Benchmark -Evidence-Based Practice Project: Literature Review Assignment

Benchmark -Evidence-Based Practice Project Literature Review Assignment

Benchmark -Evidence-Based Practice Project Literature Review Assignment

            Sustaining and improving population health has been a major goal of healthcare systems across the globe. While healthcare problems might be administrative, some difficulties are diseases that affect health negatively. For instance, a high prevalence rate of type 2 diabetes signifies an adverse healthcare outcome. Research on this disease has been playing a significant role in developing evidence-based practices that address type 2 diabetes and associated infections like foot ulcers (Aschner et al.,2020). Among patients with type 2 diabetes, there is a 25% likelihood that these patients would develop foot ulcers. Nearly half of these patients would be infected, thus, worsening the health condition of type 2 diabetic patients. In this case, a need has been identified with the current practice of how to address type 2 diabetic patients with diabetic foot ulcers. Therefore, the purpose of this assignment is to formulate a literature review focusing on sources addressing adherence in diabetes management.


PICOT Question

            In adult diabetics with type 2 diabetes (P), does implementing monthly follow-up nurse phone calls (I), in comparison to patient self-regulated practices (C), adhere to compliance to decrease the occurrence of diabetic foot ulcers/wounds (O) over a six-month period (T)?

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Search Method

            A pertinent search was conducted in an effort to gain access to articles that are pertinent to the PICOT question in order to support this question. Various sites were utilized in the search, with Google scholar becoming the most used website to locate relevant articles. The Trip database, the Cochrane Library, PubMed, and CINHAL were among the other websites that were utilized in this research. In order to find the articles needed, they were searched in these databases using the appropriate keywords. The terms diabetic type 2 and foot ulcers were used as the search keywords in this investigation.

Synthesis of Literature

A study on a pilot mobile intervention that was used to promote diabetic type 2 management in Ghana’s urban areas was carried out by Asante et al. (2020). This quantitative design was a randomized controlled trial study involving 60 patients with T2DM. The study showed that the mobile phone follow-up call by nurses emphasizing self-management practices could effectively improve glycemic and self-management among patients with diabetes. Benefits of the program were observed with significantly lower levels of an A1C in the intervention group than in the control group. The overall information incorporated from the data analysis was that there was a significant improvement in foot care practices in the intervention group. This article supports post-discharge support for diabetic patients to improve adherence and self-management, which are essential in preventing the development of diabetic foot ulcers.

Shamsizadeh et al. (2021) carried out a study to assess the effect of education and telephone nurse follow-up (telenursing) on managing diabetes self–efficacy in patients with type 2 diabetes referred to Hamadans Diabetes Center in 2018. This study was also a quantitative in nature. A clinical trial study involving a total of fifty-eight type 2 diabetes participants divided into two groups was carried out through block randomization. Among the key findings in this study was that the mean self-efficacy improved in the intervention after telephone nursing training. These findings prove that telenursing follow-up is an effective intervention for promoting self-efficacy among patients with diabetes. The study demonstrates the role of telephone follow-up by nurses in teaching patients about the intervention that can help prevent diabetic foot ulcers, such as self-management, compliance, diabetic diet, and recreation and exercise.

Another study that was carried out by Thupawirot (2019) looked at the impact that discharge planning and telephone follow-up had on HbA1c levels, as well as the nursing service satisfaction of diabetic patients and the job satisfaction of nurses working in diabetic centers. The study was a quantitative-experimental study involving seventy patients who were randomly assigned to either control or experimental group. The study found that self-management outcomes and satisfaction were higher in the experimental group than in the control group. The study confirms nurses’ valuable impacts of telephone follow-up to help patients prevent negative disease development such as diabetic foot ulcers.

Another relevant research was done by Riangkam et al. (2021) to examine the effects of a mobile health diabetes self-management program on HbA1C, self-management, and patient satisfaction in adults with uncontrolled type 2 diabetes. The study was a quantitative study comprising one hundred and twenty-nine patients divided into 43 in each group. These participants were assigned to the MHDSMP, telephone follow-up, and usual care groups. The analysis of the data showed that HbA1C decreased from 7.72 to 7.65% in the telephone follow-up group and from 7.89 to 7.72% in the usual care group. The MHDSMP group scored the best, from 7.80 to 7.17%. The article illustrates the statistical difference between telephone follow-up and usual care in diabetes management post-discharge. It recommends the use of telephone follow-up over usual care since it has better self-management outcomes.

The review also sought the idea from Li et al. (2021) on home telemonitoring for chronic disease management: Perceptions of users and factors influencing adoption in five Australian states. This study used a mixed-methods approach to collect data from fifty-six patients and clinician groups. From the analysis of the data, telemonitoring improved patients’ experiences post-discharge by empowering them with knowledge about symptoms to watch when monitoring health, self-care, and managing health conditions. It helped nurses to be involved in patient care after discharge. The article discusses the impacts of telephone monitoring to improve health management after discharge. Such knowledge helps to minimize risks that increase the risk of diabetic foot ulcers among diabetic patients.

Another study was conducted by Lemelin et al. (2020) to explore the improved glycemic control through the use of a tele-homecare program in patients with diabetes treated with insulin in a diabetes center outpatient clinic. This study recruited ninety-two participants who were assigned to an experimental and control group. Outcomes at three months were compared to baseline. From the analysis, the tele-homecare group was associated with a significant decline in A1c levels at three months. Nursing interventions such as communication and adherence were higher in the tele-homecare group than in the control group. This study supports the PICOT as it confirms the benefits of telephone care in improving health outcomes among patients with diabetes. This can help to reduce the risk of diabetic foot ulcers.

Ogunlana et al. (2021) researched the reasons for the delay in seeking medical help with diabetic foot problems in diabetes foot clinics in Nigeria. This was an explorative qualitative study involving eight patients with diabetes in sixteen randomized controlled trials. The analysis of responses showed that the knowledge and awareness of foot challenges, risk perception, and health-seeking behaviors hampered response towards diabetic foot development and complications. The article supports the EBP practice project by showing the importance of improved knowledge and awareness to reduce the risk of diabetic foot complications. Nurses can intervene through follow-up calls.

Orozco‐Beltrán (2021) also conducted a cross-sectional survey to assess the healthcare experience of patients with type 2 diabetes in primary care centers in Spanish communities. A total of 451 T2DM patients were included in the study. The multivariate analysis adopted in the study revealed that continuity of care score was high among patients who received a follow-up call or visit by a care provider. The study supports the proposed EBP project by emphasizing the need for follow-up calls to improve self-management, which is critical in preventing diabetic foot ulcers.

Comparison of the Research

The selected studies have both similarities and differences. For example, the reviewed papers all focus on addressing the effective management of diabetic foot ulcers among the patients. Again, the studies have findings that depend on the use of the interventions. However, there are notable differences in these articles. While some of the articles are primary resources with study designs, a certain number of the articles analyzed various primary studies such as randomized controlled trials. The majority of the articles included in this analysis had a variety of limitations. While others used large samples, others used significant small sample sizes that might have resulted in unbiased results.

Recommendations for Future Research

Various gaps have been identified based on the review conducted. These gaps would provide a research opportunity for want future researchers. For instance, these studies were carried out on single locations or regions, which limits generalizability. As such, there is a need to conduct similar studies majoring in comparing the issues in various locations or centers to improve generalizability. The majority of the studies that were looked at for this article had populations that ranged from moderate to low, which lowered the credibility of the results that were obtained. The interventions that were considered in the articles that came before should also be tested using larger populations.


Diabetic foot ulcers are a common problem that has an adverse impact on type 2 diabetic patients. Therefore, there is a need to control and manage the condition. The formulation of better interventions that can effectively manage diabetic foot ulcers is required to reduce the negative health outcome. As a result, the purpose of this paper was to investigate the literature review concerning the project and the PICOT question that was proposed. In addition, a comparison of the sources as well as a recommendation for additional research based on the gaps that were identified have been investigated.


Asante, E., Bam, V., Diji, A. K. A., Lomotey, A. Y., Owusu Boateng, A., Sarfo-Kantanka, O., … & Adjei, D. (2020). Pilot mobile phone intervention in promoting type 2 diabetes management in an urban area in Ghana: A randomized controlled trial. The Diabetes Educator, 46(5), 455-464.

Aschner, P., Gagliardino, J. J., Ilkova, H., Lavalle, F., Ramachandran, A., Mbanya, J. C., … & Chan, J. C. (2020). Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the International Diabetes Management Practices Study (IDMPS). Diabetologia, 63(4), 711-721.

Lemelin, A., Godbout, A., Paré, G., & Bernard, S. (2020). Improved glycemic control through the use of a telehomecare program in patients with diabetes treated with insulin. Diabetes Technology & Therapeutics, 22(4), 243-248.

Li, J., Varnfield, M., Jayasena, R., & Celler, B. (2021). Home telemonitoring for chronic disease management: Perceptions of users and factors influencing adoption. Health Informatics Journal, 27(1), 1460458221997893.

Ogunlana, M. O., Govender, P., Oyewole, O. O., Odole, A. C., Falola, J. L., Adesina, O. F., & Akindipe, J. A. (2021). Qualitative exploration into reasons for delay in seeking medical help with diabetic foot problems. International Journal of Qualitative Studies on Health and Well-being, 16(1), 1945206.

Orozco‐Beltrán, D., Artola‐Menéndez, S., Hormigo‐Pozo, A., Cararach‐Salami, D., Alonso‐Jerez, J. L., Álvaro‐Grande, E., … & Ferreira de Campos, K. (2021). Healthcare experience among patients with type 2 diabetes: A cross‐sectional survey using the IEXPAC tool. Endocrinology, Diabetes & Metabolism, 4(2), e00220.

Riangkam, C., Sriyuktasuth, A., Pongthavornkamol, K., Kusakunniran, W., & Sriwijitkamol, A. (2021). Effects of a mobile health diabetes self-management program on HbA1C, self-management and patient satisfaction in adults with uncontrolled type 2 diabetes: A randomized controlled trial. Journal of Health Research.

Shamsizadeh, M., Shaadi, S., Mohammadi, Y., & Borzou, S. R. (2021). The effects of education and telephone nurse follow-up (tele-nursing) on diabetes management self–efficacy in patients with type 2 diabetic referred to Hamadans Diabetes Center in 2018. Avicenna Journal of Nursing and Midwifery Care, 29(2), 81-90.

Thupawirot A. (2019). Effects of discharge planning and telephone follow up on HbA1c and nursing service satisfaction of diabetic patients and nurse’s job satisfaction. Journal of Preventive Medicine Association of Thailand , 4 (2), 151–161. Retrieved from


The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.

In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
Conclusion – Provide a summary statement of what you found in the literature.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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