course material

1. Analyzing Forms Of Nursing Inquiry Week 5
Analyzing Forms Of Nursing Inquiry Week 5Analyzing Forms Of Nursing Inquiry Week
5There is confusion about how evidence-based practice is different yet similar to quality
improvement and research. The overarching goal of this presentation is to evaluate 3
articles based on standards of care in quality improvement, a research article, and an
evidence-based publication.The problem identified was management of diabetes in hospital
and as an outpatient while simultaneously using the American Diabetes Association
Standards of Care in the forefront. Fundamentally, the problem, according to the Centers for
Disease Control and Prevention [CDC] (2017, as cited by Russell, Durham, & Johnson):
diabetes is the 7th leading cause of the underlying cause of other co-morbidities in the U.S.
management of diabetes a reflection on quality improvement in hospitals, scientific
research and evidence based practice. Diabetes related care also utilizes health care
resources more and more, particularly as the population ages; further, the American Nurses
Association’s social policy indicates that attention to cost containment to be fiscally and
morally responsible in the use of resources ((2005). Therefore, this presentation focus on
three different approaches: Quality Improvement, Research and Evidence Based Practice
and how the DNP practice scholar applies each form of inquiry.Management of patients
both in hospital and as outpatients require that patient safety is the first consideration as
these patients are at risk for hyperglycemia as well as hypoglycemia, both of which may be
dangerous (American Diabetes Association, 2019 [ADA]). Additionally, the significance and
scope of problem is that diabetes is a chronic, lifelong illness that requires ongoing disease
management. Russell et al. (2017) indicate that the disease prevalence in the United States
is 9% with 1.4 million people annually diagnosed with diabetes. This presentation will take
a dive into the methodologies uses to research this costly health problem that annually
costs an average of $245 billion (Russell et al.).2ORDER NOW FOR CUSTOMIZED,
PLAGIARISM-FREE PAPERSPurpose of analysisSelected nursing problem: Diabetes
managementSignificance and scope of the practice problemQuality Improvement centered
article (QI) (American Diabetes Association [ADA], 2019)“Diabetes Care in the Hospital:
Standards of Medical Care in Diabetes” (ADA, S173)Best practice protocols, evaluations, and
guidelines from admission to dischargeReport recommendations includes as a last step, a
structured discharge information communicated with outpatient providersThe American
Diabetes Association re-evaluates management of patients with diabetes annually to
provide current standards of diabetes care, outline treatment and guidelines as well as
share tools to use for further document and appraise care provided to patients with

2. diabetes (Pugh). The underlying purpose of this report is patient safety as in the acute care
setting, adverse outcomes are associated with hyperglycemia and hypoglycemia. Analyzing
Forms Of Nursing Inquiry Week 5The ADA indicates in their report that “’Best practice’
protocols, reviews, and guidelines are inconsistently implemented within hospitals”
(Moghissi et al., as cited by the ADA, p. S173).Included in this, the ADA recommends:HbA1C
testing if the patient has not had this test performed in the last 3 months.Diabetes self-
management and compliance should be evaluated upon admission. If warranted, diabetes
education should such that patients have the appropriate skills to manage their health once
discharged.The standards also address using insulin in the acute care setting that includes
written/computerized orders that follow protocols based on fluctuations in glycemic levels;
recommendations for consults with specialized diabetes teams; insulin therapy that
maintains glucose level of 140-180 mg/dL (moderate versus tight control); basal insulin
administration plus corrective boluses in critically ill patients as the sole use of sliding scale
is not recommended. Nutrition therapy as well as hypoglycemic event management
protocols should be in place in the acute care setting, and in the event of a hypoglycemic
incident (glucose level of less than 70 mg/dl) with a patient, the treatment regimen should
be adjusted; and a tailored discharge plan fits the individual needs of patients with
diabetes.3QIMethods:Not specifically outlinedLiterature review with
citationsImpact:Annual report sets national standards of patient care in the management of
diabetesQI & the doctor of nursing practice (DNP)Numerous opportunities for the DNP in
the acute care setting and beyond (White et al., 2021)Private practice (nurse
practitioner)Acute care leadershipRisk management in acute care settingDNP role with and
in QILeadership in diabetes managementPractice reviewPolicy creation, review and
updates5Research constructed article (Whitehead et al., 2016)A nurse-led education and
cognitive behavior therapy-based intervention among adults with uncontrolled type 2
diabetes: A randomized controlled trialKnowledge gap identified and quest for further
knowledge development initiated by studyMethodologyChronic Care Model (CCM) used as
frameworkLiterature reviewStudy Design: randomized controlled trial6Research
constructed articleStudy conclusions (Whitehead et al.)No evidence participants
experienced hypoglycemic eventsStudy did not collect information on experiences of
hypoglycemia or fear of hypoglycemiaIndividual and group therapy componentsStudy did
not identify which therapy setting was more effectiveInference: nurse-led intervention
effective in reducing participants’ HbA1c is cost-effective in primary care settingAdditional
areas for study identified were to examine the similarities and differences between group
and individual cognitive-behavioral therapies.7Research & the DNPThe DNP can use
research to implement projects (White et al.; Dang & Dearhold, 2018)Diabetes self-
management education (DSME) with goal of minimizing diabetes associated
complicationsCognitive-behavioral interventions in group or individual
settingsImpactFoundational science with room for more studies that DNP could participate
inFurther studies to confirm findingsEvidence Based Practice article (Russell et al., 2019)
Analyzing Forms Of Nursing Inquiry Week 5Article:Problem: Diabetes Self Management
(DSME)Framework: Chronic Care Model (CCM)Literature reviewImplementation
Project:Promote DSME to minimize the complications associated with diabetesPatient

3. education combined with mobile textmessaging to improve diabetes self-
management9Evidence Based Practice (Russell et al., 2017)Process“Knowledge gap in best
available evidence” (p. 5)Practice Question, Evidence, Translation (PET)Amalgamation of
evidence for practice adoptionImpactDecrease in participants’ average fasting blood
glucose level after text messaging that encouraged ive DSME10Evidence Based Practice
(Pugh, 2018)