NR 439 Week 1: Role of Research and the Importance of the Searchable Clinical Question
NR 439 Week 1: Role of Research and the Importance of the Searchable Clinical Question
NR 439 Week 1: Role of Research and the Importance of the Searchable Clinical Question
According to CCN 2017 week 1 lesson, evidence can form the basis of best practices for the nursing process (assessment, diagnosis, planning, implantation and evaluation). As we consider the who, what, where, when, why and how of the situation, we begin to formulate a clinical question that addresses these queries. The PICOT format is a way to develop a clinical question that leads itself to searching for evidence. PICOT is an acronym for:
P= Population of interest
I= Intervention of interest
C= Comparison of interest
O= Outcome of interest
T Time
The case study of a 57 year old female with a 13 year history of diabetes who presented to the hospital due to failure of oral hypoglycemic agents (OHAs) in controlling her sugar levels, for the last 3 years, and was using biphasic insulin aspart 30/70 for treatment. She is a regular swimmer and socially very active, which led to her to have irregular meals and so often goes into frequent hypoglycemia. Her lifestyle, eating habits, and the use of biphasic insulin are the contributing factors of her uncontrolled diabetes and hypoglycemia. In addressing this case study, I will formulate the PICOT as follows:
P= 57 year old female with 13 years history of diabetes
I=Teaching regarding diabetic management
C=No teaching regarding diabetic management
O=Improvement in diabetic management and reduction of diabetic crisis
T=Daily monitoring of fasting blood-sugar and postprandial blood-sugar levels x 3 months and monitoring HA1C levels every 3 months. Assessment of knowledge about diabetic management.
Clinical question after PICOT format:
1. Etiology and assessment: Does lifestyle (irregular meals )and biphasic insulin aspart 30/70 causes hypoglycemia on the female.
Treatment and Prognosis: With lifestyle modification(regular meals), teaching on diabetic management and insulin degludec help in controlling the ladies diabetes by maintaining her blood-sugar levels and HA1C within normal limits?
References
CCN (2017). Week 1 Lesson. NR-439 RN Evidence-Based Practice. Online lesson. Downers Grove, IL: DeVry Education. Group.CCN (2016).
Class, you may begin posting in this TD on Sunday, July 2nd for credit.
Class, this week begins your journey into evidence-based practice or EBP.
Along the way, you’ll explore nursing research and its evolution from Florence Nightingale’s time until today.
You’ll build on knowledge gained in the informatics course as you choose a significant clinical issue, formulate a searchable clinical question, and search for research-based evidence.
This process lays the groundwork for a PICOT assignment that you’ll complete during the course as you discover sources of evidence for your own EBP. Nursing research critically advances our profession through the development of evidence upon which our practice standards are based. To determine what the best evidence is, a nurse needs to look at how the information was collected, how rigorous the methods used to develop the evidence was, and what source was used to share the evidence.
The Course Outcomes (CO) we will apply in our first week include:
Examine the sources of evidence that contribute to professional nursing practice.
Recognize the role of research findings in evidence-based practice.
Read the assigned case study and formulate searchable, clinical questions in the PICO(T) format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate references.
There are many possibilities for the research question. Make sure that you also Identify the focus of each question and explain WHY. Don’t forget to give the “P”, “I”, “C”, “O” AND T
You may want to review the lesson from Week One. Dr Joy
Hi Class,
According to CCN 2017 week 1 lesson, evidence can form the basis of best practices for the nursing process (assessment, diagnosis, planning, implantation and evaluation). As we consider the who, what, where, when, why and how of the situation, we begin to formulate a clinical question that addresses these queries. The PICOT format is a way to develop a clinical question that leads itself to searching for evidence. PICOT is an acronym for:
P= Population of interest
I= Intervention of interest
C= Comparison of interest
O= Outcome of interest
T Time
The case study of a 57 year old female with a 13 year history of diabetes who presented to the hospital due to failure of oral hypoglycemic agents (OHAs) in controlling her sugar levels, for the last 3 years, and was using biphasic insulin aspart 30/70 for treatment. She is a regular swimmer and socially very active, which led to her to have irregular meals and so often goes into frequent hypoglycemia. Her lifestyle, eating habits, and the use of biphasic insulin are the contributing factors of her uncontrolled diabetes and hypoglycemia. In addressing this case study, I will formulate the PICOT as follows:
P= 57 year old female with 13 years history of diabetes
I=Teaching regarding diabetic management
C=No teaching regarding diabetic management
O=Improvement in diabetic management and reduction of diabetic crisis
T=Daily monitoring of fasting blood-sugar and postprandial blood-sugar levels x 3 months and monitoring HA1C levels every 3 months. Assessment of knowledge about diabetic management.
Clinical question after PICOT format:
1. Etiology and assessment: Does lifestyle (irregular meals )and biphasic insulin aspart 30/70 causes hypoglycemia on the female.
Treatment and Prognosis: With lifestyle modification(regular meals), teaching on diabetic management and insulin degludec help in controlling the ladies diabetes by maintaining her blood-sugar levels and HA1C within normal limits?
References
CCN (2017). Week 1 Lesson. NR-439 RN Evidence-Based Practice. Online lesson. Downers Grove, IL: DeVry Education. Group.CCN (2016).
Charles a common method for nursing to use when searching for evidence to improve practice with the goal of asking a searchable and answerable question is to use a PICOT question format. Placing the clinical, searchable problem question in PICO(T) format helps to clarify the population, intervention, comparison or variables, outcome, and time frame involved (Chamberlain College of Nursing, 2018). You have written a very well defined PICOT for this case study. Good work. What words would you use for searching for information in the library on your topic? Dr Joy
Chamberlain College of Nursing (2017). NR-439 RN Evidence-Based Practice: Week 1 lesson. Downers Grove, IL: Online Publication.
Hi ,
Thanks for reading my post and for the kind remarks. I think I would use the following words when searching for information in the library for this particular topic: Would lifestyle modification and the use of insulin degludec reduce incidence of hypoglycemia in patients with type 2 diabetes?. I hope I answered your question, and if not I would be glad to receive any feed back from you. Thanks,
Charles these are good terms to use. You may also want to consider what you mean by lifestyle modification?
Hi
Thanks for the feedback. In the scenario of the woman with diabetes and with irregular eating habits, lifestyle modification will involve altering her long-term habits of irregular eating. So the question will be: Would regular meals and insulin degludec reduce incidence of hypoglycemia in patients with type 2 diabetes? Hopefully this makes more sense. Thanks,
Great post, I think understanding the control of insulin regulation is challenging. I know patients who feel that if I they take their medication they can eat anything they want. Teaching proper meal plans as well as activity is key to the maintenance of insulin control for each individual.
Thanks
Thanks for your contribution. I agree with you that most patients with type 2 diabetes feel that they can eat anything as long as they adhere to thier medication regimen, but this is not true. In type 2 diabetes, the body may not produce enough insulin, or might be resisitance to insulin. It is the responsibility of the to teach their patients about type 2 diabetes and it’s management by providing them with evidence based literatures. I agree with you that combining a healthy meal plan, exercise and diabetes medication is key to the management of type 2 diabetes. Thanks,
I enjoyed your post and agree with your plan. My friend mother at age 60 was diagnosed last year with type 2 diabetes. She went to the hospital with polyuria, polydipsia and flu like symptoms when they found out her blood glucose was over 600. She started out with having blood sugars at AC/HS with sliding scale coverage, standing coverage at meal times and long acting Levemir once daily. After adhering to a strict diet and exercise plan like you suggest, a year later she has lost weight and is off all diabetic medication!