NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

Sample Answer for NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach Included After Question

For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source\’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

In your submission, make sure you address the following grading criteria:

Define a practice issue to be explored via a PICO(T) approach.

Identify sources of evidence that could be potentially effective in answering a PICO(T) question.

Explain the findings from articles or other sources of evidence.

Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.

Communicate using writing that is clear, logical, and professional with correct grammar and spelling using the current APA style.

A Sample Answer For the Assignment: NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach

Title: NURS FPX 4030 Assessment 3 PICO(T) Questions and an Evidence-Based Approach  

Selected Practice Issue

The selected practice issue is diabetes mellitus type 2. Diabetes mellitus type 2 is a metabolic disorder that arises from the inability of the body to regulate glucose. The prevalence of diabetes mellitus type 2 has been rising significantly in not only America but also other parts of the world too. According to statistics from empirical evidences, the percentage of people with diabetes in the US in 2015 was estimated to be 9.4%. The percentage represented about 30.3 million people in the US. The number of people with diabetes during the same year globally was also estimated to be 415 million. Statistical projections reveal that the number of people affected by diabetes will increase to 642 million people globally by the year 2040. Diabetes mellitus type 2 is the most common type of diabetes in the affected population (Xu et al., 2018).

The complications of diabetes mellitus cause significant disease burden to patients and their families. Complications such as hyperglycemia, hypoglycemia, and diabetic nephropathy require frequent hospitalizations for their management, which can be financially, emotionally, and physically exhausting to their affected and significant others (Zimmet et al., 2016). In response to this burden of the disease, a focus has been placed on the incorporation of technology into the management of diabetes mellitus. New technologies such as telehealth and telemedicine have been identified as effective interventions that can be used to improve the treatment outcomes in diabetes and optimize the experiences of the patients (Wang et al., 2017). 

Telehealth and telemedicine technologies enable the healthcare providers to monitor patients with diabetes remotely. The benefits to the patients include regular interaction with their providers, health education, and early identification and management of their symptoms. The technology also reduces the costs of care due to reduced travelling and hospitalization, and improved patient satisfaction with care secondary to patient-centeredness in care (Tchero et al., 2018). Despite the existing evidence recommending the use of technologies to improve the management of diabetes mellitus type 2, our practice setting has not embraced its use in the improvement of treatment outcomes in patients with diabetes mellitus type 2. Therefore, the proposed project will seek to determine the effectiveness of telemedicine in improving the treatment outcomes in patients with diabetes mellitus type 2. The project will guided by the following PICOT question:

In patients with diabetes mellitus type 2, does the use of telemedicine improve symptoms management and quality of life in patients within a period of six months when compared to the use of usual care?

Sources of Evidence

The proposed investigation is an evidence-based practice project. As a result, the use of credible sources of evidence is critical to ensure that the making of sound conclusions about the effectiveness of the project. The sources of evidence for the investigation will mainly comprise of peer-reviewed researches. Peer-reviewed studies provide highly accurate information that can be utilized in the implementation of evidence-based projects. Peer-reviewed sources of data also have minimal errors and issues related to validity and reliability. The peer-reviewed sources of data that are effective for the investigation include journals and articles published in professional databases such as PubMed, CINAHL, and EMBASE.

The selection of the sources of data for the project will be based on their relevance to the PICOT question. The studies should have investigated the effect of telemedicine on the treatment outcomes in diabetes mellitus type 2. The other selection criterion is the year of publication. Studies that were published within the last five years will be used to ensure currency of information and relevance to the patient experiences. Examples of sources of data that meet the above criteria and will be utilized for the project include the studies conducted by Sun et al., (2019, Tchero et al., (2018) and Wang et al., (2017).

Findings from Articles

Studies conducted in the past have demonstrated enhanced effectiveness of telemedicine in use for the management of diabetes mellitus type 2. One of these studies is a meta-analysis of 42 randomized controlled clinical trials that was undertaken by Tchero et al., (2018). The meta-analysis focused on randomized controlled trials that investigated the effectiveness of telemedicine versus the usual care in the management of diabetes mellitus type 2. The analysis of results from the selected studies showed that telemedicine was associated with a significant mean reduction in HbA1c in patients with type 2 diabetes mellitus when compared to diabetes mellitus type 1. The effects were also sustained for a period of more than six months (Tchero et al., 2018).

Another study is the one conducted by Wang et al., (2017) that compared the effectiveness of telemedicine versus the conventional care. Participants were randomly assigned to either the treatment or the control groups. The analysis of the data revealed that the participants in the treatment group had significantly lower fasting plasma than control group. Triglyceride levels, 2-hour postprandial plasma glucose levels, and HbA1c levels were significantly reduced in the treatment group than in the control group. The rate of treatment adherence in the participants in the treatment group was also higher than in the control group (Wang et al., 2017).

The last study that can be utilized to show the effectiveness of telemedicine in the management of diabetes mellitus type 2 is the research by Sun et al., (2019). The study by Sun et al., (2019) was a randomized controlled study that investigated the use of mobile phone-based telemedicine in the management of diabetes mellitus type 2 in elderly patients. The patients in the intervention group received glucometers that transmitted data electronically and health education on lifestyle and behavioral modifications for the management of diabetes mellitus type 2. The participants in the control group received the usual care without any additional intervention. The analysis of data from both groups in the study showed that there was significant improvement in the levels of postprandial plasma glucose and glycated hemoglobin in the treatment group than in control (Sun et al., 2019). As a result, the researchers recommended the need for the incorporation of telemedicine into the clinical management of diabetes mellitus type 2. The results from the above studies are most credible due to the methods used such as randomization and meta-analysis of randomized controlled studies.

Relevance of the Findings

The above findings are relevant to the PICOT statement in a number of ways. Firstly, the findings show that telemedicine is an effective intervention that can be utilized to improve the outcomes of management in patients with diabetes mellitus type 2. The findings are also relevant because they demonstrate the effectiveness of telemedicine in use in patients from different ages and backgrounds. The studies show that telemedicine can be used in adult, elderly, and young patients to optimize the management of the disease. The last relevance of the findings in the above studies is that they show that telemedicine improves the symptoms of treatment in diabetes, which enhances the quality of life and efficiency of care given to patients with diabetes mellitus type 2.

References

Sun, C., Sun, L., Xi, S., Zhang, H., Wang, H., Feng, Y., Deng, Y., Wang, H., Xiao, X., Wang, G., Gao, Y., & Wang, G. (2019). Mobile Phone–Based Telemedicine Practice in Older Chinese Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial. JMIR MHealth and UHealth, 7(1), e10664. https://doi.org/10.2196/10664

Tchero, H., Kangambega, P., Briatte, C., Brunet-Houdard, S., Retali, G.-R., & Rusch, E. (2018). Clinical Effectiveness of Telemedicine in Diabetes Mellitus: A Meta-Analysis of 42 Randomized Controlled Trials. Telemedicine and E-Health, 25(7), 569–583. https://doi.org/10.1089/tmj.2018.0128

Wang, G., Zhang, Z., Feng, Y., Sun, L., Xiao, X., Wang, G., Gao, Y., Wang, H., Zhang, H., Deng, Y., & Sun, C. (2017). Telemedicine in the Management of Type 2 Diabetes Mellitus. The American Journal of the Medical Sciences, 353(1), 1–5. https://doi.org/10.1016/j.amjms.2016.10.008

Xu, G., Liu, B., Sun, Y., Du, Y., Snetselaar, L. G., Hu, F. B., & Bao, W. (2018). Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: Population based study. BMJ, 362. https://doi.org/10.1136/bmj.k1497

Zimmet, P., Alberti, K. G., Magliano, D. J., & Bennett, P. H. (2016). Diabetes mellitus statistics on prevalence and mortality: Facts and fallacies. Nature Reviews Endocrinology, 12(10), 616–622. https://doi.org/10.1038/nrendo.2016.105