MN504-5: Evaluate interdisciplinary approaches to organizational and system change through evidence based practice

Evaluating Clinical Question Publication

Nursing research, practice, and education are significant components of nursing. Nursing research is a vital pillar that supports nursing education and nursing practice. Nursing research produces studies that test to refute or affirm abstractions, create new knowledge, and determine causal-effect relationships, contributing to evidence-based practices. Nursing research is highly sensitive, and the information produced requires evaluation to ensure it meets the data standards for nursing research. Information from studies should be shared widely to improve nursing practice. The correct choice of journal for publications is also vital to ensure the data reaches a large population and is implemented. This essay analyzes an identified clinical question focusing on research and available publication opportunities for the clinical question.

Describe a Clinical Question

The clinical question is: 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? My area of clinical practice is primary care which is the focus of family nurse practitioners. Elderly patients present various knowledge gaps and complicated healthcare conditions. Diabetes is a disease of clinical significance to primary care. Epidemiological statistics show that diabetes is the 8th leading cause of death globally and a leading cause of morbidities such as hearing and vision loss (Menneilly et al., 2018). Diabetes exacerbates underlying systemic conditions such as hypertension and renal failure. The disease has been identified as a comorbid condition associated with high mortalities in other diseases. Cancer, HIV, heart disease, COVID 19, and acute renal injury are conditions reported to have high mortality rates (Nowakowska et al., 2019). Diabetes is an expensive condition and accounts for over 25% of healthcare spending due to complications such as stroke and amputations (Riddle & Herman, 2018). Diabetes management is complex and requires collaboration between interprofessional, patient, and primary care providers. Unlike other conditions, most of the care interventions are carried out by the patient and the primary care provider hence the need for comprehensive patient assessment. Diabetes management also requires keen follow-up to detect and manage complications early.

Growth of the Question in Research Possibilities

The clinical question can grow in various ways in research. The growth will be determined by the multiple goals, objectives, and desired outcomes of the clinical question and its interventions. The first step is to identify the interaction between patient education and diabetes management and the studies that emphasize patient education in diabetes management (Ghisi et al., 2021). It is also vital to understand the traditional patient education methods and their success and flaws (Rahaman et al., 2018). The results will then inform the structured patient education to address these gaps. Evidence-based practices are vital in healthcare, and identifying studies that provide evidence on the effectiveness of structured diabetes education will further inform the research.

Another investigation identifies studies that explain how diabetes interacts with elderly patients compared to the rest of the population (Meneilly et al., 2018). These differences can further inform the chosen interventions to ensure effectiveness and relevance. The nurse practitioner, the researcher, identifies the effects of education on the identified population and determines the best interventions. Another direction is selecting healthcare technologies that can be integrated into the chosen intervention and the appropriacy in the population of interest (Rahaman et al., 2018). Contributions from different studies can also help the researcher determine the most appropriate topics in the education program. Choosing the current best practices such as recommended diets, medications, and follow-up visits is vital. The nurse practitioner will then use the information to prepare the diabetes education program and ensure quality outcomes for the patients.

Potential Publication

There are various opportunities for publishing information on structured diabetes education in future authorship. The journal of diabetes, journal of diabetes & metabolism, and journal of diabetes research are vital journals in diabetes research (Contreras & Vehi, 2018). A potential publisher is the journal of diabetes & metabolism. It is an open publications journal that features scientific work of great significance and impact from virtually all fields of diabetes. It ensures information is available online widely to improve article impact and promote the utilization of research information therein. The journal is specific to diabetes, and hence the editorial process is constructive, courteous, and effective. Articles are peer-reviewed by prominent scientists in the diabetology field. Thus, the journal is a reliable potential publisher.

The journal of diabetes is the second pliable publisher in diabetes-related research. The journal is an open-access journal from 2022, which increases the availability of the information and the possibility of its implementation. The journal does not have submission charges but only pocket-friendly costs, unlike other journals that charge high submission and publication fees. The journal of diabetes research provides open access and peer-reviewed articles that address etiology, management, pathogenesis, prevention, and complications. The journal has a serious editorial team that filters many flawed research articles, evidenced by the low acceptance rate. Hence, the journal is trusted by many individuals; articles published by the journal have a broad audience. Publishing with this journal will ensure the information is shared widely and accessible to many consumers of nursing research.

Collaborative Practice Opportunities

Interprofessional collaboration in diabetes management is vital. Interprofessional team collaboration is critical in the project’s preparation, implementation, and evaluation. In structured diabetes education, there are various opportunities for interprofessional collaboration. One opportunity is in preparing a structured diabetes education. The interprofessional team, through shared decision-making, will provide their varied perspectives to the education plan to ensure it meets the patients’ holistic needs (Nowakowska et al., 2019). Another opportunity is the implementation of structured patient education. Areas of education such as nutrition, pharmacologic management, and psychological welfare require professionals to ensure they are comprehensively addressed. Nutritionists, pharmacists, and psychologists can be assigned roles of teaching patients these interventions

Overview of Guideline and Discussion

LeRoith et al. (2019) is a clinical practice guideline that addresses diabetes management in older adults. The guideline provides a list of recommendations on diabetes management from diagnosis, management, and follow-up interventions. The guideline recommends fasting blood glucose and HbA1c tests for diagnosis and suggests a complete health history, personal values, nutritional status, and cognitive health during diagnosis.

These recommendations will be incorporated into the clinical question research to ensure holistic, individualized patient care. It also recommends lifestyle modification as the first-line management of hypoglycemia, metformin as the first-line antidiabetic medication, and insulin as the second-line intervention. These interventions will be integral in determining the best treatment regime and planning health education components (such as medications and side effects and injection sites) for the clinical question. The guideline also recommends an annual lipid profile, eye exam, foot exam, and HbA1c tests (LeRoith et al., 2019). These recommendations are most relevant, in addition to other interventions. The clinical question will address these recommendations and incorporate them to ensure high-quality outcomes.

Conclusion

Nursing research is an essential facet of professional practice and education. Diabetes management can benefit greatly from extensive research and evidence-based practices from existing research. Patient education is vital in diabetes management because most interventions are patient and primary care provider-based. There are various available opportunities for publishing diabetes research, and they include the journal of diabetes, the journal of diabetes research, and the journal of diabetes & metabolism. These journals focus on diabetes, making them the best publishing options. Incorporating interprofessional perspectives, collaboration, and clinical practice guidelines in diabetes management is also integral for practical, holistic, and individualized care.

References

Contreras, I., & Vehi, J. (2018). Artificial intelligence for diabetes management and decision support: a literature review. Journal of medical Internet Research20(5), e10775. https://doi.org/10.2196/10775

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

LeRoith, D., Biessels, G. J., Braithwaite, S. S., Casanueva, F. F., Draznin, B., Halter, J. B., Hirsch, I. B., McDonnell, M. E., Molitch, M. E., Murad, M. H., & Sinclair, A. J. (2019). Treatment of diabetes in older adults: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism104(5), 1520-1574.https://doi.org/10.1210/jc.2019-00198

Meneilly, G. S., Knip, A., Miller, D. B., Sherifali, D., Tessier, D., & Zahedi, A. (2018). Diabetes in older people. Canadian Journal of Diabetes42, S283-S295. https://doi.org/10.1016/j.jcjd.2017.10.021

Nowakowska, M., Zghebi, S. S., Ashcroft, D. M., Buchan, I., Chew-Graham, C., Holt, T., Mallen, C., Marwijk, H., Peek, N., Perera-Salazar, R., Reeves, D., Rutter, M. K., Weng, S. F., Qureshi, N., Mamas, A. M., & Kontopantelis, E. (2019). The comorbidity burden of type 2 diabetes mellitus: patterns, clusters, and predictions from a large English primary care cohort. BMC Medicine17(1), 1-10. https://doi.org/10.1186/s12916-019-1373-y

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

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

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