• Subject Name : Nursing

Critical Appraisal of Article

Selected Paper

Ennis, G., Happell, B., & Reid‐Searl, K. (2015). Clinical leadership in mental health nursing: The importance of a calm and confident approach. Perspectives in Psychiatric Care51(1), 57-62.DOI: 10.1111/ppc.12070

Introduction to Clinical Leadership in Mental Health Nursing

It is critical when educating about the knowledge of leadership nursing to the nurses to ensure that they maintain a calm environment while working in mental health centers or hospitals (Atchan, Davis & Foureur, 2016). The article appraised a study that explores the perceptions of the nurse towards clinical leadership who work in mental health areas of health care. The title is detailing about the subject and the subject’s area of working, like – who – nurses, where – mental health areas of healthcare centers or hospitals, what – clinical leadership, and how – an exploration of their perceptions by interviews. This indicates that it is an informative title and the initial section of the paper is also well detailed with heading like purpose, design, and methods, findings, and practice implications. The research design always influences the reliability of the result attained (Hercegovac, Kernot & Stanley 2020). The background also briefly explains the importance of effective clinical leadership in mental health wards or hospitals. The method section clearly states that the study is using a qualitative approach. The design, setting, and participants section is brief and provides a clear idea to the reader about the components of the study. The result is clear and brief stating and comparing it with the comments of participants regarding effective clinical leadership in mental health. The conclusion is related to the tile of the study and it does summaries the findings of the authors in the study. The perceptions of the participants were related to the management of critical situations that might arise due to violence or other unexpected situations (Hughes &McDonagh, 2016). More than enough information is provided to the reader to understand the study.

Literature Review

For this study (Ennis, Happell, & Reid‐Searl, 2015), the authors have introduced the literature review part in the introduction section. The literature review states that with effective clinical leadership values that mental health nurse can manage their work efficiently. This part discusses the importance and the need for this knowledge in nurses. The actual conceptual framework used in this section focuses on how effective clinical leadership and a positive environment can help in improving the health of the patient and prove to be helpful in times of crisis in mental health services. Therefore, the target population chosen is the nurses that form the frontline of medical health care services providers. This states that the aim of the study is double-ended. First, knowledge of nurses about effective clinical leadership and second, application of that knowledge to manage the critical situation by maintaining a calm environment with a confident approach for the patients and workplace. Furthermore, it was found that the authors used very old literature for discussion like the chosen literature is from 2001 to 2013. No latest literature was used for the authors for their study. The latest literature creates more emphasis on the study with more insights for the study like it deepens the thought process (Mascarenhas, Ferreira & Marques, 2018). Moreover, it was found that the authors did not take the perceptions of patients. This was an important missing part as the patients are the one who receives the care delivered by the nurses. So, their perception and views should also be considered on outcomes of nurse's leaderships to know about the impacts/effects. 


The methodology was broken clearly under different sections. The design stated that it used a grounded theory in which comparative analysis is performed. According to Garg (2016), there advantages if the researchers use grounded theory for their study: it provides sequential guidelines for qualitative research and it also provides explicit. It enables the researchers to integrate the collected data and perform the analysis; this is performed in this study. The setting of the study clearly defines where the study is performed and why the chosen participants are suitable for criteria. The views, experiences, and observations of the staff and registered nurses were taken to be an important part of this study. This acts as a strength to the data collected for the study to get more insights into it. The sample size is 12 which is very small and acts as a limitation for this study by creating the chances of biases. A study with a large sample size is considered more reliable as it lacks biases, variability, and standard errors (Hughes & McDonagh, 2016). The data collected through in-depth interviews that ere audio-recorded and performed face-to-face. Such interviews various strengths to the study as it enables – observations of body language, clear and brief responses, in-depth data collection, and many other (Brittain, Ibbett & de Lange, 2020). For the analysis of the data collected a grounded theory approach was used to study the perceptions and experiences of the participants. There are 2 primary characteristics of grounded theory research design: comparison of data collected and theoretical sampling to maximize the differences and similarities of information (Bhaskar & Manjuladevi, 2016). The analysis and result part depicted that there was a comparison of the data collected because the authors stated that they found no new data after a few interviews.

Ethical Considerations

The study included a separate heading if ethical considerations. For the study, the participants were voluntary and formal consent was taken from each of them. The study was performed as per the guidelines of the national statement of ethical research. Moreover, ethical approval was taken from the university human research ethics committee and the mental health service ethics committee.According to Atchan, Davis & Foureur (2016), ethical considerations are a very important part of research as it ensures that the study has not harmed the rights, respect, and dignity of its participants. If a study has performed ethical considerations like informed consent, voluntary participation, confidentiality, autonomy, communication about the research and its results, or potential harms with participants or to the participants; then such studies are considered to be strong and are widely accepted. Similarly, in this study, the outcomes of the study are of great importance to the nurses so that they understand the importance of effective clinical leadership in mental health with a calm approach for a healthy workplace environment.

Significant Results

The study conducted a face-to-face in-depth questionnaire interview rounds with every participant. The results discussed the skills and knowledge of the participant like confidence, critical thinking, maintaining a calm environment, effective communication, effective listening, and many others. Hence, it showed that the results are surrounded by maintaining a calm and confident approach by the nurses in mental health. It also showed that their knowledge of clinical leadership is also useful in managing aggressive patients and adverse unexpected stressful situations. The results also included the statements of the participants that were spoken by them at the time of their interview so that the reader can have a complete study about the thinking and views of participants through the study. According to Hercegovac, Kernot & Stanley (2020), the research study should never exaggerate the results and should provide that why and how the result helps in the care of the people. In this study, these criteria are maintained; hence we can say that results are properly illustrated. Moreover, the results showed that the nurse participants know teamwork, nursing skills, and ensure quality care for patients with effective clinical leadership qualities.

Discussion on Clinical Leadership in Mental Health Nursing

The results are very well supported by the discussion in the study. The discussion showed that the essence of clinical leadership helps the nurses in dealing with challenging behavior or aggression, managing a therapeutic relationship with the client, and many others. Few others are clinical decision-making, remaining calm in an emergency, and more positive outcomes for clients.In this way, the study discussed the knowledge of interpersonal skills in the nurse and its importance. There is also a separate heading in the study where the authors discussed the limitation of the study – small sample size. The authors stated that due to their small sample size they cannot use this study to represent the broader perceptions of nurses. Hence, the reliability of the results is decreased and the author has not specifically mentioned the strengths of the study as well. However, as per the CASP score, the aim was clearly understood and described, the methodology was appropriate, the design was appropriate and the data collected addressed the aim of the research study with ethical considerations. There was also a clear statement for the finding and research was also valuable as it included the last part of implication in nursing practice as well. So, the study has a high CASP score of 8. The study loses a few points due to its limitations.

Recommendations on Clinical Leadership in Mental Health Nursing

The study recommended the introduction of effective clinical leadership knowledge in undergraduate and postgraduate nurses to make them ready for dealing with crises or emergencies in mental health nursing and dealing with aggression or the potential for violence. Through this recommendation, there will be an improved calm and confident approach for patient care.

References for Clinical Leadership in Mental Health Nursing

Atchan, M., Davis, D., & Foureur, M. (2016). A methodological review of qualitative case study methodology in midwifery research. Journal of Advanced Nursing72(10), 2259-2271. DOI: 10.1111/jan.12946

Bhaskar, S. B., & Manjuladevi, M. (2016). Methodology for research II. Journal of Anaesthesia60(9), 646. DOI:10.4103%2F0019-5049.190620

Brittain, S., Ibbett, H., de Lange, E., Dorward, L., Hoyte, S., Marino, A., & Lewis, J. (2020). Ethical considerations when conservation research involves people. Conservation Biology. DOI: 10.1111/cobi.13464

Garg, R., 2016. Methodology for research I. Journal of Anaesthesia60(9), p.640. DOI: 10.4103%2F0019-5049.190619

Hercegovac, S., Kernot, J., & Stanley, M. (2020). How qualitative case study methodology informs occupational therapy practice: A scoping review. OTJR: Occupation, Participation and Health40(1), 6-16. DOI: 10.1177%2F1539449219850123

Hughes, J., & McDonagh, J. (2017). In defence of the case study methodology for research into strategy practice. Journal of Management36(2), 129-145. DOI: 10.1515/ijm-2017-0013

Mascarenhas, C., Ferreira, J. J., & Marques, C. (2018). University–industry cooperation: A systematic literature review and research agenda. Science and Public Policy45(5), 708-718. DOI: 10.1093/scipol/scy003

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