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Assignment 1
This competency assessment assesses the following Outcome:
MN504-1: Discover evidence based data used in clinical practice.
Assignment Details – Discover Evidence-Based Data Used in Clinical Practice
Purpose:
This assignment helps identify areas of clinical interest that you may have in integrating evidence into the population of interest. You will begin to find evidence as it relates to your practice of interest. (FNP)
An introduction, discussion, and conclusion are expected in the overview on this topic.
Directions:
Minimum Submission Requirements
If the work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision. If the work submitted does not meet the minimum submission requirements by the end of the term, you will receive a failing score.
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METIdentified three evidence-based references to formulate a valid clinical question [Clearly Identified three relevant evidence based references related to a clinical question] Defined the clinical question. [Succinctly defined the clinical question as it relates to the topic] Summarized evidence for PICOT [Clearly and precisely summarized the evidence for the PICOT] Identified relevant databases [Clearly identified databases relevant to the clinical question] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
Family Nurse Practitioners are important practitioners in primary care. Unlike other advanced practice nurses, they do not work with a specific population and thus function as general specialists in primary care. They identify gaps in care delivery for all populations across the lifespan. Their advanced knowledge and skills make it possible to provide advanced care to diverse populations. An FNP analyzes current problems and prepares well-structured and highly efficient care plans for the healthcare problems. Diabetes is a significant healthcare problem with high healthcare costs and mortality and morbidity rates. This essay analyzes a diabetes clinical question, reviews useful databases for research, and presents formidable data for the clinical question.
Clinical Question: Among elderly diabetic patients, does standardized patient education compared to traditional education improve self-management, adherence to interventions, and follow-up visits in six months?
Nursing research requires various considerations to ensure the data is reliable, relevant, and applicable. Thus, identifying the best and most relevant databases is vital in getting quality evidence. For diabetes care, there are several reliable and relevant databases. These databases include PubMed (NCBI), CINAHL Plus with Full Text (EBSCO), Academic Search Complete (EBSCO), and Cochrane Library (Wiley) (Welch Medical Library, 2021). PubMed (NCBI) is a database developed and managed by the national center for biotechnology information. The database is a free search engine containing medical-related articles, abstracts, and references. PubMed’s main aim is to improve health both globally and personally hence it has a collection of healthcare research articles that provide reliable evidence for application in managing healthcare problems. The database is reputable in providing all kinds of publications. However, the primary resources are rather wide-spreading, making accreditation and filtration of these resources difficult. Thus, the website may not be a reliable source of evidence.
CINAHL Plus with Full Text (EBSCO) database provides the top available nursing literature and other closely related health disciplines (Welch Medical Library, 2021). The database is vital because it allows for full-text nursing literature, not readily available in other databases. The researchers get all information without incurring costs or being limited by less available knowledge. The articles available are also peer-reviewed, making them reliable and applicable. Academic Search Complete (EBSCO) database is a leading source of scholarly literature. The database is designed for institutions, and thus the database is accessible through the institution library. It contains literature from all disciplines, including social sciences. The database has a higher preference for high-level evidence articles such as systematic reviews and randomized control trials. The articles in this database are also full text making it easy to read, understand, and apply evidence.
Cochrane Library (Wiley) is the database of choice for the Picot question. The database collects systematic reviews, which provide the highest level of evidence in research and evidence-based practices evaluation and implementation (Welch Medical Library, 2021). The systematic reviews identify an intervention for a healthcare condition or problem and analyze evidence to determine the effectiveness of the intervention. The database is free and open, with open access to majorly of the research articles. They are critically filtered and reviewed before being published, making the database a globally recognized and reputable database for systematic reviews in healthcare. These databases are vital for providing evidence for developing the PICOT question.
Diabetes is a severe clinical problem. It is the most expensive chronic illness and has a high mortality and morbidity rate; hence it is a disease of clinical significance (Riddle & Herman, 2018). Diabetes care is palliative and requires the collaboration of the patient, primary caregivers, and healthcare providers (Lee et al., 2019). Diabetes education is a vital aspect of diabetes care. Most interventions in diabetes management depend on the patient. The quality of patient education determines their self-efficacy, self-management, and overall success in diabetes care. The components of diabetes education are insulin injection and injection sites, medications and side effects, diet, exercise, disease complications (for early identification and management), and patient follow-up interventions and their importance (Ghisi et al., 2021).
Traditional patient education has no clear framework for delivering the education. Healthcare providers teach patients about diabetes care, but there is a high possibility of ignoring or forgetting components. Ignoring some aspects leads to patient knowledge deficits hence deficiencies in self-care and self-management. Structured patient education is a formidable tool in ensuring patients receive education in all diabetic care interventions (Chatterjee et al., 2018). In addition, it ensures that patients receive uniform and quality care, hence better patient outcomes. The primary aims of diabetes management are stabilizing blood sugars, achieving therapeutic targets (HbA1c tests), increasing self-efficacy and self-management, and minimizing complications (Zheng et al., 2019).
Education removes negligent excuses and promotes ethical responsibility. Diabetes follow-up visits are also vital in diabetes management. The components of follow-up visits include diabetic foot and diabetic eye examinations, HbA1c tests, treatment modality evaluation, and drug replenishment (Lee et al., 2019). Individuals rely heavily on merit systems to gauge interventions. Emphasizing the importance of follow-up visits is integral to ensuring individuals take the initiative, plan, and attend these follow-up visits without fail. These interventions are essential to providing high-quality disease management and early detection and treatment of complications. According to Rahaman et al. (2018), diabetes education on foot care decreases diabetes foot complications and increases diabetes foot examinations rates. Educating patients will improve their care-seeking behavior. Diabetes education reminds patients of the importance of these follow-up visits and the consequences of attending follow-up visits.
As mentioned earlier, standardized nursing technologies ensure patients receive uniform education (Chatterjee et al., 2018). Preparing the education checklist will require advanced knowledge and skills. As an FNP, I will utilize my advanced knowledge and skills, care collaboration, and leadership skills to gain buy-in from the healthcare leaders and develop a diabetes education checklist for the institution. The checklist will be uploaded in the electronic health system and signed when education is delivered. The checklist will be part of diabetes patient care and stored in the patient falls for record purposes and future references.
FNPs are advanced practice nurses with advanced knowledge which can be used to improve the health outcomes of populations across the lifespan. Formidable databases that provide articles for evidence-based practice include PubMed, Cochrane Library, Academic Search Complete (EBSCO), and CINAHL Plus with Full Text (EBSCO). They have extensive collections of articles for interventions in diabetes care. Structured diabetic patient education improves adherence to medications, increases patient follow-up visits, and improves self-management and self-efficacy. Structured patient education is thus more effective than traditional patient education. Hospitals should utilize structured patient education and diabetes education checklist to help improve diabetic patient outcomes.
Chatterjee, S., Davies, M. J., Heller, S., Speight, J., Snoek, F. J., & Khunti, K. (2018). Diabetes structured self-management education programs: a narrative review and current innovations. The Lancet Diabetes & Endocrinology, 6(2), 130-142. https://doi.org/10.1016/S2213-8587(17)30239-5
Ghisi, G. L. D. M., Seixas, M. B., Pereira, D. S., Cisneros, L. L., Ezequiel, D. G. A., Aultman, C., Sandison, N., Oh, P., & da Silva, L. P. (2021). Patient education program for Brazilians living with diabetes and prediabetes: findings from a development study. BMC Public Health, 21(1), 1-16. https://doi.org/10.1186/s12889-021-11300-y
Lee, D., & Zonszein, J. (2022). Outpatient Management of Type 2 Diabetes Mellitus. In A Case-Based Guide to Clinical Endocrinology (pp. 369-385). Springer, Cham. https://doi.org/10.1007/978-3-030-84367-0_40
Rahaman, H. S., Jyotsna, V. P., Sreenivas, V., Krishnan, A., & Tandon, N. (2018). Effectiveness of a patient education module on diabetic foot care in outpatient setting: An open-label randomized controlled study. Indian Journal of Endocrinology and Metabolism, 22(1), 74. https://dx.doi.org/10.4103/ijem.IJEM_148_17
Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care—an elephant in the room. Diabetes Care, 41(5), 929-932. https://doi.org/10.2337/dci18-0012
Welch Medical Library (2021). Databases for Nursing Research. Nursing Resources. The John Hopkins University of Medicine. https://browse.welch.jhmi.edu/nursing_resources
Zheng, F., Liu, S., Liu, Y., & Deng, L. (2019). Effects of an outpatient diabetes self-management education on patients with type 2 diabetes in China: a randomized controlled trial. Journal of Diabetes Research, 2019. https://doi.org/10.1155/2019/1073131
This competency assessment assesses the following Outcomes:
MN504-2: Examine the key elements of evidence based practice.
Assignment Details – Descriptive Statistics Overview
Purpose:
The purpose of this assignment is to review the statistics presented in the articles you reviewed in relation to your clinical topic. You will provide a brief overview of statistics in the studies.
Directions:
Minimum Submission Requirements
If the work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision. If the work submitted does not meet the minimum submission requirements by the end of the term, you will receive a failing score.
Textbook Readings
Evidence-Based Practice in Nursing and Healthcare
Journal Readings
Please retrieve and read the following Journal articles from the Library. Articles can be located through a search in the CINAHL database, OVID database, Course Resources, or by using the link at the end of the reference if provided.
Jesson, J., & Lacey, L. (2006). How to do (or not to do) a critical literature review. Pharmacy Education, 6(2), 139–148.
Pierce, L. (2009). Twelve steps for success in the nursing research journey. Journal of Continuing Education in Nursing, 40(4), 154–164.
Salmond, S. W. (2007). Advancing evidence-based practice: A primer. Orthopedic Nursing, 26(2), 114–125.
Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics & Decision Making, 7(1), 16–26
Web Resources
Review the following website, specifically the Continuing Education articles under Tools and Resources, and the About Us section.
Review the sites below that detail ongoing research efforts.
Review the NCQA website, paying special attention to the clinician’s website, specifically the Patient Experience Reporting section.
It is expected that you spend approximately 1–2 hours reviewing this resource.
Practice
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METDefined key clinical question with reference to evidence-based databank (for example, Pubmed, Medline, CINAHL, etc). [Clearly defined the key clinical question as it relates to the evidence] Reviewed database results (based on key clinical question search) [Succinctly reviewed database detailed results] Referenced randomized control study research and systematic review of randomized control studies (Level 1 and 2 Evidence). [Clearly referenced randomized control study research studies , representing Level 1 and 2 of evidence with clarity] Provided an overview of the evidence using descriptive statistics, including the sample size, p-factor and strength of evidence. Clearly provided and overview of the evidence with descriptive statistics used throughout to define the strength of the evidence and study. Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
CLA and Grade Criteria Chart
CRITERIACLA ScoreGradePointsMeets all bold criteria and 50%-100% of mastery criteria5A1,000Meets all bold criteria and 0%-49% of mastery criteria4B850Meets 75%-99% of bold criteria3Not yet competent (F at term end)0Meets 50%-74% of bold criteria2Not yet competent (F at term end)0Meets 1%-49% of bold criteria1Not yet competent (F at term end)0Meets no bold criteria0Not yet competent (F at term end)0No submissionNANot yet competent (F at term end)0MN504-3: Differentiate statistical output for data analysis.
Assignment Details
Evidence-Based Clinical Question Search Assignment
Purpose:
The purpose of this assignment is to give you a practical application to implement your compelling clinical question idea, supported by the evidence-based research you have obtained during your systematic review. You will apply evidence-based research findings discovered from your clinical question, and then integrate those to support your suggested change in nursing practice.
Directions:
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METDescribe systematic review and include an errors analysis. [Clearly described the systematic review with errors analysis integrated] Summarize the case study (RCT) selected including the study approach, sample size, and population studied. [Clearly summarized the case study with a detailed overview of case details such as sample size, control group, and study approach] Evaluate the study outcomes, identifying the validity, reliability, and bias. [Provide a clear description of the study including any unique approach, reliability, validity, and bias noted] Apply the evidence from this review to your practice specifically in your overview. [Clearly applied the evidence from the review to practice including detailed descriptions of the study] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
CLA and Grade Criteria Chart
CRITERIACLA ScoreGradePointsMeets all bold criteria and 50%-100% of mastery criteria5A1,000Meets all bold criteria and 0%-49% of mastery criteria4B850Meets 75%-99% of bold criteria3Not yet competent (F at term end)0Meets 50%-74% of bold criteria2Not yet competent (F at term end)0Meets 1%-49% of bold criteria1Not yet competent (F at term end)0Meets no bold criteria0Not yet competent (F at term end)0No submissionNANot yet competent (F at term end)0Clinical questions help improve nursing practice, education, and research. They require extensive research to validate or refute claims and gain insight into the topic to ensure it is of high quality and efficacy. A proper analysis of randomized control trials provides high-level evidence, and their results are applicable in various ways in healthcare settings. The information can also be used in various ways to inform care interventions. Advanced practice nurses are majorly managers of the healing environment, and they utilize research to prepare and improve care interventions. They also utilize their knowledge, skills, and positions to improve healthcare institutions and care delivery. This essay evaluates a clinical question and supporting literature and utilizes the evidence to improve FNP practice.
Among elderly diabetic patients, does standardized patient education compared to traditional education improve self-management, adherence to treatment modalities, and follow-up visits in six months? This short review evaluates evidence that informed the clinical question and any modifications to ensure the change is impactful and relevant to the selected healthcare settings. The review also gives reasons and insights that led to the development of the question. Diabetes among elderly patients is a rummaging condition, affecting about 20-30% of adults above 65 years old (Sinclair et al., 2020). The condition is also very expensive due to the daily treatment modalities such as insulin. In addition, elderly patients have declining cognitive, physical, and physiologic functions primarily due to old age and associated conditions. Decreasing immunity, physiologic function, and activity are leading causes of poor prognosis in managing diabetes in the elderly. Thus, the group is exposed to higher mortalities and morbidities than other groups creating the need for vigorous management.
Standardized or structured patient education is education based on a checklist or education tailored to meet all patient needs and offer vital skills and knowledge. It focuses on the outlined components of health education that are carefully selected and appraised as vital to achieving the desired output (Chatterjee et al., 2018). For example, the care provider can teach patients specific exercises for older adults considering their physical and physiologic limitations instead of just telling them to exercise, as in traditional patient education. It is organized in chronological order of relevance and importance to promote patient understanding and minimize time wasted gathering education materials (Ernawati et al., 2021). The checklist also provides a vital follow-up tool that improves professionals’ responsibility and adherence to the interventions. Traditional education lacks order of education increases the chances of missing out on information or the education exercise because it provides no care provider follow-up intervention. Thus, structured education is integral for diabetic patients to promote better health outcomes.
The disease is preventable through education and collaborative intervention between healthcare providers and patients. Knowledge and skills to manage diabetes are vital. Educating patients to help ensure they adhere to routine medication administration, diet/ eating habits, and exercise/ physical activity. Individuals with skills have a likelihood of utilizing them (self-efficacy). Treatment adherence is also expected to increase when patients learn the importance of adhering to the modalities. Diabetes complications are notorious and take a long to manage, and thus, it is vital to prevent them (Ghisi et al., 2021). They are prevented through up and periodic visits to determine patterns leading to their development and thus preventing them from developing early in their development stages. Diabetes follow-up entails diabetic foot examination, eye examination, and HbA1c tests. Educating patients helps them understand the importance of adhering to these visits, thus increasing their adherence to follow-up care which helps prevent complications and promote effective glycemic control.
Diabetes management interventions take time to produce change. Individuals also take time to adapt to new interventions hence the need for six months. The change has been clearly and carefully crafted to produc
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