Question:

Topic: PICO System

Introduction to the Problem and Problem Description. Statement Assignment

The introduction is where the topic is explained and the purpose of your paper clearly stated.

Literature Review

Define your PICO, the scope of research done and the application to it.

Answer pico question about patient with recently diagnosed t2d.

Answer to Question: NURS 3402-001 Nursing Research And Evidence-Based Practice

Introduction

Diabetes mellitus can be described as a metabolic condition in which blood sugar levels rise with elevated blood pressure.

If diabetes is not managed, it can lead directly to hyperosmolarhyperglycemic syndrome and ketoacidosis.

Long term conditions can include heart disease, diabetes, eye damage, and cardiovascular diseases. (Dorresteijn and Valk 2012).

Diabetes can be managed with a healthy diet.

To manage diabetes properly, it is important to be educated.

It is a very common condition that affects over 30% of the global population.

You must take immediate action because of the high prevalence of diabetes.

This paper provides critical research about the importance and benefits of education to newly diagnosed diabetes patients.

A PICO question is needed to be answered in order to do an evidence-based research regarding the importance and benefits of education to newly diagnosed patients.

A comparison has been made between patients with diabetes who have had education and those without.

Each term in the PICO is described by many literatures. A literature review is also provided to support the PICO question.

P- Patients with type 2 Diabetes newly diagnosed are released from acute care

I- Educating patients about diet, exercise and insulin therapy. Regular check-ups are necessary to maintain control of diabetes.

C- In comparison to patients with diabetes who are not educated or follow the recommended treatment methods.

O- Teaching the information to increase nursing comfort.

The study population is made up of patients with newly diagnosed diabetes and those who have just been discharged from acute medical care.

Acute care patients need to be managed with a high glycemic index.

T2D is a condition that requires strict glycemic control protocols for acute care patients.

Proper management and early diagnosis of diabetes can reduce the negative effects of diabetes, even if it is not completely curable (Haase & al., 2012).

This group was chosen because of the fact that patients with diabetes who are already struggling with other illnesses need extra education to manage their condition.

There are also studies showing that patients with diabetes have three times the likelihood of being hospitalized than those without, with the odds increasing with acute care patients.

According to reports, 7.7 million people with diabetes were admitted to hospital.

Additionally, diabetes can be managed with proper diets and exercise and medication compliance.

This population was ideal for my research.

Literature Review

Dorresteijn & Valk (2012) found that hyperglycemia levels greater than 140mg/dl are common in 22 to 26 percent of non-critically ill people.

This data shows that patients may not have had a previous diagnosis.

According to the International Diabetes Federation (IDF), more than 415,000,000 people around the globe are diagnosed with diabetes.

The most severe effects of diabetes are caused by patients in acute care.

Reports state that around 70-80% patients with critical illnesses are now victims of acute care diabetes.

Mayberry & Osborn (2012) report that the plasma glucose level in patients without diabetes is kept within the range 70-100mg/dl.

Maintaining a normal level of glucose is crucial for proper brain function.

Evert (2014) states that the primary goal of the study should be the rapid diagnosis and treatment.

Patients under acute care should have a complete medical history taken and undergo a physical exam with a metabolic panel.

This paper needs to be critically evaluated. It discusses the assessment of diabetes in critically ill patients who are under acute care.

After the required examinations and assessments, the next step is to educate the patient about diabetes management.

Diabetes self-management education could be considered to be the key element of care for those with diabetes. This is important in order improve the outcomes for patients.

It is important to offer evidence-based education to patients in acute care.

Peyrot, et al. (2012) found that diabetes diagnosis can be confusing. It is worth taking precautions and preventive measures to increase your quality of living.

It is essential to first inform the patient about diabetes’ pathophysiology.

It is important to inform the patient about the different levels of blood sugar as well as the level to where he is.

Next, patients should be advised to take effective precautions to keep their blood sugar within the normal range.

Patient should be educated about the possible adverse effects of high blood Sugar levels.

Evert et.al. (2014) claim that the main goal for diabetic management should be to bring high blood sugar levels down to a normal level.

Diabetes comes in two forms. The patients must be able to distinguish between them. Type 1 diabetics are treated with insulin replacement therapy. Type 2 diabetics need therapies that normalize their sugar levels.

When we were searching for information on T2D treatment in patients, there are many articles that we found.

Malanda (2012) states that the key to diabetes self management is self monitoring of blood sugar levels regularly.

There are many blood glucose monitoring devices on the market. These devices can monitor the blood sugar level every day.

According to the author, those who regularly monitor their glucose levels and keep a proper logbook to track the data will achieve better results.

In acute cases of diabetes, it is essential to keep an eye on urine ketones as well as blood glucose levels.

Portable glucose monitoring devices can be used to monitor your glucose level on a daily basis.

It is important to teach patients with new diagnoses how to use the devices.

Clarke & Foster (2012) suggest that a glycosylated, or glucose-attached hemoglobin cell, can be viable for three months.

As this would reflect sugar exposure, it is essential to measure blood glucose levels over the last three month.

Malanda (2012) and his colleagues argued that electronic devices can’t always monitor blood glucose levels. However, there has been an increase in the sales of different brands.

Inzucchi et. al. (2012) suggest that patients can learn curtain therapies to help them manage their symptoms.

High blood sugar levels can occur in people with T2D, even when they eat less carbohydrate food.

Incretin-based drugs can be used to lower blood sugar levels after meals.

The management of diabetes is dependent on the food we eat.

Controlling diabetes requires careful nutritional assessment.

(Ajala English and Pinkney, 2013) The estimated nutritional needs of diabetic patients are the same as for other people, however, individual metabolic needs should guide diets.

To prepare a proper meal plan for the patient, it is possible to refer to a qualified dietician.

Non-carbohydrate types of food should be emphasized, including whole grains and dietary fibers.

Al-Khawaldeh, (2012) has stressed the importance of foods high in fiber and low in glycemic index.

Inzucchi, et al. (2012) conducted a study on a large population and found that people who have been drinking are more likely than non-alcoholics to get diabetes.

The higher risk ratio suggests that diabetes symptoms are directly related to alcohol intake in patients.

Clinical trials data from the Finnish Diabetes Prevention study, and the Diabetes Prevention Program of the U.S. strongly suggested that obesity increases diabetes risk in patients who are discharged from acute medical care.

Clinical trials show that patients can engage in moderate weight loss and maintain a healthy lifestyle.

Powers et.al. (2012) strongly support that obesity does not increase the risk of developing diabetes, but can also lead to other conditions such as hypertension and inflammatory markers.

Patients with hypo glycemia can receive artificial glucose intake.

Patients with severe diabetes should continue taking insulin and oral glucose lowering drugs.

Chen et.al. (2012) state that Insulin administration may pose challenges for patients with newly diagnosed acute diabetes.

The patient should be instructed about the application and the site of the injection.

To prevent scarring, rotate the injection site.

The patient should know how to store the insulin vials.

It is best to guide the patient when choosing which type of syringe should be used for injection.

Steinsbekk (2013) suggested that it was important to instruct patients about the proper disposal of insulin syringes.

In order to ensure the best care for patients in acute care facilities it is essential to create an interprofessional team and implement MNT.

Peyrot and colleagues (2012) have found that pre-diabetes can be defined as a condition where the blood glucose level is higher than the normal range, but lower than the diabetic range.

The intensity of diabetes can be reduced by proper education.

Davies et.al. (2013) warn that diabetes educators may encounter difficulties when some patients feel embarrassed to confess they don’t have the right information.

To make it easier for the patients in acute care to listen to the instructions, it is essential to build trust, non-judgment and emotional safety with the educator.

Powers et.al., (2017) state that Education is important in diabetes management as it aids patients with managing their disease.

The self management of diabetes’ main goal is to help patients become better managers of their disease.

These interventions improve clinical results.

The primary goal of diabetes education is to educate the patient and allow them to make their own decisions regarding treatment.

Another important outcome is the increase in autonomy for patients.

Haas et.al. (2012) state that education of newly diagnosed patients helps reduce hospital revisits as well as reducing health care expenses.

The families of patients can participate in the care regimen, even though it can be difficult for them to become involved in their own treatment. This will ensure that they are receiving safe and effective care.

Das et.al. (2013) report that proper diabetic education in acute patients prevents complications compared to patients with poor diabetes management education.

Al-Khawaldeh, (2012) observed a relationship between diabetes literacy and the progression chronic diseases.

Out of 402 patients suffering from hypertension and diabetes, 114 had moderate symptoms and the rest suffered from severe diabetes.

It was found that 94 students out of 114 had knowledge about self management techniques.

The remaining participants were ignorant about self management education.

Many reports stress that patients must have literary skills when caring for them.

Education should be straightforward so that critical care patients can understand it.

The literature reviewed was appropriate in that it addressed each of the PICO questions.

The papers show that education in diabetes patients can help change the disease landscape and improve outcomes.

Conclusion

According to the literature review, diabetes is primarily a lifestyle condition and self-management techniques can be used to mitigate any adverse effects.

Studies have shown that those with diabetes education have a faster rate of recovery than those who did not have such education.

The literature review could discuss the demographics of the participants and the reasons they were chosen.

Educations can help new patients with diabetes monitor their sugar levels and get them the right medication.

We can conclude that a proper evaluation, a management plan, glycemic monitoring, and referrals can all help to reduce the adverse effects of patients with diabetes.

ReferencesAjala, O., English, P., & Pinkney, J. (2013).

A meta-analysis and systematic review of the different dietary strategies for managing type 2 diabetes.

American journal clinical nutrition, 37.3, 505-516.Al-Khawaldeh, O. A., Al-Hassan, M. A., & Froelicher, E. S. (2012).

Adults with type-2 diabetes mellitus are able to self-manage, manage their own lives, and control their glycemic levels.

Journal of Diabetes, 26(1), 10-16.Chen, S. M., Creedy, D., Lin, H. S., & Wollin, J. (2012).

An randomized controlled trial investigating the effect of motivational interviews on self management, psychological, and glycemic outcomes.

International journal nursing studies, 49(6).Clarke, S. F., & Foster, J. R. (2012).

A history of blood sugar meters and their role as self-monitoring devices for diabetes mellitus.

British journal in biomedical sciences, 69(2),83.Das, S. L., Singh, P. P., Phillips, A. R., Murphy, R., Windsor, J. A., & Petrov, M. S. (2013).

A systematic review, meta-analysis and new diagnosis of diabetes mellitus due to acute pancreatitis. Gut, gutjnl-2013.Davies, M. J., Gagliardino, J. J., Gray, L. J., Khunti, K., Mohan, V., & Hughes, R. (2013).

Real-world factors that impact insulin therapy compliance in Type 1 or Type 2 diabetes mellitus patients: A systematic review.

Diabetic medicine, 30(5), 524-524.Dorresteijn, J. A., & Valk, G. D. (2012).

Patient education in preventing diabetic foot ulceration.

Review of diabetes/metabolism research, 28(S1) 101-106.Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J., … & Yancy, W. S. (2014).

The management of adult diabetes requires nutrition therapy.

Diabetes care, 37(Supplement 1), S120-S143.Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., … & McLaughlin, S. (2012).

National standards in diabetes self-management education.

The Diabetes Educator (38(5), 619-629.Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2012).

Treatment of type 2 diabetes hyperglycaemia: A patient-centered strategy.

American Diabetes Association (ADA), European Association for the Study of Diabetes. Diabetologia, 55(6), 1577-1596.Malanda, U. L., Welschen, L., Riphagen, I. I., Dekker, J. M., Nijpels, G., & Bot, S. D. (2012).

Self-monitoring glucose levels in patients with type II diabetes mellitus.

The Cochrane Library.Mayberry, L. S., & Osborn, C. Y. (2012).

Adults with type-2 diabetes require support from the family, medication adherence, as well as glycemic control.

Diabetes Care, 35(6) 1239-1245.Peyrot, M., Barnett, A. H., Meneghini, L. F., & Schumm?Draeger, P. M. (2012).

Insulin adherence behaviours and barrier in the multi-national Global Attitudes of Patients and Physicians in Insulin Therapy.

Diabetic Medicine. 29(5), 682-689.Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., … & Vivian, E. (2017).

Diabetes self-management education and assistance in type 2 diabetes: a joint statement of the American Diabetes Association and American Association of Diabetes Educators and Academy of Nutrition and Dietetics.

The Diabetes Educator (43(1), 40–53).Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M. B., & Fretheim, A. (2012).

Group-based diabetes self-management education is better than regular treatment for type 2 diabetics.

A systematic review with metaanalysis.

BMC Health services research, 12(1): 213.