NURS FPX 4030 Assessment 3 Picot Questions and An Evidence Based Approach

Assessment 3 Picot Questions

Name

Capella university

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

PICO(T) Question and Evidence-based Approach

PICO(T) is an acronym for Population, Intervention, Comparison, Outcome, and Time. This mnemonic is used by nurses to address a research question and understand a clinical problem effectively. By developing the PICOT, registered nurses are able to provide better care to patients. First, a great PICOT question is created, and based on that question, evidence-based studies are researched and evaluated whether the outcomes are parallel to the raised research question or not. Lastly, these outcomes help in making best-decisions and improve care and outcomes. It is important to raise a correct and appropriate question for research as the outcomes of the research are based on how the question is built (Gallagher Ford & Melnyk, 2019).

Practice Issue to be Explored

The PICOT question for this assessment is: In Patients with type 2 diabetes (P), is self-management more effective (I) as compared to medication (C) to control hyperglycemia (O)? There are plenty of research data that suggests that self-management of diabetes is effective in controlling the progression of diabetes. Many healthcare organizations promote this practice of self-management. But, there is still a conflict about whether medication is enough to treat and control diabetes. Some research identifies that medication is not taken by diabetics but only self-management is practiced. Some health professionals consider both medication and the self-management to be the best strategy to control diabetes. Therefore, by using PICO(T) question analysis health professionals can find the best strategy to control hyperglycemia. In this assessment, we will explore this conflict using research data and draw some conclusions based on the research.

Sources of Evidence to Answer PICOT Question

While searching for PICO questions, it is important to look for credible, trustworthy, and authentic sources of evidence as the outcomes based on these research resources will be the basis for patient care. Therefore, the CRAAP test is utilized to evaluate the credibility of the source of evidence and is an effective method to rule out any fake or doubtful source of information. The CRAAP methodology includes the elements of currency, relevance, authority, accuracy, and purpose (Kilcrease, 2021). Google Scholar, PubMed Central, CINAHL, BioMed Central, MEDLINE, and Capella University’s Library are the databases and journals that will be potentially effective in answering the PICO question. Additionally, authentic websites and journals including the American Diabetes Association, Clinical Diabetes, Clinical Diabetes and Endocrinology, Current Diabetes Reports, and BMJ Open Diabetes Research and Care can also be potentially effective resources in answering PICO questions. All of these databases are highly reliable and specific to the issue of interest and can be potentially effective sources of generating evidence-based data to answer the PICO question of our interest.

Findings from Articles – Related to Diabetes Self-Management and Medication

Several studies have been conducted by nurses and other health professionals to find out the best practice for diabetes between self-management and mediation to control the high glycemic levels in the blood.

Relevant Findings from Different Articles

A literature review by Al Harbi and colleagues (2022) on the efficacy of self-management intervention with comparison to standard treatment of diabetes i.e. medication was studied. It concluded that self-management educational interventions showed significant and consistent effectiveness as compared to the standard care. They also found that a self-management strategy caused a 1% reduction in HbA1c levels in type 2 diabetes. This study recommends the usage of self-management education and implementation for type 2 diabetics because of its efficacy in the glycemic control of patients along with other health benefits (Al Harbi et al., 2022). This resource is the most relevant and credible as it fulfills all the criteria of the CRAAP test. Currency (the article is published in 2022), relevance (it is relevant to the issue of interest as it shows the comparative study between the efficacy of self-management of diabetes and standard treatment i.e. medication), authority (the authors of the article are related to the field of the study and the publication journal is credible and relevant journal – Journal of Family Medicine and Primary Care), accuracy (all the claims are justified and accurate), purpose (the purpose of the article is to evaluate the effectiveness of self-management of diabetes). According to Lee and his colleagues (2019), the role of self-management in diabetic patients who were willing to practice this resulted in better glycemic control and can prevent long-term health problems associated with diabetes (Lee et al., 2019). This showed that self-management intervention is more effective in controlling diabetes by regulating glycemic levels of the blood.

NURS FPX 4030 Assessment 3 Picot Questions and An Evidence Based Approach

According to El Sayed and coauthors (2022), diabetes self-management should be opted for the regulation of glucose levels in the blood in type 2 diabetes. Medication therapy should only be selected in severe cases such as comorbidities and must be guided by individual-centered treatment factors e.g. presence of comorbidities and treatment goals (ElSayed et al., 2022). This reveals that medication and self-management both are effective in managing diabetes but medication therapy should not be started without patient-centered treatment factors. In cases of onset of type 2 diabetes, self-management has shown effectiveness in controlling and managing the disease (Ernawati et al., 2021) so, it should be selected as the treatment of choice, and medication therapy should be initiated if the self-management alone is not effective.

Decision-Making on PICOT Question Related to the Findings

All the evidence-based resources utilized above are credible and relevant to the issue of interest “self-management or medication – what is more effective in diabetes?”. The resources favored both interventions: self-management is effective in all cases of diabetes, particularly in early diagnosis of diabetes and severe cases of diabetes. Medication, on the other hand, should be guided and taken in those cases when self-management alone is not effective in controlling the diabetes (Al Harbi et al., 2022; ElSayed et al., 2022). It was also revealed that diabetics who have a willingness to practice self-management show better glycemic control of blood. Therefore, diabetics should have support groups that can motivate them to practice self-management strategies (Lee et al., 2019). These shreds of information from the evidence-based research data helped us answer our PICO question by concluding that both the interventions are effective for controlling glycemic levels of blood in diabetics but their use depends on the severity of diabetes. Self-management is effective in all cases of diabetes but medication therapy should be started when self-management alone is not effective in controlling hyperglycemia.

Conclusion

To conclude, PICO(T) question is a valuable source for finding the best possible solution to a certain health problem in healthcare systems. It helps nurses and other health professionals choose the most effective method to treat patients by utilizing an evidence-based approach. It is important to evaluate the credibility of evidence-based resources by utilizing the standard criteria of the CRAAP test. These standard criteria of the CRAAP test facilitate healthcare professionals in finding credible evidence-based research data which can determine the best possible solution to health problems which ultimately improves healthcare practices.

References

Al Harbi, S., Alajmi, M., Algabbas, S., & Alharbi, M. (2022). The comparison of self-management group education and the standard care for patients with type 2 diabetes mellitus: An updated systematic review and meta -analysis. Journal of Family Medicine and Primary Care, 11(8), 4299. https://doi.org/10.4103/jfmpc.jfmpc_2087_21 ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R. A. (2022). 9. Pharmacologic approaches to glycemic treatment: Standards of care in diabetes—2023. Diabetes Care, 46(Supplement_1), S140–S157. https://doi.org/10.2337/dc23-s009 Ernawati, U., Wihastuti, T. A., & Utami, Y. W. (2021). Effectiveness of diabetes self-management education (DSME) in type 2 diabetes mellitus (T2DM) patients: Systematic Literature Review. Journal of Public Health Research, 10(2). https://doi.org/10.4081/jphr.2021.2240

NURS FPX 4030 Assessment 3 Picot Questions and An Evidence Based Approach

Gallagher Ford, L., & Melnyk, B. M. (2019). The underappreciated and misunderstood PICOT question: A critical step in the EBP process. Worldviews on Evidence-Based Nursing, 16(6), 422–423. https://doi.org/10.1111/wvn.12408 Kilcrease, B. (2021). 4. Evaluating sources with the Craap test. In 4. EVALUATING SOURCES WITH THE CRAAP TEST (pp. 47–74). University of Toronto Press. https://www.degruyter.com/document/doi/10.3138/9781487588649-005/html?lang=en Lee, A. A., Piette, J. D., Heisler, M., Janevic, M. R., & Rosland, A.-M. (2019). Diabetes self-management and glycemic control: The role of autonomy support from informal health supporters. Health Psychology, 38(2), 122–132. https://10.1037/hea0000710

ADDITIONAL INSTRUCTIONS FOR THE CLASS – NURS FPX 4030 Assessment 3 Picot Questions and An Evidence Based Approach

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. NURS FPX 4030 Assessment 3 Picot Questions and An Evidence Based Approach

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. NURS FPX 4030 Assessment 3 Picot Questions and An Evidence Based Approach

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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