Discussion: The aim of this Discussion Board is for you to update and revise your clinical question. In your MSN 600: Theoretical Foundations of Nursin Practice course, you began the journey of develo

Identify the topic of Interest and write it out in a PICO question format.

• This student nurse's PICOT question differs from the one submitted in MSN 600 because of the concentration of practice as a Family Practioner in an acute setting, including medical-surgical and telemetry. Furthermore, this PCU nurse witnessed falls in everyday practice despite implementing numerous standard safety fall precautions. The unit alone has had at least 15 patient falls since January of this year. The last fall happened last week, and the patient was at risk for orthostatic hypotension and intermittent confusion; her knees buckled down as soon as she got up from bed without calling for assistance. Therefore, the topic of interest is reducing falls in acute care settings by individualizing care plans for falls versus the universal standard safety precautions. Thus, the PICOT question is: Does implementing individualized safety measures interventions for adult patients in acute care settings reduce fall incidence compared with patient standard safety precautions during hospitalization?

2. Identify the PICO type and explain why it "fits" your topic of interest, provide rationale.

• The formulated PICO question falls under the prevention category. According to Melnyk & Fineout-Overholt (2019), this category's primary focus is exploring ways and studying pertinent information, whether improving the current practice or developing new approaches to reduce or resolve problems and issues. Fall is one of those "never event" that is preventable; however, it keeps on occurring despite the standard safety precautions in place. Furthermore, inpatient falls negatively impact patients as they can cause an unnecessary burden for them, physically and economically, as well as the healthcare system, because of increased lengths of stay, medical care costs, and litigation (LeLaurin & Shorr, 2019). Thus, it is imperative to find solutions to mitigate the problem of inpatient falls. Accordingly, the underlined components of the PICO question presented by this nurse student centered around patient fall prevention during hospitalization.

3. What is the primary type of research design that aligns with your PICO question and provide rationale.

• The primary type of research utilized with the prevention PICO question includes randomized controlled trials (RCT) and controlled trials. According to Polit & Beck (2020), RCT is a research design randomly assigning participants to one of two groups, either in the experimental or the control group, and the result may vary. On the other hand, a controlled trial is a study design that includes a comparison or control group where participants are given placebo treatments and no treatments at all (Polit & Beck, 2020). This student can utilize these study models with the prevention PICO question as they provide unbiased analysis of considerably comparable data. Furthermore, systematic reviews are considered a secondary research model using databases such as CINHAL, Cochrane, and Medline for this type of PICO question (Melnyk & Fineout-Overholt, 2019). These scholarly databases allow this student nurse to carefully consider factual and valuable data for the PICO question presented by utilizing peer-reviewed journals.

4. Choose a Nursing Theory /Model that aligns with your topic/project, Explain the chosen theory/ Model Briefly.

• The PICO question presented aims to develop an individualized care plan using the nursing process during patients' stay to address patients' risk of falls. Moreover, to achieve this goal, patients must be involved in planning their care together with their families. Thus, Ida Jean Orlando Pelletier's middle-range, research-based theory, Deliberative Nursing Process, is the conceptual framework that aligns with the PICO question. According to her theory, caring for patients is work progress between nurses and patients based on patients' needs and changing conditions utilizing the nursing process. In addition, the deliberative nursing process enables nurses to develop individualized nursing care plans that are effective and can be efficiently adapted throughout the patients' hospitalization utilizing components of the nursing process; assessment, diagnoses, planning, interventions, and evaluations (Alligood, 2018).

5. Explain how the application of the Theory/Model will help guide nursing practice specific to your topic/project.

• The Deliberative Nursing Process theory offers a solid ground for the PICO question proposed utilizing the nursing process by promoting nursing-patient relationships throughout patient care. Also, it is a goal-oriented framework designed for qualitative data collection, commonly used in control trials and RCT. Hence, it allows further analysis of the postulated PICO question by comparing individualized safety measures formulated using the nursing process against those universal standard safety precautions.

Reference

Alligood, M. R. (2018). Nursing theorists and their work (9th ed.). Elsevier.

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients. Clinics in Geriatric Medicine, 35(2), 273–283. https://doi.org/10.1016/j.cger.2019.01.007

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

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Ashley Hyatt

May 10, 2023 9:42pm

Manage Discussion by Ashley Hyatt

Sarah,

Thank you for sharing your PICO question. This is a very interesting topic that could potentially lead to increased compliance and health of schizophrenic patients. In an article by Acosta and his colleagues it was observed that non-compliance ranged from 4% to 72% in depot neuroleptic drugs. This variability was due to the definition of non-compliance, criteria, methods and observation period. (Acosta et al, 2012). This would be something to keep in mind if a study was ever completed regarding the PICO question you proposed. When doing research and preparing for a project, it is important to view how others have succeeded and where they ran into issues.

What issues would you anticipate running into when preparing for a study regarding this PICO question?

Acosta, F. J., Hernández, J. L., Pereira, J., Herrera, J., & Rodríguez, C. J. (2012). Medication adherence in schizophrenia. World journal of psychiatry, 2(5), 74–82. https://doi.org/10.5498/wjp.v2.i5.74

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MC

Mary Correa

May 10, 2023 3pmLast reply May 12, 2023 9:23pm

Manage Discussion by Mary Correa

Module 1: Discussion Board-Theoretical Frameworks

1. Identify the topic of interest and write it out in a PICO question format.

Patient/Problem: For mentally ill patients 18 years and older at Sun Behavioral Hospital

Intervention: Will addressing their socioeconomic needs

Comparison: Compare to not addressing their socioeconomic needs

Outcome: Reduce 30 days readmission rate

Time: Within six months

1. Identify the PICO type, explain why it "fits" your topic of interest, and provide a rationale.

The PICO type that aligns with my topic of interest is prevention. My topic of interest is based on the strategies that can be done to help reduce the 30-readmission rate amongst patients 18 years and older. Using prevention will help us find ways and areas that need to be taken care of to help reduce the readmission rate at Sun Behavioral Hospital.

1. What is the primary type of research design that aligns with your PICO question and provides the rationale?

The type of research design that aligns with this writer's PICO question is randomized controlled trials (RCT). A randomized controlled trial is a prospective study evaluating the effectiveness of an intervention or treatment in a large sample of patients (Fain, 2017). For example, the readmission rate at Sun Behavioral Hospital has been increasing, especially among patients 18 years and older. Previous less than 30 days readmission data will be collected randomly and compared to the current data in which the intervention addresses their socioeconomic needs to measure and determine if the intervention will help reduce the 30 days readmission rate within the next six months. Randomized trials prevent researchers from being biased and allow any previous readmission data to be involved in the study. Data will be collected randomly and placed in the experimental group.

1. Choose a nursing Theory/Model that aligns with your topic/project; explain the chosen theory/Model Briefly.

The nursing theory that aligns with this writer's topic is The Theory of Nursing as Caring by Anne Boykin and Savaina Schoehofer. The theory of nursing as caring came to be because Boykin and Schoehofer revised the caring-based curriculum at the Florida Atlantic University College of Nursing to recognize the importance and human necessity of continuing to develop ideas towards a comprehensive conceptual framework that expressed the meaning and purpose of nursing as a discipline and as a profession (Purnell, 2018, p. 294). The nursing as caring theory is a grand nursing theory that provides a comprehensive philosophical framework with practical consequences for changing practice (Purnell, 2018, p.303). The theory's central assumption focuses on the individual, health, environment, nursing, and research. A person's existence entails living so that one's existence and capabilities are fully realized (Purnell, 2018, p.297). Nursing as a discipline is envisioned as a unity of knowledge within a greater unity and applying that knowledge in response to human needs (Purnell, 2018, p. 298). According to the philosophy, to be human is to be caring. The objective of the discipline and profession is to get to know people and develop them as people who are alive and growing in caring (Purnell, 2018, p.298). Nursing as Caring theory reveals, brings to attention, and articulates the ideals of nursing care (Purnell, 2018, p. 303). Nursing as Caring relevance is demonstrated by its adaption from individual practice to hospital departments, nursing management, and system-wide (Purnell, 2018, p. 303). As nurses, we care for ourselves, our patients, the community, and society.

1. Explained how applying the theory/Model will help guide nursing practice specific to your topic/project.

The Theory of Nursing as Caring will help reduce less than 30 days of readmission rate at Sun Behavioral Hospital. Caring is the core value of nursing, and as nurses, we must be all about caring for our patients and their families. Caring is beyond carrying out one's daily nursing assignment, and it involves seeing every person as a unique being with needs to help them function in society. Addressing the socioeconomic needs of the mentally challenged to reduce the readmission rate will help nurses at Sun Behavioral Hospital take care of patients holistically and not just focus on one aspect of their being. Mentally challenged need resources and support to be reintegrated into the community to their full potential. Making sure that their appointments are up to date, medications are sent to pharmacies that are within reach, and shelter placement is intact for the homeless patient or residential placements are set up. Using the Theory of Nursing as Caring will help this writer and the nurses at Sun Behavioral Hospital ensure that patients are cared for holistically by the interdisciplinary team and that their needs are addressed to save them from failing to fit in the community. Purnell (2018) claims that the theory provides a comprehensive philosophical framework with practical consequences for reforming practice. As a compassionate profession, nursing allows us to express our feelings for our patients and their families. In mental health, we nurses must take care of patients and avoid causing them damage to shorten their hospital stay and decrease readmission. If we use nursing as caring philosophy, we can advocate for our mentally ill patients and present them to the best of our ability.

Reference

Fain, J. A. (2017). Reading, Understanding, and Applying Nursing Research (5th ed.). DavisPlus.

Purnell, M. J. (2018). The Theory of Nursing as Caring: A Model for Transforming Practice. In Alligood, M. R. (Ed.), Nursing Theorists and Their Work (9th ed., pp. 293-308). St Louis. MO: Elsevier

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Lauren Lacy

May 10, 2023 1:37pm

Manage Discussion by Lauren Lacy

Tessa,

This is an interesting topic for a picot question. One thing to note would be to put a timeframe on the length of time you will conduct the study. One suggestion would be to study the results of falls amongst patients with sitters over the course of a year.

Neuman's Systems Model is a good framework for falls prevention because as the number of stressors may interact to breach the body’s lines of defense, risk for falls increases with the combination of multiple risk factors. Having risk factors such as disease processes, medications, and environmental factors can contribute to an imbalance which results in falls. Only by decreasing stressors, increasing lines of defense, or maintaining a balance between the two can wellness be maintained and falls prevented.

Another theory that could be used is Roy's Adaptation Model. This theory recognizes the patient separate from the environment. However, instead of focusing on the mutual interaction of intrinsic and extrinsic factors, Roy focuses on a person’s need to adapt to environmental changes. Adaptation occurs when the person reacts positively to changes using innate or acquired mechanisms. If adaptation or maladaptation
occurs, wellness or illness will inevitably follow (Wolf, 2019).

Reference:

Wolfe, E. (2019). Core phenomenon: Risk for Falls - Saginaw Valley State University. Crystal M. Lange College of Health & Human Services. https://www.svsu.edu/media/writingprogram/activedocs/Wolf.pdf

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Felicia Olaifa

May 10, 2023 1:24pm

Manage Discussion by Felicia Olaifa

Hello Haley,

This is an interesting PICOT question. Patients with congestive heart failure often require ongoing monitoring and disease management efforts throughout their lifetime. Adherence to treatment is vital to their welfare, however, lack of adherence to medications and lifestyle modification are frequently the contributing factors to long stay of hospitalization. Several behaviors in terms of lifestyle modifications can positively contribute to the health and wellbeing of patients with congestive heart failure and this include eating well, regular exercise, limiting alcohol intake, managing stress well and smoking cessation (Aggarwal et al.,2023). This author's choice of nursing theory aligns with your choice of nursing theory that support your topic, Virginia Henderson and the fourteen components is all encompassing to address this lifestyle modification for patients with congestive heart failure. The appropriate research design for this topic that will examine intervention and outcome is randomized controlled trial (Polit & beck, 2020). What has your experience been in your clinal practice when it comes to patients' adherence to education and lifestyle modification in management of congestive heart failure?

References

Aggarwal, M., Bozkurt, B., Panjrath, G., Aggarwal, B., Ostfeld, R. J., Barnard, N. D., Gaggin, H., Freeman, A. M., Allen, K., Madan, S., Massera, D. & Litwin, S. E. (2018). Lifestyle Modifications for Preventing and Treating Heart Failure. Journal of the American College of Cardiology, 72(19), 2391–2405. https://doi.org/10.1016/j.jacc.2018.08.2160

Links to an external site.

Polit, D. F., & Beck, C. T. (2020). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

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Emily Munson

May 10, 2023 12:48pmLast reply May 11, 2023 9:29pm

Manage Discussion by Emily Munson

1. Identify the topic of interest and write it out in a PICO question format.

This student is interested in aspects of role transition from Registered Nurse (RN) to Advanced Practice Registered Nurse (APRN). How can an individual reduce reality shock? Several changes will systematically occur and need to be addressed upon the acceptance of a new career. Feelings of being overwhelmed, shocked, and doubtful in one’s abilities may be unavoidable. The novice APRN needs to be able to remain collected, confident, and competent while functioning in this role despite added stressors that may fester when starting as a beginner all over again. Cartwright (2021) explains that a great deal of pressure is placed on newly practicing APRNs, but the use of Fellowship programs can help reduce the gap between education and practice. Do many organizations offer these programs?

One aspect to consider after conquering the long and challenging road to becoming an APRN, but prior to selecting employment, is if a mentorship program is offered to new graduates. A mentorship program may be able to assist the novice APRN by providing support during the transition phase which can lead to several beneficial outcomes. Increased individual confidence, establishment of responsibilities, creation of a peer network, promotion of patient satisfaction, and ultimately the assurance of patient safety can be achievable through having a mentor when changing roles.

PICOT Question: Among novice Advanced Practice Registered Nurses (APRNs), does the use of a peer mentor for six months ease stress and affect job retention related to role transition compared with individuals that do not use a peer mentor?

2. Identify the PICO type and explain why it "fits" your topic of interest, provide rationale.

This PICO question is well-suited among two forms of PICO type questions: etiology and intervention. As described by Melnyk & Fineout-Overholt (2023), etiology examines which factors are highly associated with an outcome. As related to this PICOT question, having a peer mentor versus not having a peer mentor is a large factor that demonstrates a possibility which can lead to multiple outcomes for novice APRNs. Mentorship can influence a new APRN and create a sense of belonging and trust. When the provider feels included and confident, patients being treated may feel more optimistic with care and have higher satisfaction for the organization. Intervention can be applied to this question due to referencing what processes occurred that alleviated the natural stressors related to role transitioning. Among individuals that describe having excess role stress, were no interventions made during the orientation phase?

Furthermore, the research findings can assist organizations to positively promote the use of providing mentorship which can lead to attracting more APRNs. On the contrary the research findings can confidently provide understanding that mentorship may not prove to be beneficial for novice APRN’s. Such programs may hinder development of strong roles and allow organizations to overlook implementation.

3. What is the primary type of research design that aligns with your PICO question and provide rationale.

The primary type of research design that aligns with this PICOT question are randomized controlled trials (RCT) and controlled trials. RCT’s are the most accurate methods to identify the relationship between interventions and outcomes (Melnyk & Fineout-Overholt, 2023). Controlled trials allow the ability of the researcher to have complete control of the subjects in the trial (Polit & Beck, 2021). Surveys can also serve as a resource to obtain information. Surveys provide multiple benefits. A survey yields quantitative data, may be used in a variety of settings, and provides flexibility as to how it can be conducted such as in-person interviews, phone calls, or mailed questionnaires (Polit & Beck, 2021). The least expensive and most time efficient method for this PICOT question would be using a survey due to quick responses from participants.

4. Choose a Nursing Theory /Model that aligns with your topic/project, Explain the chosen theory/ Model Briefly.

Transitions theory by Afaf Meleis is a nursing theory that aligns well with this topic. Transitions theory incorporates the changes an individual faces throughout a lifetime and the ways of which one handles these changes (Im, 2018). This PICOT question studies how a novice APRN perceives and deals with stressors related to role transitioning. Transitions theory can assist the researcher with more deeply understanding the nature of transition, conditions associated, patterns of response, and methods of nursing interventions (Im, 2018). An individual will face many changes related to life and career. A positive healthy approach to forming new relationships, new work habits, and new routines are all areas a novice APRN needs a strong foundation to build on these transitions for a successful profession.

5. Explain how the application of the Theory/Model will help guide nursing practice specific to your topic/project.

The Transitions theory by Meleis will help guide nursing practice through forecasting the ability of individuals to foresee changes with knowledge to develop healthy ways to conquer these changes. Transitions theory describes and recognizes how transitions in life are not always healthy or sufficient (Im, 2018). Rather, role insufficiency may occur when a transition was not made smoothly; the performance of the role can suffer (Im, 2018). Understanding this theory may help novice APRNs develop healthy coping mechanisms to adapt to role changes. Transitions theory can encourage individuals to look ahead to evaluate organizations prior to seeking employment. Transitions theory can assist to close the gap among graduate students and education programs. This theory can highlight the changes coming after graduation and even play a role in how people use healthy coping skills daily. This can be taught early to graduate students to establish a strong foundation. From this foundation a graduate student can use what was learned when starting a new career. Potential work organizations can be critiqued regarding special offerings for new APRNs. Mentorship programs may be sought after, or avoided, depending on individual preferences. Meleis’ Transitions theory can pave the way for APRNs to better understand human obstacles, such as new life, death, and recovery, to provide quality care to patients undergoing these experiences (Im, 2018).

References

Cartwright, C., C. (2021). Job satisfaction and retention of an advanced practice registered nurse fellowship program. Journal for Nurses in Professional Development, 37(6), 15-19, https://doi.org/10.1097/NND.0000000000000720

Links to an external site.

Im, E. (2018). Transitions theory. In M. R. Alligood (Ed.), Nursing theorists and their work (9th ed., pp. 309-322). Elsevier.

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidenced-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

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Felicia Olaifa

May 10, 2023 12:03pm

Manage Discussion by Felicia Olaifa

Hello Haley,

This is an interesting PICOT question. Patients with congestive heart failure often require ongoing monitoring and disease management efforts throughout their lifetime. Adherence to treatment is vital to their welfare, however, lack of adherence to medications and lifestyle modification are frequently the contributing factors to long stay of hospitalization. Several behaviors in terms of lifestyle modifications can positively contribute to the health and wellbeing of patients with congestive heart failure and this include eating well, regular exercise, limiting alcohol intake, managing stress well and smoking cessation (Aggarwal et al.,2023). This author's choice of nursing theory aligns with your choice of nursing theory that support your topic, Virginia Henderson and the fourteen components is all encompassing to address this lifestyle modification for patients with congestive heart failure. The appropriate research design for this topic that will examine intervention and outcome is randomized controlled trial (Polit & beck, 2020).

References

Aggarwal, M., Bozkurt, B., Panjrath, G., Aggarwal, B., Ostfeld, R. J., Barnard, N. D., Gaggin, H., Freeman, A. M., Allen, K., Madan, S., Massera, D. & Litwin, S. E. (2018). Lifestyle Modifications for Preventing and Treating Heart Failure. Journal of the American College of Cardiology, 72(19), 2391–2405. https://doi.org/10.1016/j.jacc.2018.08.2160

Links to an external site.

Polit, D. F., & Beck, C. T. (2020). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

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Makenzie Beals

May 10, 2023 11:32amLast reply May 13, 2023 5:28pm

Manage Discussion by Makenzie Beals

1. Identify the topic of Interest and write it out in a PICO question format.

The topic of interest is the effect of distraction techniques in neonates and pediatric patients receiving vaccinations or undergoing painful procedures. PICO format: In young children and infants, does the use of distracting techniques compared to no intervention, effect pain scores, at the time of the health visit?

1. Identify the PICO type and explain why it "fits" your topic of interest, provide rationale.

After reviewing the worksheet in part one of this discussion, the therapy type is the best that fits my topic of interest. According to Duke University (2023), the therapy type PICO is based on the selection of interventions, that are offered, that do more good than harm, and is worth it to use in practice. This type matches my topic perfectly because implementing distraction techniques have been found to decrease pain in pediatric patients and should be widely used in practice.

1. What is the primary type of research design that aligns with your PICO question and provide rationale.

The primary type of research design that aligns with the PICO question is randomized control trials. Randomized control trials are, according to Hariton and Locascio (2018), the study of the relationship between interventions and outcomes using randomization to eliminate bias. This type of research measures the effectiveness of the interventions and if they should be used or not. This type of research collection aligns with the selected PICO because there is a specific intervention being tested (distraction techniques), and we’re looking at the effect of the intervention and if it is effective compared to no intervention.

1. Choose a Nursing Theory /Model that aligns with your topic/project, Explain the chosen theory/ Model Briefly.

The theory of human caring by Jean Watson aligns with this students topic because it describes the qualities of caring that is proposed in the topic. This theory is built on ten carative factors that all describe how a person should show care for another person. Watson describes the human care relationship as a unique bond with another person keeping special attention on the whole person and their being in the world (Willis and Leone-Sheehan, 2018). Using the ten carative factors is the foundation for the caring-loving relationship that is essential in nursing practice. For example some of the concepts are being authentically present, cultivation of ones own spiritual practices and transpersonal self, going beyond ego-self, creating a healing environment at all levels, and being present to, and supportive of, the expression of positive and negative feelings (Willis and Leone-Sheehan, 2018).

1. Explain how the application of the Theory/Model will help guide nursing practice specific to your topic/project.

The application of Jean Watson’s Theory of human caring is essential to nursing practice. It is a guide of how to bond with your patients and build a loving, trusting, and caring relationship that is crucial in practice. The topic of pediatric patients and distraction techniques is to lessen the pain they will go through in vaccinations and other painful procedures they may endure. This theory is impactful for this topic because if there is anything that can be done to take away the pain and make the process smoother, for the patient and family, of vaccinations a nurse should do that.

References

Duke University. (2023, April 20). Evidence-based practice: Pico. Duke University Medical Center Library & Archives. https://guides.mclibrary.duke.edu/ebm/pico

Hariton, E., & Locascio, J.J. (2018) Randomised control trials- the gold standard for effectiveness research. An International Journal of Obstetrics and Gynaecology, 125(13), 1716. https://doi.org/10.1111/1471-0528.15199.

Willis, D.G., & Leone-Sheehan, D.M. (2018) Watson’s philosophy and theory of transpersonal caring. In M.R. Alligood (9th ed.), Nursing theorists and their work (pp. 68-70). Elsevier.

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Kayla Felton (She/Her)

May 9, 2023 8:24pm

Manage Discussion by Kayla Felton

1. Identify the topic of Interest and write it out in a PICO question format.

Does continued lactation support postpartum increase success rates of breastfeeding in new mothers to support and encourage breastfeeding for at least 6 months?

Patient/problem: The patient population would be breastfeeding mothers. The problem the intervention would try to improve is breastfeeding rates. In the United States in 2015, only 25% of infants younger than 6 months were exclusively breastfed according to Huang et al., (2019).

Intervention: The intervention would be extended lactation support to mothers during the 6 months following their infant’s birth to increase breastfeeding success rates.

Comparison: Extended lactation support would not be offered in the comparison group.

Outcome: The hypothesized outcome would be that with extended lactation support, more new mothers will succeed at breastfeeding for at least 6 months versus the control group.

Timeframe: The timeframe is the 6 months following birth.

1. Identify the PICO type and explain why it "fits" your topic of interest, provide rationale.

Despite the immense benefits that breastfeeding can give to a newborn, early discontinuation of breastfeeding is high (Huang et al., (2019). This nurse practitioner student’s PICO would be considered supportive or interventional. Continued lactation support postpartum is something that would benefit new mothers as they adjust to breastfeeding. The healthcare provider could answer questions and help troubleshoot any issues, hopefully increasing the success rates of breastfeeding in new mothers.

1. What is the primary type of research design that aligns with your PICO question and provide rationale.

Polit and Beck describe research design as the plan for finding answers to questions in a study or research (2021). A controlled trial with manipulation of an independent variable by offering an intervention to one group, while withholding it from another group is a type of research design that would be fitting for validating the PICO question. One group of new mothers would receive extended lactation support postpartum, while another group would not. The breastfeeding rates would be collected and compared at the end of the study.

1. Choose a Nursing Theory /Model that aligns with your topic/project, Explain the chosen theory/ Model Briefly.

Danuya M. Wojnar (2018) wrote that through Swanson’s experience in nursing, she was made very aware of the impact that caring made in her patients’ lives. Swanson’s Theory of Caring advocated that displaying care for a patient was as equally essential as the clinical tasks that nurses provide. Swanson also believed that caring is a nurturing way of relating to a patient and having a personal sense of responsibility for them. Taking the time to provide extended breastfeeding support to new mothers would show them the act of caring and would help them during times when breastfeeding gets tough. It is not just about caring about the mothers but also caring for what is most beneficial for their infants.

1. Explain how the application of the Theory/Model will help guide nursing practice specific to your topic/project.

Without caring how could one truly do their job as a nurse, advanced practice or otherwise? Caring is what drives nurses and is what compels a study such as this one. Breast is best for infants (Huang et al., 2019) and new mothers deserve the opportunity to be supported adequately during their lactation to potentially increase their success. During the early postpartum period, emotions run high and the added stress of lactation can overwhelm new mothers. Having support and someone to help troubleshoot issues relieves a lot of the stress that can ensue in those early days.

References

Huang, P., Yao, J., Liu, X., & Luo, B. (2019). Individualized intervention to improve rates of exclusive breastfeeding: A randomised controlled trial. Medicine, 98(47), e17822. https://doi.org/10.1097/MD.0000000000017822

Polit, D. F., & Beck, C. T. (2021). Nursing Research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.

Wojnar, D.M. (2018). Theory of Caring. In Alligood, M. R (Ed.) Nursing Theorists and Their Work (9th ed., pp. 553-561). Elsevier.

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Sarah Soto (She/Her)

May 9, 2023 2:21pm

Manage Discussion by Sarah Soto

Jason, thank you for sharing your picot question. I will be interested in following along with this topic as you share further information and research to prove transformational style of leadership has better outcomes for both patients and staff alike. Per Kumar et al. (2022), “The necessity that clinical personnel be shown a higher level of deference and have their achievements recognized by their colleagues and management is consistent with the traits of transformative leadership” (pg. 1573). Nurses were noted to have the need for appreciation, they want a manager that is authentic and appreciative, rather than a manager who berates them and micromanages, which tends to be the interpretation in a transactional nursing leadership style.

References

Kumar, D., Rajput, M., Chaudhary, A. S., Singh, S., Katoch, N., Rohilla, G., Prakash, P., Moin, M., Kakran, N., Huidrom, H., & Tiwari, N. (2022). The

Nursing Leadership’s Function In Mental Health Running Title: - Nursing Leadership’s Function In Mental Health. International Journal of Early

Childhood Special Education, 14(6), 1572–1576.

https://doi-org.northernkentuckyuniversity.idm.oclc.org/10.9756/INTJECSE/V14I6.186

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Jason Paoletti

Edited May 12, 2023 3:05pmLast reply May 29, 2023 4:08pm

Manage Discussion by Jason Paoletti

PICO: In acute care hospital settings, how does the transformational nursing leadership style, compared to the transactional nursing leadership style, impact nurse satisfaction, retention, and patient outcomes over six months?

P-leadership style I- change of leadership style C- transformational or transactional O- which type impacts nursing staff for satisfaction, retention, and patient outcomes.

This question fits an intervention PICO type, which is appropriate for this topic because it aims to investigate whether implementing a transformational nursing leadership style can result in better outcomes for nurses and patients than a transactional leadership style (Reinhardt, Leon, & Summers, 2022). Patient/Problem - Nurses working in acute care hospital settings (varied age, race, and sex).

An experimental study is the primary research design for this PICO question. This design is suitable because it allows for comparing the effectiveness of transformational and transactional nursing leadership styles in real-world settings where randomization may not be feasible (Marufu, Collins, Vargas, Gillespie, & Almghairbi, 2021). This type of study can be a valuable insight into the impact of nursing leadership styles on nurse and patient outcomes. The Transformational Leadership Theory aligns with this topic, suggesting that leaders who inspire and motivate their followers to perform beyond expectations can achieve significant organizational improvements. This theory emphasizes the importance of a leader's ability to build trust, provide support, and foster professional growth among their team members (Reinhardt et al., 2022).

Transformational Leadership Theory in nursing encourages collaboration, open communication, and team-building to raise nurse satisfaction and retention (Reinhardt et al., 2022). It also allows nurses to make decisions, showing their commitment and ownership of patient care, leading to better outcomes (Marufu et al., 2021). Providing nurses with professional development, education, and mentoring is essential for quality patient care. Lastly, creating an alignment between the organization’s values and the needs of patients and nurses strengthens the nursing leadership-staff relationship. Data on nurse satisfaction and patient outcomes would be collected through surveys and focus groups to evaluate the quality of nursing care. Analyzing this data will help to pinpoint which leadership style is more effective in improving healthcare outcomes. This study will provide valuable insights for nursing leaders and practitioners, enabling them to make informed decisions about leadership styles and their impact on patient health.

Dr. Jean Watson's Transformational Leadership Theory, also known as the Theory of Human Caring, can be used to address this PICO question. This theory prioritizes the relationships between healthcare providers and patients, aiming to create a caring, trusting, and collaborative environment while enabling personal and professional development (Gunawan et al., 2022). By utilizing the principles of transformational leadership, inspiring a shared vision, empowering others, and encouraging collaboration, nurse leaders can improve nurse satisfaction, retention, and patient outcomes in acute care hospitals (Gunawan et al., 2022).

Reference

Gunawan, Joko, Yupin Aungsuroch, Jean Watson, and Colleen Marzilli. 2022. “Nursing Administration: Watson’s Theory of Human Caring.” Nursing Science Quarterly 35 (2): 235–43. doi:10.1177/08943184211070582.

Marufu, T. C., Collins, A., Vargas, L., Gillespie, L., & Almghairbi, D. (2021). Factors influencing retention among hospital nurses: systematic review. British Journal of Nursing, 30(5), 302–308. https://doi-org.northernkentuckyuniversity.idm.oclc.org/10.12968/bjon.2021.30.5.302

Links to an external site.

Reinhardt, A. C., Leon, T. G., & Summers, L. O. (2022). The Transformational Leader in Nursing Practice -- An Approach to Retain Nursing Staff. Administrative Issues Journal: Connecting Education, Practice, and Research, 12(1), 1–12.

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