NR 439 Week 1 Discussion Role of Research and the Importance of the Searchable Clinical Question
NR 439 Week 1 Discussion Role of Research and the Importance of the Searchable Clinical Question
NR 439 Week 1 Discussion Role of Research and the Importance of the Searchable Clinical Question
According to CCN 2017 week 1 lesson, evidence can form the basis of best practices for the nursing process (assessment, diagnosis, planning, implantation and evaluation). As we consider the who, what, where, when, why and how of the situation, we begin to formulate a clinical question that addresses these queries. The PICOT format is a way to develop a clinical question that leads itself to searching for evidence. PICOT is an acronym for:
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P= Population of interest
I= Intervention of interest
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C= Comparison of interest
O= Outcome of interest
T Time
The case study of a 57 year old female with a 13 year history of diabetes who presented to the hospital due to failure of oral hypoglycemic agents (OHAs) in controlling her sugar levels, for the last 3 years, and was using biphasic insulin aspart 30/70 for treatment. She is a regular swimmer and socially very active, which led to her to have irregular meals and so often goes into frequent hypoglycemia. Her lifestyle, eating habits, and the use of biphasic insulin are the contributing factors of her uncontrolled diabetes and hypoglycemia. In addressing this case study, I will formulate the PICOT as follows:
P= 57 year old female with 13 years history of diabetes
I=Teaching regarding diabetic management
C=No teaching regarding diabetic management
O=Improvement in diabetic management and reduction of diabetic crisis
T=Daily monitoring of fasting blood-sugar and postprandial blood-sugar levels x 3 months and monitoring HA1C levels every 3 months. Assessment of knowledge about diabetic management.
Clinical question after PICOT format:
- Etiology and assessment: Does lifestyle (irregular meals )and biphasic insulin aspart 30/70 causes hypoglycemia on the female.
Treatment and Prognosis: With lifestyle modification(regular meals), teaching on diabetic management and insulin degludec help in controlling the ladies diabetes by maintaining her blood-sugar levels and HA1C within normal limits?
References
CCN (2017). Week 1 Lesson. NR-439 RN Evidence-Based Practice. Online lesson. Downers Grove, IL: DeVry Education. Group.CCN (2016).
It is a very accurate observation you have made regarding the patient’s perspective of a liberated diet with the use of insulin, and I agree with you as I have seen this myself.
I have to say though, one of the endocrinologists that I work with almost, inadvertently, leads patients to practice this in that he has them count their carbs for every meal and give a sliding scale accordingly with any additional amount for every 25 mg/dl above 100 mg/dl reading in their blood sugar. I don’t think that is his intention because he still gives nutritional education and encourages limited, consistent carbs, but I can almost see that’s why they start to think that way.
This conversation has helped me to identify this trend and now I will be sure to implement in my diabetic education for my patients as we have many diabetic patients!!!
Class, you may begin posting in this TD on Sunday, July 2nd for credit.
Class, this week begins your journey into evidence-based practice or EBP.
Along the way, you’ll explore nursing research and its evolution from Florence Nightingale’s time until today.
You’ll build on knowledge gained in the informatics course as you choose a significant clinical issue, formulate a searchable clinical question, and search for research-based evidence.
This process lays the groundwork for a PICOT assignment that you’ll complete during the course as you discover sources of evidence for your own EBP. Nursing research critically advances our profession through the development of evidence upon which our practice standards are based. To determine what the best evidence is, a nurse needs to look at how the information was collected, how rigorous the methods used to develop the evidence was, and what source was used to share the evidence.
The Course Outcomes (CO) we will apply in our first week include:
Examine the sources of evidence that contribute to professional nursing practice.
Recognize the role of research findings in evidence-based practice.
Read the assigned case study and formulate searchable, clinical questions in the PICO(T) format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate references.
There are many possibilities for the research question. Make sure that you also Identify the focus of each question and explain WHY. Don’t forget to give the “P”, “I”, “C”, “O” AND T
You may want to review the lesson from Week One. Dr Joy
Role of Research and the Importance of the Searchable Clinical Question
Research is a fundamental role that every nurses plays but in different ways. How do you fulfill the research role now? What trends have created a push for nursing practice based on evidence?
As you contemplate your role in the research process, read the assigned Week 1 Case Study and formulate one searchable, clinical question in the PICO (T) format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate references
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Participation: RN-to-BSN
In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.
1. Attendance
Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.
2. Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:
- Demonstrate understanding of concepts for the week
- Integrate scholarly resources
- Engage in meaningful dialogue with classmates
- Express opinions clearly and logically, in a professional manner
Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.
Participation points: It is expected that you will meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
- You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.
3. Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
4. Participation Guidelines
You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.
5. Grading Rubric
| Discussion Criteria | A (100%) Outstanding or highest level of performance |
B (87%) Very good or high level of performance |
C (76%) Competent or satisfactory level of performance |
F (0) Poor or failing or unsatisfactory level of performance |
|---|---|---|---|---|
| Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points |
Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.
16 points |
Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.
14 points |
Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.
12 points |
Minimally addresses the initial discussion question(s) or does not address the initial question(s).
0 points |
| Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points |
Integrates evidence to support your discussion from:
Sources are credited.* 12 points |
Integrates evidence to support discussion from:
Sources are credited.* 10 points |
Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.
Sources are credited.* 9 points |
Does not integrate any evidence.
0 points |
| Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points |
Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
14 points |
Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.
12 points |
Responds to a classmate and/or instructor but does not further the discussion.
10 points |
No response post to another student or instructor.
0 points |
| Communicates in a professional manner. 8 points |
Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).
8 points |
Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).
7 points |
Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).
6 points |
Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).
0 points |
| PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T. |
0 points lost
Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
-5 points
Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
||
| PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days. |
0 points lost
Posts in the discussion at least three times AND on two different days. |
-5 points
Posts fewer than three times OR does not participate on at least two different days. |
||
| NOTES: * Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required. |
||||
| ** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites. | ||||
| *** Scholarly source – per the APA Guidelines in Course Resources, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings. | ||||
| NOTE: A zero is the lowest score that a student can be assigned. | ||||
The case study I chose is about the 57 y.o. female diabetic with episodes of hypoglycemia. Here is my PICO:
P – 57 y.o female diabetic with a 13-year history of diabetes and episodes of hypoglycemia. keyword-Hypoglycemia
I – Lifestyle and diet changes. Keyword– Lifestyle and diet
C – No change in lifestyle and diet.
O – Modification of lifestyle and diet combination. Keyword-modification
T – No time frame
Search question: Does modification of lifestyle and diet prevent hypoglycemia? The focus of the question is “Teaching”
I used two sources to obtained my information to answer my search questions. The first one is base on the explanation
of Herto(2011), in which he stressed the classic signs of hypoglycemia and how hypoglycemia is monitored. Patients with hypoglycemia, insulin levels fluctuate and this lead to temporary insulin resistance. The brain shows an attempt to avoid permanent damage, by the symptoms of hypoglycemia. Herto explained how diet and lifestyle can have an impact on hypoglycemia by strategy and tactics. The major factor with strategy is to stress to patients “Their body is doing what it should be doing giving their lifestyle they are living” (the brain, which is highly sensitive to glucose level, directs the body to do what needs to be done to raise the glucose to an acceptable level).” Patients must understand this to practice lifestyle and diet changes” In other words, the patient’s glucose response reacts to the patient’s lifestyle. Good clinical outcomes result from patient understanding this concept.
The patient can be thought the tactics aspect after she understands that what she does (diet and exercise) can impact her glucose level. Tactics involve teaching healthy diet along with shorter time period of high energy exercise. Diet will include breakfast( high protein, low glycemic snacks, and no deserts). Encourage patient not to skip meals or go long periods without meals. When the patient understands her diet, and recommendations of the lever of activities and recommendation of her diabetic diet, the process can help reduce surges of insulin and temporary insulin resistance.
The U.S. Dept (NIH) emphasized healthy meal and active lifestyle prevent hypoglycemia, but there has to be a balance between the diabetic meal and active lifestyle. The NIH article stated patients need to be taught meal pattern and what the diet should compose off. NIH stressed patient should be thought that snack must be taken during active or strenuous activity.
These articles provide the answer to my search question and conclude that modification of diet and lifestyle changes have to be made and balanced by this 57 y.o. diabetic patient to allow efficient insulin therapy and prevent hypoglycemia.
Herto, S.( 2011 ). Hypoglycemia – Strategies and Tactics for Winning. Nutritional Perspectives: Journal of the Council on Nutrition (NUTR PERSPECT), Oct. 2011; 3u(4):5-8:5-8(4p).
U.S.Department of Health and Human Resources. National Institute of Diabetic and Digestive and Kidney Disease. Health Information. Retrieved from: https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes
Class, you may begin posting in this TD on Sunday, July 2nd for credit.
Class, this week begins your journey into evidence-based practice or EBP.
Along the way, you’ll explore nursing research and its evolution from Florence Nightingale’s time until today.
You’ll build on knowledge gained in the informatics course as you choose a significant clinical issue, formulate a searchable clinical question, and search for research-based evidence.
This process lays the groundwork for a PICOT assignment that you’ll complete during the course as you discover sources of evidence for your own EBP. Nursing research critically advances our profession through the development of evidence upon which our practice standards are based. To determine what the best evidence is, a nurse needs to look at how the information was collected, how rigorous the methods used to develop the evidence was, and what source was used to share the evidence.
The Course Outcomes (CO) we will apply in our first week include:
Examine the sources of evidence that contribute to professional nursing practice.
Recognize the role of research findings in evidence-based practice.
Read the assigned case study and formulate searchable, clinical questions in the PICO(T) format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate references.
There are many possibilities for the research question. Make sure that you also Identify the focus of each question and explain WHY. Don’t forget to give the “P”, “I”, “C”, “O” AND T
You may want to review the lesson from Week One. Dr Joy
Hi Class,
According to CCN 2017 week 1 lesson, evidence can form the basis of best practices for the nursing process (assessment, diagnosis, planning, implantation and evaluation). As we consider the who, what, where, when, why and how of the situation, we begin to formulate a clinical question that addresses these queries. The PICOT format is a way to develop a clinical question that leads itself to searching for evidence. PICOT is an acronym for:
P= Population of interest
I= Intervention of interest
C= Comparison of interest
O= Outcome of interest
T Time
The case study of a 57 year old female with a 13 year history of diabetes who presented to the hospital due to failure of oral hypoglycemic agents (OHAs) in controlling her sugar levels, for the last 3 years, and was using biphasic insulin aspart 30/70 for treatment. She is a regular swimmer and socially very active, which led to her to have irregular meals and so often goes into frequent hypoglycemia. Her lifestyle, eating habits, and the use of biphasic insulin are the contributing factors of her uncontrolled diabetes and hypoglycemia. In addressing this case study, I will formulate the PICOT as follows:
P= 57 year old female with 13 years history of diabetes
I=Teaching regarding diabetic management
C=No teaching regarding diabetic management
O=Improvement in diabetic management and reduction of diabetic crisis
T=Daily monitoring of fasting blood-sugar and postprandial blood-sugar levels x 3 months and monitoring HA1C levels every 3 months. Assessment of knowledge about diabetic management.
Clinical question after PICOT format:
1. Etiology and assessment: Does lifestyle (irregular meals )and biphasic insulin aspart 30/70 causes hypoglycemia on the female.
Treatment and Prognosis: With lifestyle modification(regular meals), teaching on diabetic management and insulin degludec help in controlling the ladies diabetes by maintaining her blood-sugar levels and HA1C within normal limits?
References
CCN (2017). Week 1 Lesson. NR-439 RN Evidence-Based Practice. Online lesson. Downers Grove, IL: DeVry Education. Group.CCN (2016).