developing goals as they meet those that have been set. Sfantou and his associates (2017), adds that leaders should have the ability to benefit off strengths and have the ability to assess weaknesses as they find ways to mend them. Some of the leadership behaviors used in the workplace involve discovery skill questioning.

The use of discovery skill questioning can assist an individual by assisting them get an appropriate answer to resolve his or her issue. The area of weakness one foresee in the discovery skill is not getting to the point of one’s question and a language barrier. At times leaders need to sit back and observe. One should be keen when doing this since it can be perceived by others as a weakness which one does not understand. The way to enhance this area is to ensure that you are always engaging while observing. An example is Steve Jobs Amazon CEO who used the skill to develop and manage an effective workplace in the firm (Gregersen, 2015).

Discovery skill can aid in solving an issue while also learning from the experiment. Personal weakness with the discovery skill experimenting is the fear of something going wrong which cannot be changed. For an individual to improve the discovery skill, it is a good idea for one to experiment in aspects which can be the opposite. By doing this one tends to get contented in the area of experimenting thus enabling one to accept experimentation to the identification of new ideas. Using discovery skill, workplace can be made effective in a way that the leadership mingles with each worker this developing a healthy working context.

References

Gregersen, H. (2015). The one Skill that made Amazon’s CEO Wildly Successful. Retrieved from https://fortune.com/2015/09/17/amazon-founder-ceo-…

Jimenez, P., Winkler, B., & Bregenzer, A. (2017). Creating a healthy working environment with leadership: the concept of health-promoting leadership. The International Journal of Human Resource Management, 28(17). DOI: 10.1080/09585192.2015.1137609

Stanfou, D., Laliotis, A., Patelarou, A., Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare (Basel), 5(4), 73. doi: 10.3390/healthcare5040073

Adam Gears  

Main post – Gears

COLLAPSE

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Discussion: Leadership Theories in Practice

Adam Gears

Walden University

March 22, 2021

Dr. Velasquez

    Effective leadership can make all the difference for employees in the workplace. What works for some employees doesn’t work for others. However, I learned via a study done by Delay and Clark (2020) that there was a large positive effect size in a study of 10,000 magnetic resonance techs that showed a preference for transformational and transactional leadership styles, while laissez-faire leadership style negatively correlated with job satisfaction. The transformational leader resonates the most with me. Reading Kiwanuka et al. (2021) gave me an “aha” moment when they said that transformational leadership consists of “leading by example, communication, ability to think outside the management square, knowing your staff, and stepping up during times of crisis” (para. 17). These are all attributes I aspire to in leadership roles as well as the qualities that leaders I have looked up to possess.

    We currently have an abundance of nursing supervisors at my work. When I held the position, I carried a full patient load, did all of the supervisor duties, and was alone. Since I stepped down, they now have two supervisors on duty, and neither carries a patient load. I would describe the majority of them as having a laissez-faire leadership style. Most of the floor nurses don’t respect them.

     However, one stands out. She works harder than anyone else on the unit. She is always there when you need her. She will offer to take vitals and medicate your patients if you are busy with a crisis. She will take over a petition or voluntary patient transfer to another facility so that we can focus on our patient load. She leads by example, she knows her staff, she doesn’t always care what corporate’s needs are, but does care about our needs, and she steps up in times of crises.

    However, her transformational leadership style comes at a cost in the workplace. She works longer hours than anyone. She comes in on her days off when we are short-staffed. She burns herself out. Although her leadership style motivates many of us, it also allows other nurses to slack off because they know she will take care of loose ends. In this regard, her leadership style is not always effective and can create a chaotic work environment when she storms through like a tornado trying to do everything at once.

    For those of us that work harder and find inspiration from her leadership style, it works well. However, there may need to be a mix of styles to motivate all employees effectively. Foster (2021) says that sometimes that mix must come with a stern, commanding leadership style. However, to maintain employee trust and respect, a commanding leadership style must also be tempered by kindness and that the best leaders, regardless of their style, will always “show respect, compassion and kindness towards their staff” (para. 8).

    Leaders are human. They aren’t perfect, and they can’t all be placed perfectly into a labeled box with a particular leadership style. From the research I looked at, I lean towards a predominantly transformational leader. However, a mix is necessary when working with a large group of individuals.

References

DeLay, L., & Clark, K. R. (2020). The relationship between leadership styles and job satisfaction: A survey of MR technologists’ perceptions. Radiologic Technology, 92(1), 12–22.

Foster, S. (2021). Finding the right leadership style. British Journal of Nursing, 30(1), 83.

Kiwanuka, F., Nanyonga, R. C., Sak, D. N., Muwanguzi, P. A., & Kvist, T. (2021). Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review. Journal of Nursing Management (John Wiley & Sons, Inc.), 29(2), 133–142. https://doi-org.ezp.waldenulibrary.org/10.1111/jon…

Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.