Role of Research and the Importance of the Searchable Clinical Question

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:

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).

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!!!

Role of Research and the Importance of the Searchable Clinical Question – The practice of nursing is deeply rooted in nursing knowledge, and nursing knowledge is generated and disseminated through reading, using, and creating nursing research. Professional nurses rely on research findings to inform their practice decisions; they use critical thinking to apply research directly to specific patient care situations. The research process allows nurses to ask and answer questions systematically that will ensure that decisions are based on sound science and rigorous inquiry. Nursing research helps nurses in a variety of settings answer questions about patient care, education, and administration.

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As you contemplate your role in the research process, read the following article.

Kumar, S. (2015). Type 1 diabetes mellitus-common cases. Indian Journal of Endocrinology & Metabolism, 19, S76–S77. doi:10.4103/2230-8210.155409. http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=102354944&site=eds-live (Links to an external site.)Links to an external site.

1. Choose onecase study, and formulate one searchable, clinical question in the PICO(T) format. There are several potential questions that could … asked.
2. Identify whether the focus of your question is assessment, etiology, treatment, or prognosis.
3. Remember to integrate references.

Role of Research and the Importance of the Searchable Clinical Question Guide