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Capella 4030 Assessment 3

Capella 4030 Assessment 3 PICO (T) Questions and an Evidence-Based Approach

Student Name

Capella University

NURS-FPX 4030 Making Evidence-Based Decisions

Prof. Name

Date

Introduction of PICO(T) Question

The growing need for systematic reviews and evidence-based practices for healthcare professionals encourages the need for a literature search. It is critically important to search for quality literature that is credible and relevant to the topic of research. There are several techniques to perform a literature search however, one of the easiest search strategies is the development of a PICO(T) question. 

PICO(T) approach is used by healthcare professionals to effectively research sources of information related to their patient’s health conditions so that applicable evidence-based practice is performed. PICO(T) stands for P= problem/patient/population, I= intervention, C= comparing variable, O= outcome, and T= time (this depends on the type of situation) (Eriksen & Frandsen, 2018). This paper focuses on developing a PICO question related to diabetic patients along with the identification of relevant resources to complete the search. Moreover, some of the articles will be shared with relevant findings of the question and a decision will be derived based on available evidence. 

Health Condition to Investigate – Diabetes Mellitus

This analysis is focused on patients with type II diabetes (T2DM) and how to control their glycemic levels. Type II diabetes is characterized by chronic uncontrolled blood sugar levels (hyperglycemia) as well as raised levels of insulin in the body. This is non-insulin dependent diabetes where body cells do not react to the function of insulin, hence developing insulin resistance.

T2DM is a long-term condition that is treated with pharmacological options as well as with dietary modifications and exercise (Westman, 2021). Therefore, there is a need to find reliable and relevant sources of information so that their glucose levels are controlled and patients are prevented from ending up with complications. A PICO question developed for these patients is: 

Do type II diabetic patients (P) improve their glycemic levels (O) with physical activity as the primary treatment (I) than those who get pharmacological treatment as a primary treatment (C)?

Since patients with diabetes end up with several morbidities like loss of kidney function, cardiovascular diseases, stroke, systemic infections, retinopathy, peripheral vascular disease, and other metabolic disorders as well as the mortality risk is high in this population (Tomic et al., 2022), it is essential to carry out effective research for these patients to prevent their complications and improve quality of life. The PICO approach will assist healthcare workers to succinctly find evidence-based information to integrate into their professional practices so that effective healthcare is delivered. 

Identification of Sources of Evidence

There are several sources available online to perform the search strategy however, it is essential to find credible and relevant resources. Databases like PubMed Central, ScienceDirect, BioMed Central, CINAHL, and Medline are authentic medical and health-related databases that will provide specific articles related to diabetes and other health conditions. Some of the journals that can be accessed to find diabetes-specific information are Diabetes Care, BMJ Open Diabetes Research and Care, The Lancet Diabetes and Endocrinology, and Nature Reviews Endocrinology.

These journals have high impact factors and are ranked top by most of the journal ranking authorities, which makes them authentic and trustworthy for researching the PICO question. Although there is a lot of information available online, it is imperative to perform a credibility test on the resources to avoid encountering unreliable information. The CRAAP test is used to evaluate the credibility and relevance of the sources of evidence. The CRAAP is an acronym for C = currency, R= relevance, A = authority, A = accuracy, and P = purpose.

This test enables researchers to find credible information, which is currently published, is relevant to the topic of research, authorized by unfailing authors and the journal, the article is supported with scholarly evidence, and the purpose is clear and relevant to the audience (Lowe et al., 2021). The CRAAP test combined with the PICO question is a beneficial strategy for healthcare professionals to ensure that only credible and meaningful information is used in clinical practices for bettering patient outcomes and improving quality of care. 

Findings from the Relevant Sources

Physical activity has been considered an effective strategy against diabetes mellitus. Some of the studies that justify this PICO question are: 

  1. A study by Alghafri and colleagues (2020) introduced a program MOVEdiabetes as an intervention to encourage diabetic patients for physical activities. It is recommended because physical activity has proven to show positive results in normalizing glucose levels in diabetic patients. Moreover, the interventions reduced cardiovascular risks by reducing blood pressure and controlling triglyceride levels (Alghafri et al., 2020). 
  2. Another article mentions that physical activity is the foundation of the management of type II diabetes. It has reduced cardiovascular risks and minimized the overall mortality rate associated. However, there is a need that healthcare professionals must develop individualized physical activity plans for the patients considering their comorbidities and other sociocultural factors to ensure personalized and appropriate care is provided (Harrington & Henson, 2021). 
  3. An article by Syeda and coworkers (2023) claims that regular exercise helps in managing blood glucose levels, aids insulin sensitivity in type II diabetics, and physical activity can also help in controlling glycemia (Syeda et al., 2023). 

All of these articles fulfill the CRAAP criteria as they are published currently within five years of publication, they are relevant to the topic of research, the authors and publication journals are authentic and reliable, the claims are accurately justified using various scholarly evidence, and the purpose of all three studies to provide adequate information related to physical activity and its benefits for patients with type II diabetes. 

Decision-Making on PICO Question Using the Findings

The decision that can be derived from the findings above is that physical activity and exercise help reduce glucose levels, improve glycemic control, and minimize complications like cardiovascular problems in type II diabetes patients. However, pharmacological therapy is also essential as some of the patients have various comorbidities and their health condition is complicated. Thus, physical activity and medicinal regimens should be coupled together in the management of type II diabetes. Moreover, healthcare professionals must develop personalized management plans for individual patients. 

Conclusion

In conclusion, diabetes mellitus, specifically type II diabetes is a chronic condition that requires healthcare professionals to effectively manage their patients. For this purpose, evidence-based practice is important but it can only be achieved if proper research is conducted using the PICO strategy. The PICO approach helps direct healthcare workers in the right direction of the research by using specific terms and specific questions. Along with the PICO approach, the CRAAP test is important for finding credible and relevant resources.  Healthcare professionals should be trained for this purpose so that healthcare practices are improved and quality care is provided. 

References

 Alghafri, T. S., Al Harthi, S. M., Al-Ajmi, F., Al-Farsi, Y., Craigie, A. M., Bannerman, E., & Anderson, A. S. (2020). Acceptability of the “Movediabetes” physical activity intervention in diabetes primary care settings in Oman: Findings from participants and Practitioners. BMC Public Health20(1). https://doi.org/10.1186/s12889-020-09029-1 

Eriksen, M. B., & Frandsen, T. F. (2018). The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review. Journal of the Medical Library Association106(4). https://doi.org/10.5195/jmla.2018.345 

Harrington, D., & Henson, J. (2021). Physical activity and exercise in the management of type 2 diabetes: Where to start? Practical Diabetes38(5), 35. https://doi.org/10.1002/pdi.2361 

Lowe, M. S., Macy, K. V., Murphy, E., & Kani, J. (2021). Questioning Craap. Journal of the Scholarship of Teaching and Learning21(3). https://doi.org/10.14434/josotl.v21i3.30744 

Capella 4030 Assessment 3

Syeda, U. S. A., Battillo, D., Visaria, A., & Malin, S. K. (2023). The importance of exercise for glycemic control in type 2 diabetes. American Journal of Medicine Open, 100031. https://doi.org/10.1016/j.ajmo.2023.100031 

Tomic, D., Shaw, J. E., & Magliano, D. J. (2022). The burden and risks of emerging complications of diabetes mellitus. Nature Reviews Endocrinology18(9), 525–539. https://doi.org/10.1038/s41574-022-00690-7 

Westman, E. C. (2021). Type 2 diabetes mellitus: A pathophysiologic perspective. Frontiers in Nutrition8. https://doi.org/10.3389/fnut.2021.707371

Capella 4030 Assessment 3