Sharing Clinical Knowledge
Discuss the ethical aspects of acquiring and sharing knowledge, and how to share the knowledge with the body of the industry. Investigate the process for sharing knowledge through professionally acceptable venues.
Describe the following:
1. Area of interest – Advanced Clinical Practice
2. Discuss a clinical problem or a potential clinical problem to focus on as an identified topic in the Doctor of Nursing Practice Program (High blood Pressure, Diabetes)
3. Create a clinical question utilizing the PICOT format and PICOT formatting document
4. Why interested in this clinical problem (family history)
5. How is it relevant for the current society
6. Why it potentially warrants evidence-based practice change
7. Discuss plan for dissemination to share the knowledge attained from completing the proposed project
Sharing Clinical Knowledge
No one in the healthcare fraternity can claim to be self-sufficient in clinical expertise. Hence, practitioners often share their knowledge to boost care processes and improve health outcomes. However, for one to share, one must first acquire it. Knowledge acquisition occurs either in research or evidence-based practice (EBP) projects. The two often combine into one multidisciplinary concept where clinicians gather information, analyze, evaluate it, and then apply it to their clinical settings. The knowledge, in this case, would be the application outcomes. Therefore, the current paper explores a clinical problem, develops an EBP framework, and suggests an ethically-sound approach to sharing the knowledge one could gain from the project.
Area of Interest
The investigation will focus on evidence-based practice at the advanced clinical level. Advanced clinical practitioners usually have a Master’s degree and hence possess extensive and specialized skills and leadership competencies (Stewart-Lord et al., 2020). In nursing, they are the advanced practice registered nurses (APRNs). APRNs are paramount to modern healthcare systems due to their interdisciplinary capacities. First, they can conduct clinical processes such as assessment, diagnosis, prescription, and ordering laboratory. Their foundational nursing principles allow them to integrate various aspects into the healthcare delivery system. For instance, they can consider cultural inclinations and individual preferences in developing care and treatment plans. Lastly, APRNs are professional leaders. They can coordinate a team of junior clinicians to accomplish organizational goals. They are also pivotal to healthcare legislation and policymaking. Hence, APRNs are excellent examples of what advanced clinical practice entails. Exploring a clinical problem at this level will provide a comprehensive outlook on knowledge acquisition and sharing.
The paper will focus on the hypertension-diabetes comorbidity. Hypertension is a condition where an individual’s blood pressure is high, damaging different internal organs and affecting functionality. On the other diabetes mellitus occurs when the pancreas cannot regulate the amount of glucose present in the blood. Diabetes mellitus can be type 1 (where an autoimmune response damages the pancreatic tissues) or type 2 (where the body develops tolerance to insulin). Both chronic diseases and comorbidity require advanced clinical knowledge to guarantee positive health outcomes.
First, two conditions share the risk factors, making their coexistence non-accidental. For instance, dietary habits are significant. Poor eating habits are likely to result in one being obese, which increases the likelihood of developing type 2 diabetes (Taylor, 2020). Similarly, consuming foods with high sodium content expose one to hypertension. While the sodium may come from table salt, people also consume it from soft drinks, which also have high caloric contents, contributing to weight gain. Another important shared risk factor is genetics and family history. The autoimmune response in type 1 diabetes and the insulin insensitivity in type 2 have a strong genetic history. The same applies to hypertension, where a family history significantly increases the risk of developing it (WHO, 2021). Lastly, the incidence of both diseases has a strong correlation to age. While type 1 diabetes tends to develop more during childhood and early adulthood, type 2 diabetes and hypertension affect older adults more. Thus, as the average global lifespan extends and the population ages, these conditions appear more often.
Either disease is potentially life-threatening on its own, making their comorbidity devastating. Patients experience a much more severe syndrome, resulting in an accelerating decline in functionality. Also, since both diseases require clinical attention, patients spend twice on medication and other healthcare services. However, these drugs tend to interact with each other, altering their impact on the body or causing severe side effects (Dobrică et al., 2019). Therefore, there is no standardized care and treatment plan. Clinicians modify it during the cause of treatment until they find what works for each patient. Thus, the clinician must be highly-skilled and culturally competent to achieve medical stability.
However, hypertension-diabetes comorbidity has one advantage: the management protocols for each disease are similar. Healthcare professionals encourage self-management interventions, such as drug administration and daily remote testing. Also, changes to dietary patterns and activity levels require the patient to be in control of their health (WHO, 2021, Taylor, 2020 ). Hence, the shared risk factors, treatment complications, and common self-care routines present an interesting knowledge-gaining and sharing field for advanced clinical practitioners.
PICOT is an acronym representing the population, intervention, comparison, outcome, and time. Thus, it is a format that healthcare researchers use to formulate research questions. PICOT questions warrant an evidence-based research approach where one compares two interventions to determine which provides better outcomes.
The PICOT question for the current investigation is:
Among people with hypertension-diabetes comorbidity (P), how do patient empowerment programs (I) compare to family engagement (C) in promoting adherence, reducing multi-drug interaction, and improving quality of life (O) during the first year of diagnosis (T)?
The research will focus on people with the hypertension-diabetes comorbidity; hence they are the designated population. Next, the intervention relates to patient empowerment. Patient empowerment is a therapeutic approach where the caregiver enables the client to gain more control of their health status (Wakefield et al., 2018). Empowering patients entails educating them, connecting them to community resources, finding personal motivators, and utilizing them to maintain their well-being. On the other hand, family engagement involves using relatives to promote health outcomes. Thus, the caregiver empowers the family member to take care of the patient.
One can compare the efficacy of the two approaches based on the outcomes. The research question focuses on three primary results: adherence, multi-drug interaction, and quality of life. First, adherence refers to the patient’s commitment to follow the prescribed treatment and care plan. Reducing or eliminating multi-drug interaction is also an important outcome as it improves the patient’s general wellness. Ultimately, one can evaluate the alternative interventions based on the individual’s quality of life (QoL). The patients should be free from the adversities of the comorbidity and conduct their personal, professional, or academic tasks as healthy individuals. Therefore, the three metrics will form the basis of the EBP project’s evaluation.
Lastly, the time limit for determining the intervention’s effectiveness is the first year since diagnosis. During this time, the patient usually struggles to adjust to a new lifestyle. Furthermore, drug-drug interactions manifest at this point, prompting clinical revisions to the treatment process. Hence, if the caregiver’s intervention can guarantee positive outcomes within this time frame, one can consider them successful in improving the comorbidity’s management.
Reasons for Interest
The student-practitioner is interested in the hypertension-diabetes comorbidity due to family history. Various relatives have developed the two conditions simultaneously, and the student witnessed the challenges they encountered. Furthermore, the strong hereditary risk factor means that the student could also develop either or both illnesses. Thus, seeking additional knowledge on the topic and sharing it with other clinicians will allow other individuals and families not to undergo the same hardships as the student’s kin.
Relevance of the Hypertension-Diabetes Comorbidity
Individually or in coexistence, the diseases are relevant concerns in modern society. First, advancements in medical processes have allowed clinicians to develop cures for most traditional diseases. Furthermore, technological developments have made life more conducive, resulting in fewer natural health hazards (Ogura & Jakovljevic, 2018). Consequently, people live longer. Both of these diseases tend to occur more during older age. Hence, as the population ages, the diseases’ prevalence increases.
Next, people now lead more sedentary yet hectic lives. Most professions entail spending a lot of time immobile (Park et al., 2020). Moreover, socioeconomic dynamics make people spend more time working and commuting to and from work, reducing the amount of time they have to prepare decent, healthy meals. Thus, the same people that work for over twelve hours per day, most of which is sedentary, will then waste more time in traffic. By the time they arrive home, they are too tired to cook and eventually rely on processed foods. Therefore, this modern lifestyle makes exploring the hypertension-diabetes comorbidity relevant.