NSG 6999 Assignment: PICOT Question on Type II Diabetes

NSG 6999 Assignment: PICOT Question on Type II Diabetes

Sample Answer for NSG 6999 Assignment: PICOT Question on Type II Diabetes Included After Question

NSG 6999 Assignment  PICOT Question on Type II Diabetes

 

I. PICOT QUESTION:

In geriatric patients with Type II diabetes (P), does having a diabetic nurse educator (I) compared to not having a diabetic nurse educator (C) decrease hypoglycemic episodes of self-management (O) during a six-month time frame (T)?
1. Will you have a comparison group or will subjects be their own controls?
The research will use a comparison group to assess hypoglycemic episodes between geriatric diabetic patients who have a diabetic nurse educator and those not having an educator. The comparison will analyze outcomes to guide decision on the implementation of self-management to improve quality outcomes to the elderly patients diagnosed with diabetes.
2. Is a ‘time’ appropriate with your question – why or why not?
Yes. It is important to have a time limit in the clinical question considering that aspects of self-management need to be assessed in relation to confounding variables of hypoglycemic frequencies. In essence, time limit enhances a cohesive tracking of self-management practices to make a logical conclusion about the benefit of the intervention to the target population. Time in the clinical question helps to maximize the internal reliability of the given research to improve its applicability in patient care.

 

A Sample Answer For the Assignment: NSG 6999 Assignment: PICOT Question on Type II Diabetes

Title: NSG 6999 Assignment: PICOT Question on Type II Diabetes

II. Evidence Synthesis:

Database: ex. Cochrane Study #1
Bhutani et al., (2015). Study #2
Gagliardino et al., (2019). Study #3
Hope et al., (2018). Study #4
Sinclair et al., (2019). Study #5
Yong et al., (2015). Synthesis
Population (P) 137 diabetic elderly patients attending out-door facility of the hospital. 1316 adult participants with diabetes mellitus enrolled into the International Diabetes Management Practice Study (IDMPS) 335 Diabetic patients aged >65 years 10 study articles evaluated aspects of diabetes care for older adults (60-90 years) 20 men aged between 35 to 75 years and diagnosed with type 2 diabetes. All the participants were adults or elderly patients diagnosed with type 2 diabetes and most of whom were on a previous diabetes intervention program.
Intervention (I) Patients treated with oral hypoglycemic drugs; health education on hypoglycemia Participants enrolled in a diabetes education program From the total study populations, 79 patients were treated with insulin, 85 on sulphonylureas while 121 received metformin only and 50 participants had no diabetes. Data was searched from CINHAL, MEDLINE, Embase and Google Scholar to retrieve relevant review articles on the management of type 2 diabetes for older people. Participants received intensive individualized diabetes education program to influence prevention of hypoglycemic events. With exception of one study, all the four articles focused on the use of diabetes education as an intervention strategy on self-care for the target population diagnosed with type 2 diabetes. The other study was more of the use of pharmacologic agents to respond to the complications of diabetes.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: NSG 6999 Assignment: PICOT Question on Type II Diabetes

Comparison (C) Diabetes care education on hypoglycemic control compared with actual practice among the population Self-management care was compared between diabetes-educated group and non-educated groups. Insulin treated patients were compared with sulphonylurea-treated patients and metformin-only treated patients together with patients without diabetes to assess the episodes of documented hypoglycemia. Up-to-date summaries of articles on glycemic control and outcome in older people with type diabetes were compared by analyzing glucose-lowering interventions with other care outcomes. This aimed to provide evidence-based individualized diabetes care. Differences in hemoglobin A1c values were identified between the control group (CG=22) and intervention group (IT=24) attending follow-up visits at 2,8,12 and 24 weeks. Distribution of simulated participants receiving diabetes education was compared with those not receiving the intervention to determine predictive numeric checker for future adoption in clinical setting.
Outcome (O) Improvements in knowledge, attitude and practice (KAP) of diabetic patients towards hypoglycemia. Participants who received diabetes education were more likely to practice self-management than those who had not Hypoglycemia consultation were most common for insulin-treated patients followed by the sulphonylurea-treated patients and finally metformin only-treated patients. Non-diabetic patients recorded the least documentation on the episodes of hypoglycemia. This is attributed to unrecognized hypoglycemia. Comorbid burdens among the elderly diabetic patients reduces the benefits of improved glycemic control.

The intervention group demonstrated better practices in avoidance of hypoglycemia when compared to the control group. This include adherence to frequencies of physical exercise, improved dietary habits and self-monitoring of blood glucose. Study participants were assessed on the episodes of hypoglycemia to determine the effective of diabetes education for effective implementation.
Time (T) 1 month 22 months 1 year Articles published within the past five years 24 weeks Subjects were observed as per the respective time to monitor outcomes. Besides, follow-up was made on the target population to evaluate the effectiveness of the intervention program. Study duration above 6 months was adequate to assess the quality outcomes as per the given intervention. Those beyond one year provided results that were reliable to guide decision on implementation in clinical practice.

III. Evaluation Table:

Citation Design Sample size: Adequate? Major Variables: Independent Dependent Study findings: Strength and Weaknesses Level of Evidence Evidence synthesis
Bhutani et al., (2015). Longitudinal study design Sample size used was adequate. Actual study used 109 patients (male=63, female=46) Independent: Diabetes care education
Dependent: Improvements in KAP of diabetic patients towards hypoglycemia Proper diabetic education improves knowledge, attitude of patients towards practice aimed at decreasing hypoglycemic episodes in diabetics.
Strength: The study compared hypoglycemic symptom score with the Stanford reference score to assess influence of diabetic education on the patients. Ensured reliability of study outcomes.
Weakness: study used a limited duration (1-month) not adequate for monitoring behavior change. Symptoms as judged by Stanford score were not backed with biochemical confirmation to affirm glycemic changes. I Research is based on experimental study to determine baseline information about knowledge, attitude and practices on hypoglycemia. Patient received diabetic information from the treating doctor on hypoglycemia, symptoms and prevention. Occurrence of hypoglycemia compared before and after diabetic education.
Gagliardino et al., (2019). Cross-sectional study design The study population was adequate to assess behavior change Independent: Self-management education (self-monitoring of blood glucose, self-adjustment of insulin dose)
Dependent: Attainment and maintenance of glycemic targets Diabetes education provides knowledge and skills to improve self-management thereby favoring HbA1c target attainment.
Strengths: Use of large sample size and a standardized method of data collection ensured that outcomes provide objective outcomes for decision makers and health authorities on the importance of diabetes education and self-management to improve treatment outcomes.

Weakness: The research implemented observational study among participants across different cultures in Middle East and this was not an effective design to assess outcomes about knowledge and skills on self-management due to a lack of active participation among the study population. I The study used logistic regression analysis to identify predictive factors in self-management based on diabetes education and the need for glycemic control among the target population.
Hope et al., (2018). Cross-sectional survey Sample size adequate and appropriate for the study. Independent: Primary care practice on patients
Dependent: Numbers of hypoglycemia consultations by both diabetic and non-diabetic patients. Non-specific symptoms of hypoglycemia are a common presentation to primary care especially in people above 65 years with or without diabetes. Insulin-treated patients above 65 years have a higher episode of recognized hypoglycemia as compared non-diabetic patients who represent unrecognized hypoglycemia.
Strengths: Use of primary care consultation records guaranteed consistency and reliance of the outcomes.
Weakness: Inaccuracy of the outcomes especially due to the use a single primary care record which implies that outcomes on the episodes of hypoglycemia consultation could have been artificially elevated. I The study was based experimental research to monitor the episodes of hypoglycemia consultations between diabetic patients given different therapy options and those without diabetes.
Sinclair et al., (2019). Randomized Control Trials Study articles used were adequate to predict the patterns of glycemic control among the elderly patients with type diabetes. Independent: Non-pharmacologic diabetes interventions
Dependent: Improved glycemic control. From the studies, intensive glycemic control is important for older people with diabetes. These include the use of pharmacologic or non-pharmacologic interventions.

Strength: The studies selected contributed strongest evidence on the aspect of glycemic control for elder patients with type 2 diabetes.
Weakness: Some articles used weak study designs and this contributed to a high attrition rates in the overall outcome. V Study articles selected included clinical reviews that incorporated interventional, observational or descriptive data obtained from people with diabetes enrolled on educational programs. It includes literature analysis and expert opinion to describe a range of non-pharmacological glucose lowering therapies.
Yong et al., (2015). Randomized control trials The study population was 55 and this is not adequate to formulate an evidence-based practice for implementation in clinical setting. A population more than 100 would provide a bundle of evidence to evaluate outcome as it affects a larger intervention group. Independent: Intensive individualized diabetes education
Dependent: Baseline HbA1c based on the episodes of hypoglycemia reported by the target population. Intensive individualized education on hypoglycemia provided additional benefits as it helped the intervention group to manage blood sugar control. The intervention reinforced the need for healthy life style behavior related to dietary practices and physical exercise pattern to manage blood sugar.

Strength: Reinforcement education on diabetes management followed a standard protocol as defined in the education curriculum for self-care. This ensured that intervention of practice was guided by evidence.
Weakness: The study included a small number of participants and this is not substantial to draw evidence on practice. The research was based on a limited duration (6-months) to monitor change in behavior. A QOL assessment on hypoglycemia management was not conducted in the research meaning that outcomes of the results could be affected by patient factors such as anxiety, fear or non-adherence to the education program.
I The study used randomized control trials to analyze hypoglycemic episodes for target populations based on the intensive individualized diabetes education. The hypoglycemic episodes analyzed between the control and intervention groups was vital to affirm the effectiveness of the program. This is because the intervention improved behavior change towards lifestyle habits that enhances care for patients with type 2 diabetes mellitus.

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 LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 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.

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.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource