PICOT Statement – Diabetes 2 Barriers

Introduction

Evidence Based Practice is usually accessible for different geriatric patients with diabetes 2; however this practice is often not realized in most hospital and a number of health institutions can grow. A lot of studies concentrate on information to realize the issues that call for more training in nursing care for people living with diabetes 2 which is meant to promote the wellbeing of patients. In addition there is also few studies does in regard to how issues are addressed (Abbatecola, Paolisso, & Sinclair, 2015). This means that there can be more positive results when it comes to address the barriers of diabetes 2 care for geriatric patients when evidence based training for nurses is put in to care practice.  This has often proved to be a challenge for many and call for different techniques in meeting the needs of the top authority in hospitals, the specialists and changing the view of the society regarding people living with diabetes 2. 

PICOT Question

When it comes to the geriatric adult patients with diabetes 2, clinical staff, organisational mission statement and goals are at stake. How does it incorporate the use of evidence based practice to enhance the patient’s experience living with type 2 diabetes? 


Also Read: Pico Questions and Examples


 

Population

In assessing the implementation of evidence based practice, this activity worked with geriatric patients of ages 40-80  that already have a clinical diagnosis  of Diabetes 2 that are yet to receive self-management education in the past year. All the non-geriatric patients were also excluded. 

Intervention

The activity worked with about 30 patients that have diabetes 2. All the interventions were evidence based and included the following: 

  1. Ensuring that all forms of care is centered towards the wellness of the patient. It is important that all nurses in the line of care learn to practice recommendations whether they are evidence based or are based on the opinion of the charge nurse. This is because all of them are intended to ensure that there is an overall approach to continuum of care for geriatric patients living with diabetes 2  (Migdal & Abrahamson, 2016).  The art and science of medicine will thus come in when the clinician is also experiencing recommendations for treatment especially for patients that may not have been able to meet the criteria for eligibility for the studies that all the treatment guidelines have been based (Nyambuya, Dludla, & Nkambule, 2018).  
  2. Evidence Based Practice interventions will consider other illnesses that individual patients might be treating like asthma, blood pressure or cancer.  This is because type 2 diabetic patients were often seen to increase in the risk of other illnesses like the cardiovascular disease, meaning when the nurse has a patient centered approach, this will entail coming up with a comprehensive plan that can reduce the risk for cardiovascular disease by also addressing the blood pressure and the control of lipids, cessation and smoking prevention, management of weight, health lifestyle choices and physical activities (Migdal & Abrahamson, 2016). 
  3. Intervention will look at the issue of treatment and care for the diabetes 2 patient across the whole lifespan. Since an increasing population of patients living with type 2 diabetes are adults. This means that there they may have transformed from Type 1 as they grow older, a stage life for which there is need to call for more evidence required for any clinical trial or lead the required therapy.  All the changes in demography means that there is a lot of challenges  when it comes to the practice of high quality care for geriatric patient with diabetes 2, which calls for the need to improve the coordination required among the clinical teams as the patients grow from various lifespan stages. 
  4.  As part of intervention there was the issue of becoming advocates for evidence based practice for patients living with diabetes 2. Among the interventions include providing an active support and engagement for which they will require in advancing the policy cause. Advocacy is important and will be required in improving the lives of patients especially those with other chronic diseases. With the fact that there is the growing number of people with type 2 diabetes who are not able to perform several physical activities, while others are overcome by social lifestyle like smoking, the nurse will be a very important person in educating and encouraging the patient to address and change most of the societal determinants at the main cause of the problem (Migdal & Abrahamson, 2016).  Within the community healthcare setting for nursing clinical practice, there will be standard evidence based guidelines  and recommendation for practice  that can be used in identification of various issues to be looked in to and more research to be done (Onofrei & Smith, 2019). The intervention would also mean that the nurse educates the patients about their choices for healthy lifestyle management of the disease like taking medications the right way and in time and prevention other diabetic related complications (Komkova, Brandt, Hansen Pedersen, Emneus, & Sortsø, 2018). 

Comparison

For all the 30 participants, there was a supervised exercise for evidence based practice which included diet, exercise, and management of medication among other factors that provided an active development for the geriatric patients with type 2 diabetes. Evidence based approaches were used as the control factors for the group for a period of 3 months. By use of this strategy, it is evidence that there could be prolonged life and increased activities among geriatric individuals with diabetes 2. 

Outcomes

Evidence based Practice interventions can help increase the lifespan of geriatric patient with diabetes 2.  The risk however will increase with various Protease Inhibitors and nucleoside reverse transcriptase inhibitor, meaning when the management of insulin is put in to practice, then diabetes 2 can be contained and the patient is able to live with it for a long time.  In most cases in a community hospital setting, nurse for patients with diabetes 2 lack evidence based training which means that provision of care is often compromised in regard to the social, cultural and economic aspects of the patients, however, when EBP is implemented, that the continuum of care is well documented. 

Time

These outcomes will be measured weekly to determine the use of Evidence Based practice in countering barriers for geriatric patients with diabetes 2. 

References

Abbatecola, A., Paolisso, G., & Sinclair, A. (2015). Treating Diabetes Mellitus in Older and Oldest Old Patients. Current Pharmaceutical Design, 21(13), 1665-1671. Doi:10.2174/1381612821666150130120747

Awoyemi, A., Trøseid, M., Solheim, S., Arnesen, H., & Seljeflot, I. (2018). Metabolic endotoxemia as related to metabolic syndrome in an elderly male population at high cardiovascular risk. Atherosclerosis, 275, e55-e56. doi:10.1016/j.atherosclerosis.2018.06.149

GUO, M., & XU, Y. (2018). SGLT2 Inhibitors and Stroke Risk in Patients with Type 2 Diabetes—A Systematic Review and Meta-analysis. Diabetes, 67(Supplement 1), 165-OR. Doi: 10.2337/db18-165-or

Komkova, A., Brandt, C. J., Hansen Pedersen, D., Emneus, M., & Sortsø, C. (2018). Electronic Health Lifestyle Coaching Among Diabetes Patients in a Real-Life Municipality Setting: Observational Study (Preprint). doi:10.2196/preprints.12140

Migdal, A. L., & Abrahamson, M. J. (2016). Treating Type 2 Diabetes Mellitus. Principles of Diabetes Mellitus, 1-24. Doi: 10.1007/978-3-319-20797-1_44-1

Nyambuya, T. M., Dludla, P. V., & Nkambule, B. B. (2018). T cell activation and cardiovascular risk in type 2 diabetes mellitus: a protocol for a systematic review and meta-analysis. Systematic Reviews, 7(1). Doi: 10.1186/s13643-018-0835-1

Onofrei, L., & Smith, A. G. (2019). Advocacy for patients with neuropathic pain. Advocacy in Neurology, 347-360. doi:10.1093/med/9780198796039.003.0030

Rodriguez-Saldana, J. (2019). Clinical Practice Guidelines, Evidence-Based Medicine, and Diabetes. The Diabetes Textbook, 333-355. Doi: 10.1007/978-3-030-11815-0_21

 

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