NSG 6999 Evidence Based Project (EBP) & PICOT Question Essay

NSG 6999 Evidence Based Project (EBP) & PICOT Question Essay

Reflection

1. What does the literature say about your question?

The available literature strongly supports the PICO question, which investigated the impact of a nurse-led integrative medicine-based structured education program on self-management behaviors among individuals recently diagnosed with type 2 diabetes. The research consistently shows that these programs help patients improve their ability to manage their health, control their blood sugar levels, and believe in their abilities. In addition, following specific dietary patterns like veganism, vegetarianism, and the Mediterranean diet be effective strategies for managing type 2 diabetes.

1. To what extent is the answer from the literature consistent with what you expected?

The findings from different literature sources align with our initial expectations. It is widely recognized that self-management is vital in managing chronic conditions like type 2 diabetes. Therefore, implementing a structured education program led by trained nurses was expected to help improve patient outcomes regarding self-care behaviors and glycemic control. Numerous studies have consistently shown that interventions led by nurses have been effective in improving glycemic control in patients diagnosed with type 2 diabetes. For example, a study conducted by Guo et al. (2019) found that patients who received nurse-led education intervention while continuing their oral hypoglycemic treatment experienced significant improvements in glycemic control. Additionally, the study showed that these patients could delay initiating insulin therapy. These results further support the notion that empowering nurses to administer self-management support interventions can substantially enhance clinical outcomes for individuals with type 2 diabetes.

1. Does the literature you have entirely answer your question?

While the existing literature presents considerable evidence in support of the PICO question, there is still room for further exploration. The studies that have been reviewed primarily concentrate on structured education programs and specific dietary patterns as interventions for diabetes management. Nevertheless, a significant gap exists in investigating the potential impacts of other components associated with an integrative medicine-based approach, such as mindfulness or yoga practices. Future research should focus on comprehensive investigations into these additional facets of an integrative medicine approach. It’s worth looking into how practicing mindfulness techniques or adding yoga to their routine can help people with type 2 diabetes control their blood sugar levels and improve their overall well-being. By thoroughly examining all relevant components within this framework, we aim to better understand their therapeutic benefits as part of holistic diabetes management strategies.

1. Were there any inconsistencies between what you read in the literature you reviewed?

Both Yu et al. (2022) and Papamichou et al. (2019) supported the efficacy of nurse-led structured education programs and specific dietary patterns for controlling type 2 diabetes, consistent with the literature review findings. This consistency reinforces the reliability of the conclusions drawn from this review. This literature review emphasizes the importance of integrative, patient-centered care and education in effectively managing chronic conditions like type 2 diabetes. This emphasizes how changing your diet and participating in education programs led by nurses can significantly improve your ability to manage your diabetes and overall health. Therefore, these findings could serve as a solid basis for implementing evidence-based strategies to manage diabetes.

References

Guo, Z., Liu, J., Zeng, H., He, G., Ren, X., & Guo, J. (2019). Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a chinese community: A randomized controlled trial. Patient Preference and Adherence, Volume 13, 1353–1362. https://doi.org/10.2147/ppa.s213645

Papamichou, D., Panagiotakos, D. B., & Itsiopoulos, C. (2019). Dietary patterns and management of type 2 diabetes: A systematic review of randomized clinical trials. Nutrition, Metabolism and Cardiovascular Diseases, 29(6), 531–543. https://doi.org/10.1016/j.numecd.2019.02.004

Yu, X., Chau, J. P. C., Huo, L., Li, X., Wang, D., Wu, H., & Zhang, Y. (2022). The effects of a nurse-led integrative medicine-based structured education program on self-management behaviors among individuals with newly diagnosed type 2 diabetes: A randomized controlled trial. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00970-7

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Module 4 Evidence Based Practice: Finding the Evidence

Submit by the due date and time listed in your syllabus.
Overview
This assignment will allow you to create an evidence-based practice project that includes the development of a PICO question and follows the initial steps of the Iowa Model. You will share your findings using an APA formatted paper.
Submitting your assignment
• Save this document to your desktop as a Word document.
• Open the document from your desktop and review the assignment instructions and grading rubric.
• Create a separate Word document for your paper.
• Return to the course and upload your paper and your approved nursing research article to the assignment submission link. Please note: if you forget to upload your source articles, up to 5 points penalty will be applied to your paper.
Grading Rubric
See the grading rubric posted in the assignment link to guide your work the assignment. Points are awarded for each section based on content and clarity of expression.
Instructions for Completing Your Assignment
o Step one: Using the topic you chose, identify a nursing clinical practice question that you would like to explore.

o Step two: You may use the PICO(T) question in the final form approved by your instructor or coach. We will give you feedback on questions and articles up until Wednesday before the assignment is due. If you have not had a question or article approved by that time, carefully review the instructions for what constitutes an acceptable PICO question and what constitutes an acceptable article.

o Step three: Search for a nursing quantitative research article (or two) that relates to your PICO question using Academic Search Complete, CINHAL, Pubmed, Google Scholar, or any other database that contains nursing research articles. Please note: you can use the article that you submitted in Module Two to meet this requirement so long as it was approved.
o The article you will find must meet the following mandatory requirements:
 It must be based on the approved topic list unless other arrangements were made with your instructor or coach.
 It must be from a nursing research journal or have a nurse as an author.
 It must be no more than 5 years old from the current publication year.
 It must include implications and / or interventions that are applicable to nursing practice.
 It may not be a qualitative article, systematic review, meta-synthesis, meta-analysis, meta-summary, integrative review or a retrospective / quality improvement study. For more information on how to recognize these types of article see Grove & Gray (2019) pp. 21-23.
 It may not be a clinical information article or “how-to” article.

o Step Four: Collecting More Evidence (Do the research)
 Find a credible scholarly or government resource published within the past 5 years that provides you with at least two facts (ex. costs, morbidity, mortality, safety, or other related statistics) for why your clinical problem is important (provide statistics). (The internet is a great place to get this information…just don’t forget to cite this information and add it to your reference page). If you find that your reference is the name of a webpage with n.d. instead of a date, then it is very questionable whether or not this is truly a scholarly source.
 Find a clinical practice guideline that relates to your question. It must have information that relates to the role of the nurse. Guideline is the most recent version or published within the past five years. (It is true that guidelines are not always updated within 5 years so you will need to discuss this.) There are several websites listed in your textbook that can help with searching for guidelines. The UTA library also has resources for clinical practice guidelines.
 Find a research based article published within the last five years from a discipline other than nursing (medicine, social work, physical therapy, etc.) The article must support at least three statements that are relevant to your question and to nursing practice.
 Hint: Did you notice that you will be finding a total of four different sources of information for your PICO question? To re-cap, these four sources are:
• Statistics you are reporting in paragraph one.
• Nursing quantitative research article for paragraphs 2, 3, and 4
• Clinical Practice Guideline (paragraph 5)
• A other discipline article (paragraph 6)

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o Step Five: Write up your findings in APA format and submit them to assignment portal by the due date and time listed in your syllabus. Here’s how to write up your findings:
 Start with a 7th edition APA cover page. An example is provided by the instructor.
 Paragraph #1: This is your opening paragraph. Start with an introduction statement. What is your PICO question? Describe why was it important (share the dollars, morbidity / mortality, statistics, safety stats you found with citation)? If your source was a website, then include a working link to that website.
 Paragraph #2: What did your nursing quantitative research article add to your knowledge on this topic? State the design using one of these terms: descriptive, correlational, predictive correlational, experimental, or quasi-experimental. State the sampling method, and setting of the study (this should only take one sentence: e.g. “Smith and Johnson conducted a predictive correlational study using a convenience sample from a psychiatric outpatient clinic.”). State the major findings of the study (2 or 3 findings). The findings you share should come from the results or discussion settings and should be relevant to your PICO question and your practice as a nurse. (Hint: major findings are findings that are meaningful to the reader. For example, findings such as that a majority of the study was within a certain age group are not major findings).
 Paragraph #3. Mention the research variables in your article. Do not include demographic variables unless they are important to the results of the study. If the study includes independent and dependent variables, mention which ones are independent or dependent. For each major variable, give a conceptual and operational definition. If the authors gave a conceptual definition for a variable, you may quote it with proper citation(this is the only place in this paper that direct quotations are allowed). Otherwise you must infer a conceptual definition for the variable based on your understanding of the article. Authors do not usually state operational definitions, but you can tell what the operational definition was for each variable by what they describe about how the variables were measured. Give the level of measurement for each variable (nominal, ordinal, interval, or ratio).

 Paragraph #4: Using the skills you have learned in your critique of a research article, describe two strengths or two weaknesses (or one strength and one weakness) that you found as you read this article. Go back to what you learned in your article critique about sampling methods, measurement methods (ex. questionnaires), and data collection (how did they collect the data to make sure you are being thorough in your assessment. Be specific, so that your instructor, if reading the article, can find them too. Do not re-state the limitations provided by the authors of your study unless they have to do with the study’s sampling, measurement methods, or data collection. Do not discuss the research design or the descriptive or inferential statistics used by the authors as a strength or weakness of the study, as this is not related to with the study’s sampling, measurement methods, or data collection. (Hint: be sure to describe strengths or weaknesses of the study itself, not strengths or weaknesses of the article).
 Paragraph #5: What is the name and website of the clinical practice guideline that you found? Share at least three facts that you found within the guideline that is relevant to the PICO question and your practice as a BSN nurse and cite the guideline appropriately. Make sure that the source you are using is actually a clinical practice guideline. Clinical practice guidelines are generally written by interdisciplinary teams and offer evidence based advice to professionals. Do not use sources that offer advice to patients or the general public or sources that offer advice without discussing the evidence behind their recommendations.
 Paragraph #6: Identify the other discipline article that you found. The article needs to be research based, but it does not have to be a research article itself. For example, it could be a systematic review. Qualitative, mixed methods, and retrospective studies can also be used for this source. It must have facts related to your practice question. Share at least three facts that you found within this source that is relevant to the PICO question and your practice as a nurse, and cite appropriately.
 Paragraph #7 (and #8 if needed): re-state your PICO question and briefly summarize what you have learned through your search. What would you recommend, if anything, as a change in practice for nurses? Why? Remember, this is your closing paragraph(s). This paragraph should include information from each of your sources. Therefore you should also cite all of your sources in this paragraph. Also be sure to include recommendations for practice based on what you learned from your four sources.
 Note to students about writing up your findings:
o This is a formal APA paper. Do not use first or second person language in this paper. Points will be taken off if you do. Look at the Rubric for more APA information for this paper. APA points will be taken off for spelling, grammar, and usage errors.
o Your paper must be between five and seven pages (double spaced), not including the cover page and references. Use the following headings for paragraphs 2 through 7: Summary of Research Article, Major Variables, Strengths and Weaknesses, Practice Guideline, Fourth Resource, Conclusion
o Turn your paper (as a word document) and your source articles (in pdf format) to the assignment submission link in Module Four at the due date and time listed in your syllabus. If you included a working link to your practice guideline and/or your statistics source in your paper itself you do not need to include pdf of those things.
o No direct quotes are allowed in this paper. The only exception is that you may use direct quotes for conceptual definitions of variables. If you do use a direct quote in such circumstances it must be properly cited. Any other direct quotes will receive a point deduction.
o Possible points for this assignment: 100 points