PICOT 2

 
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)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews-
Diabetes Type 1

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

· Identify and briefly describe your chosen clinical issue of interest.
Diabetes Type 1

· 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.

References x 4 to include:

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

· Chapter 2, “Asking Compelling Clinical Questions” (pp. 37–60)

· Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 62–104)

Walden University Library. (n.d.-c).

Evidence-based practice research: CINAHL search helpLinks to an external site.

. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

DISCUSSION: PATIENT PREFERENCES AND DECISION MAKING

To Prepare:

  • reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
  • Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
    • Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
  • After you have chosen a topic (or condition) and a decision aid, consider if social determinants of health were considered in the treatment plan Social determinants of health can affect a patient’s decision as these are conditions in the patient’s environment, such as economic stability, education access, health care access and quality, neighborhood, and social and community context.
  • NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.

 Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences, social determinants of health, and values impacted the outcome of their treatment plan. Be specific and provide examples and at least 3 references. Then, explain how including patient preferences, social determinants of health, and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.

(Please Note: The underlined “social determinants of health” in the above content is meant to hotlink to the following Walden webpage and content:

Social Determinants of Health – Social Determinants of Health – Academic Guides at Walden University)

Discussion Post- Presentation Reflection

Please answer the questions below on regards of   

Inadequate Pain Management in Postoperative Patients

  1. Regarding your presentation assignment, what did you learn about the research project?
  2. Would you have approached the assignment differently? Why or why not?

 

Submission Instructions:

  • Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 

R615

 

 Introduction

In today’s work environment, managers and team leaders are faced with the reality of a growing need for a remote workforce to remain competitive and economically viable. This need for a remote workforce has come about due to companies’ and multinational organizations’ quest to expand into emerging markets, make use of cost-effective opportunities in other regions, and their hunt for the best talents around the globe.  It is no surprise businesses are putting so much emphasis on human capital development compared to other areas in today’s work environment. According to a recent 2019 IWG study, 62% of remote work teams are comprised of workers that are three or more cultures around the world and only 15% of leaders have successfully managed a cross cultural remote team (Ferguson, 2022, June 22). In a separate citing Mesolu et al (2020), 80% of corporations remote work policies have shifted to virtual or mixed team of virtual collaboration and 64% of those virtual teams may likely remain permanent (Anthony, 2022, November 6). With these statistics in mind, I cannot overemphasize the dire need for team leaders to improve cross cultural remote team management in our global business climate.                                          Evaluation and Analysis of the Video

After a careful viewing of the video from Ricardo Fernandez, it’s fair to conclude that the most immediate issue team leaders face in managing a cross-cultural remote group is getting information across to team members effectively. And the best communication skills needed for success in managing this type of diverse remote team is understanding the context in which you communicate with your team members. The interaction between Ricardo and a team member from India where he (Ricardo saying “you’re killing it out there”) intended to commend his teammate (who understood it to mean “he’s not doing well”) clearly demonstrates the danger in not considering context of the cultural implications of one speech in a global setting. For example, you should avoid comparing other cultures to yours and understand that people from different cultures will have different communication styles – and so a leader must adjust their communication style to suit context. So, to effectively lead a global team and communicate effectively, managers and team members must have some cultural intelligence training to help leaders understand team members cultures – “One way is to visit foreign lands and talk with local people about their customs and social norms. Another way is to study the works of noted anthropologists and other social scientists. A third way is to consider the observations of people whose opinions we respect” (Steers & Nardon, 2014).

Another skill to communicate effectively is for a leader to avoid slang and jargon, but instead speak plain direct language that involves cultural nuances. (Bullock and Sanchez, 2021 March 22). Multilingualism (the ability of leaders to speak 2 or more languages) is also a vital skill needed in a global work environment. It is vital because it improves communication, builds relationships, and positively influences community building and networking. Diversity or inclusivity training is another skill to communicate.  This type of training helps managers deal with team members of diverse cultures more effectively by helping them understand the assumptions, values, and communication styles of the people that they may encounter in the workplace. “Language capabilities. Learning local languages facilitates learning local cultures. It also helps the manager develop close personal and business relationships abroad” (Steers & Nardo, 2014, p. 285). With this in place, managers are better prepared to be effective communicators in the workplace and understand the message of others and get their own message across as well.   

                                                                                                 Challenges

Managing these remote teams in cross cultural workplaces has numerous advantages if managers and team leaders do harness and utilize the necessary skills and tailor them to organizational goals. However, these success stories do come as enormous challenges that organizations must overcome to obtain their goals and success. As stated earlier, communication is the immediate hurdle in working with a diverse remote team but there are other difficulties that team members must overcome. To name a few of these challenges, team members face difficulties (i) communication and collaborating with each other, (ii) loneliness physically working solo, (iii) unable to unplug and focus, (iv) distractions at home as is mentioned in the video by Ricardo Fernandez, (v) different time zones which means some members must work odd hours making it hard to keep up, (vi) keeping motivated by oneself becomes harder when alone, (vii) taking some vacation – the work seems to follow you everywhere, (viii) no reliable internet – as is seen with Ricardo, poor internet or wi-fi hinders communication, and (ix) other cultural challenges as outlined in the graph below (Anthony, 2022).

Description: A graph of a number of peopleDescription automatically generated with medium confidenceSource: Anthony (2022)

 Relationship Building in a Cross-Cultural Remote Team

To build a successful relationship for a remote team, leaders must be willing to listen more, get feedback from the teams and learn more about different cultures and their backgrounds. Leaders must understand what their team members want and provide them with the necessary tools to motivate them. For example, Ricardo Fernandez in his video “Managing Cross-Cultural Remotes Teams believes that the workforce of today which predominant are made of millennials –  “By 2029, more than 38.5 million people ages 35 to 44 are expected to fit that definition, outnumbering all other age groups in the labor force” (Torpey, 2020); want training and development, flexibility of work hours, cash bonuses, private health care, retirement schemes, vacation allowances, housing assistance, company transportation, higher wages over benefits, help with debts, and childcare (Fernandez, 2017). On the other hand, other generational diversities like baby boomers might prefer different things in a remote team to motivate them. Unlike millennials, baby boomers may want higher benefits to higher pay to be motivated for example. Understanding these needs not only promotes job satisfaction but is indeed part and parcel of relationship building in a cross-cultural team.

Adaptability is an integral part of relationship building in a remote team and a productive team is based on a leader’s ability to understand individual work styles and make the necessary adjustment skillfully blending one’s own leadership with the team cultural nuances. Remote team leaders must also have excellent Self-awareness skills to pick up constant changes around the cross-cultural teams they manage by constantly monitoring feedback to avoid, or promptly resolve conflicts when they arise. There is no “one size fits all’ in managing a culturally diverse team; team leaders must adapt to the group dynamics regarding age, gender, cultures, and other aspects when communicating or building relationships for organizational goals. For example, while it may be acceptable sending a contract proposal to a western millennial, it is risky or completely unacceptable sending the same contract proposal to a 60-year-old Japanese because of the diversity of their respective cultures. A western millennial is more tech savvy and flexible and will most likely see nothing wrong with the medium of communication. However, Japanese combine both non-verbal and verbal communication styles in communication and believe in bodily gestures to transmit respect avoiding eye contact – “Previous literature has found that, compared to Westerners, Japanese tend to rely more on vocal tones than verbal contents or facial expressions when inferring emotions. These findings point to the possibility that Japanese people tend to both express and perceive emotions through nonverbal vocal information to a greater degree than Westerners” (Yoshie & Sauter, 2020, p. 516).

As stated earlier, clear Articulation is a masterful tool for relationships building as it sends information to and from team members with little risk of miscommunication. Equally important as articulation is Writing Proficiently – leaders should always practice putting verbal meetings in writing so team members get all information including those that might have been lost in words or pronunciations (Ferguson, 2022).

Multilingualism, though an important and effective communication skill, is also a vital tool for relationship building in a global work environment. It is widely assumed that English is the preferred language in most international or global diverse team meetings which can be an advantage to English speaking team leaders, but at the same time it is a drawback when it comes to relationship building with other team members who speak other languages – “English speakers have an advantage in international English-speaking teams, but this apparent “political” advantage masks potential negative consequences” (Henderson, 2005, p. 77). Leaders who are multilingual and speak the local language of team members communicate efficiently and build trust and understanding that is way more efficient than leaders who don’t.

                                                                                      Conclusion

Human capital is now the sine qua non in all culturally diverse organizations in today’s business climate. That’s why it is vital for managers and team leaders to have the requisite training and cultural intelligence to successfully navigate the cultural and diversity hurdles in the global workplace to obtain organizational growth and sustainability. The workplace as we know it, is largely and gradually moving towards a virtual, remote, and culturally diverse global village and business must get prepare and gear up to meet the challenges that the global workforce is throwing at us.

case

Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.

History – Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.

Social – non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.

PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.

Do not consider COVID-19 for this patient diagnosis.

For the assignment, do the following:

1. Diagnose the child and describe how you arrived at the diagnosis (i.e. how you ruled out other diagnoses).

2. Provide a specific treatment plan for this patient, pharmacologic and/or nonpharmacologic.

3. Provide a communication plan for how the family will be involved in the treatment plan.

4. Provide resources that Mr. Smith could access which would provide information concerning your treatment decisions.

5. Utilize national standards, your pharm and/or patho book and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts to support your diagnosis and treatment.

6. Use references to support your concepts. Utilize correct APA formatting and mechanics of professional communication.

Present this Assignment as a narrative document, with a minimum of 4, and maximum of 5 pages not counting the cover page or reference page. It is not necessary to repeat the facts of the case in your narrative.

Before finalizing your work, you should:

·
Read the Assignment description carefully (as displayed above);

·
Consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary; and

· Utilize 
spelling and 
grammar check to minimize errors.

Your writing assignment should:

· Follow the conventions of 
Standard American English (correct grammar, punctuation, mechanics, etc.);

· Be 
well organized, logical, and 
unified, as well as 
original and insightful;

· Utilize correct APA formatting, 7th edition.

· Submit to, and review results of Turnitin.

Unit 6 Assignment Criteria

Level III

Level II

Level I

Not Present

Criteria 1

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

Not Present

0 Points

Making a correct diagnosis

· An accurate diagnosis is provided

· Rationale for arrival at the diagnosis with support from literature

· An accurate diagnosis is provided

· Rationale for the diagnosis is provided without support from literature

· An accurate diagnosis is provided

· Rationale for the diagnosis is not provided

· Does not meet the criteria

Criteria 2

Level III Max Points

Points: 12

Level II Max Points

Points: 9.6

Level I Max Points

Points: 7.2

Not Present

0 Points

Developing a treatment plan

· A correct and specific pharmacologic and non-pharmacologic treatment plan for the case study patient is provided

· A specific treatment plan is provided for the case study patient but is missing less than 50% of pharmacologic and non-pharmacologic treatment.

· A specific treatment plan is provided for the case study patient but is missing more than 50% of pharmacologic and non-pharmacologic treatment.

· Does not meet the criteria

Criteria 3

Level III Max Points

Points: 8

Level II Max Points

Points: 6.4

Level I Max Points

Points: 4.8

Not Present

0 Points

Providing the patient or family with resources

· Three or more patient resources to assist with understanding the treatment plan are provided

· Two patient resources to assist with understanding the treatment plan are provided

· One patient resource to assist with understanding the treatment plan is provided

· Does not meet the criteria

Criteria 4

Level III Max Points

Points: 7

Level II Max Points

Points: 5.6

Level I Max Points

Points: 4.2

Not Present

0 Points

Developing a communication plan

· A communication plan which includes principles of therapeutic communication is included

· A communication plan that does not include principles of therapeutic communication is provided

· Does not meet the criteria

· Does not meet the criteria

Criteria 5

Level III Max Points

Points: 10

Level II Max Points

Points: 8

Level I Max Points

Points: 6

Not Present

0 Points

College-level academic writing

· Professional, peer-reviewed, advanced practice references are used

· Grammar and mechanics of writing demonstrate graduate level work

· Adheres to page number requirements

· The majority of references used are professional, peer-reviewed and advanced practice

· Errors in grammar or mechanics of writing are present but do not interfere with readability

· Adhere to page number requirements

· The minority of references used are professional, peer-reviewed and advanced practice

· Errors in grammar or mechanics of writing are present Which interferes with readability

· Does not adhere to page number requirements

· Does not meet the criteria

Criteria 6

Level III Max Points

Points: 10

Level II Max Points

Points: 8

Level I Max Points

Points: 6

Not Present

0 Points

Citations and Formatting

· Includes a strong attempt to cite all sources using APA style.

· Minor paper formatting errors may occur.

· Minor in-text citation errors may occur.

· All authorship is clear and retrievable.

· Includes an overall attempt at APA formatting and citation style.

· Errors in formatting of citation or sources are present.

· All sources have some form of citation and all citations have a matching source.

· Citations generally make authorship clear.

·  Major errors in citations or source formatting are present.

· Citation or source information may be missing or incorrect.

· Authorship may be unclear.

· Does not meet the criteria

Maximum Total Points

55

44

33

0

Minimum Total Points

45 points minimum

34 points minimum

1 point minimum

0

DB

  

 compose a description of the national healthcare issue/stressor you selected for analysis and explain how the healthcare issue/stressor may impact your work setting. Which social determinant(s) most affects this health issue? Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

The national healthcare issue / stressor I selected is: Mental Health and Substance Abuse

description should include at least 3 scholarly sources of evidence, cited within the body of your discussion & at the end of your posting

DB

 

  • Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).
  • Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.
  • Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

** the national healthcare issue/ stressor I selected is : mental health and substance abuse

** this summary should be 3 pages long 

** APA format

PRACTICUM EXPERIENCE PLAN (PEP)

 

  • Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?  
  • Review the information related to developing objectives provided in this week’s Learning Resources. Your practicum learning objectives that you want to achieve during your practicum experience must be: 
    • Specific  
    • Measurable  
    • Attainable  
    • Results-focused  
    • Time-bound
    • Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)  

Note: Please make sure your objectives are individualized and outlined in your Practicum Experience Plan (PEP). While you may add previous objectives to continue to work toward. You must have 3 new objectives for each class, each quarter. 

  • Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.  
  • Select one nursing theory and one counseling/psychotherapy theory to best guide your clinical practice. Explain why you selected these theories. Support your approach with evidence-based literature.
  • Create a timeline of practicum activities that demonstrates how you plan to meet these goals and objectives based on your practicum requirements.