Using a minimum of 3 scholarly nursing sources, current within 5 years:
Identify and describe one practice-related issue or concern. You may choose to build on the practice issue you identified in NR500NP/NR501NP.
Explain why the issue/concern is important to nurse practitioner practice and its impact on health outcomes.
Describe each element of your PICOT question in one or two sentences, being sure to address all of the following:
P- “Population and problem” What is the nursing practice concern or problem and whom does it affect?
I- “Intervention” What evidence-based solution for the problem would you like to apply?
C- “Comparison” What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.
O- “Outcome” Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome.
T- “Time frame” What is the Timeframe involved for the EBP initiative or the target date of completion?
Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as:
PICOT question written in full =
Abide by the Chamberlain College of Nursing Academic Integrity Policy.
At the graduate level, we like to see you synthesizing your ideas into your own words. No direct quotes may be used in this worksheet.
Use APA formatting guidelines for references and citations.
Type 2 Diabetes.
Diabetes mellitus, type 1, type 2, or gestational diabetes, is among the chronic diseases that constitute the world’s leading mortalities. Diabetes is a metabolic disorder caused by extreme glucose levels in the body triggered by inadequate insulin or the body cells’ resistance to the available insulin (Ali et al., 2019). The prevalence of diabetes is increasing every day in the United States, with an estimated 13% of US adults being diabetic (Davidson et al., 2021). The disease is the leading cause of kidney failures, cardiovascular complications, blindness, non-alcoholic liver disease, and hepatitis. Type 2 diabetes is a common type constituting 90% of diabetic cases in the USA is linked to the inadequacy of insulin production in the body or the body cell’s resistance to its insulin. The condition is non-communicable and can be genetically inherited or triggered by environmental agents like smoking, unhealthy diet, stress, sedentary lifestyle, and pollution. A1c haemoglobin test is crucial in detecting the presence of type 2 diabetes by checking the blood sugar levels in a 2-3 months’ span; a drop in the HbA1c levels is positive while high HbA1c levels indicate high diabetic signs (Maggi et al., 2019).
Preventative care is a crucial practice in nursing to identify or prevent severe medical conditions and infections before their impacts are intensified through; screening, monthly or annual check-ups, immunizations, and psychological counselling. Type 2 diabetes can only be managed and prevented. Such preventative care strategies like early screening for symptomatic and asymptomatic patients, monitoring glucose levels, watching one’s lifestyle, diet, and any consumption is crucial in preventing diabetes and managing it before it advances to chronic stages. Kuts et al. (2018) compared A1c levels and general wellbeing of type 2 diabetic patients subjected to systematic primary care settings and those lacking the standardized preventative healthcare algorithms. The results depicted an improvement from 22 to 41 % in haemoglobin A1c control levels for the patients undergoing preventive care, with none for the patients lacking the care.
Importance of Preventative Care of Type 2 Diabetes to Nurse Practitioners’ Practice
Nurse practitioners (NP) are better positioned to integrate preventative care strategies in their practice. The risk of patients progressing from prediabetes to diabetes is minimized if preventive care strategies are integrated into nurses’ practice. The danger intensifies if the haemoglobin A1c level increases, commonly witnessed in patients with no primary preventative care. According to the US Preventive Services Task Force (USPSTF), preventative care measures avails effective preventive intervention for patients with a moderate net benefit on the health outcomes (Davidson et al., 2021).
NP s are the key stakeholders in providing primary care to all patients under them, and their role in the collaborative fight against diabetes type 2 is crucial. The American Diabetes Association (ADA) highly recommends Primary care for diabetic patients. NPs can easily engage in collaborative clinical practices to help patients control their HbA1c levels (Whitehead et al., 2017). The care strategies integrated by the NPs ensure that the A1c levels, blood pressure, and nephropathy attention are all regulated and help boost patients’ wellbeing and consequently reduce their haemoglobin A1c levels to normal range. According to Whitehead et al. (2017), NPs’ work in treating and managing type 2 diabetic patients is simplified. Their role is focused on implementing primary prevention care instead of treating and managing complex complications of the condition.
Generally, preventative care enhances the improved quality of care delivered by NPs to diabetic patients caused by the shift from inadequate to adequate care strategies. Early diagnosis helps shift focus to the specific type and implement the appropriate diabetic drugs to alleviate the symptoms for already infected patients. The NPs can use the intervention to guide type 2 diabetic patients to improve their self-efficacy and clinical outcomes by adhering to recommended care strategies.
Impacts of Preventative Care of Type 2 Diabetes on the Health Outcomes
The preventative care measures are vital in preventing further complications, which the type 2 patients without the care are susceptible to. According to Kutz et al. (2018), early screening of asymptomatic persons for type 2 diabetes and prediabetes, which triggers diabetes, helps immediately detect the diseases, which allows diagnosis and treatment at the early stages of the disease. Prevention helps improve the quality of life and health outcomes (Rowley et al., 2017). Patients at risk of contracting the disease, for example, the overweight and obese, the elderly, and those with the disorder in their lineage, should cautiously take preventive interventions as advised by the medical practitioners.
Embracing preventative care strategy implies ending any linked complications or associated health issues. The Continuous monitoring and controlling of blood sugar levels reduces the risk incidences of hypoglycaemia, a condition that bars glucose control efficacy, cardiovascular complications, blindness, and other associated risks. The intervention Informs research and invention of effective non-insulin diabetic treatment drugs. The health outcomes are impacted positively through the relevant positive modifications. Ali et al. (2019) highlight that diabetes preventative care helps implement programs that advise on lifestyle modification, diet control, awareness, education, and facilitating access and referrals for the patients. These measures remove inequalities in health access and generally reduce the prevalence of the disease. The example of the Latinos, African Americans, and Asian Americans whose prevalence of type 2 diabetes is high will improve their health.
Will an adult with type 2 diabetes provided with preventative care have a significant drop in haemoglobin A1c compared to a type 2 diabetic without preventative care in one year’s time?
Population: Adult with Type 2 diabetes (This comprises older patients above 18 years diagnosed with type 2 diabetes)
Intervention: Preventative care (This is a strategy used to identify or prevent severe medical conditions and infections before its impacts are intensified through; screening, education, monthly or annual check-ups, immunizations, and psychological counselling)
Comparison: Adults with Type 2 diabetes without preventative care (This is a comparison group consisting of Diabetic type 2 patients who lack all the preventive care measures)
Outcome: A significant drop in haemoglobin A1c levels (A reduction of HbA1c levels signifies a decrease in the diabetes infection in the body)
Time: In one year (Period for the outcome to be evident)
Ali, M. K., Bullard, K. M., Imperatore, G., Benoit, S. R., Rolka, D. B., Albright, A. L., & Gregg, E. W. (2019). Reach and use of diabetes prevention services in the United States, 2016-2017. JAMA network open, 2(5), e193160-e193160.
Davidson, K. W., Barry, M. J., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., … & US Preventive Services Task Force. (2021). Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. Jama, 326(8), 736-743.
Kutz, T. L., Roszhart, J. M., Hale, M., Dolan, V., Suchomski, G., & Jaeger, C. (2018). Improving comprehensive care for patients with diabetes. BMJ open quality, 7(4), e000101.
Maggi, D., Montecucco, F., Adami, G., & Cordera, R. (2019). Glycosylated haemoglobin (A1c) best values for type 2 diabetes in the battlefield much ado about nothing?(apparently). Diabetology & Metabolic Syndrome, 11(1), 1-3.
Rowley, W. R., Bezold, C., Arikan, Y., Byrne, E., & Krohe, S. (2017). Diabetes 2030: insights from yesterday, today, and future trends. Population health management, 20(1), 6-12.