Clinical Practice Question and Literature Review Essay
Clinical Practice Question and Literature Review Essay
Clinical Practice Question and Literature Review Essay ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Clinical Practice Question and Literature Review Essay I need an explanation for this Nursing question to help me study. This is a formal paper that requires APA 7 for reference and citation. Paper MUST be 8 PAGES MAXIMUM, It is a continuation of a previous assignment. I have provided the foundation on which this paper will be built. Rubric must be followed STRICTLY to be successful. Paper needs 10 articles, I have provided 6 already. Extra 4 is needed Clinical Practice Question and Literature Review Essay rubric.docx sample_literature_review_1.docx writing_instruction.docx writing_template.docx my_completed_picot_assignment.docx Clinical Practice Question and Literature Review This is 20% of the total grade. The purpose of this assignment is to state your clinical/practice question (PICOT) and explore the literature pertaining to your clinical/practice problem. When conducting a literature review, the goal is to obtain a representative sample of the literature which describes the concepts related to the phenomenon of interest and the research results applicable to the clinical/practice question and identify what gaps need to be further researched. Please follow the rubric below. Paper length is no more than 8 pages excluding references and title page. Criteria Points Section I: Introduction and Question State the practice question you wish to address (include Independent Variable(s) and Dependent Variable(s) in PICOT format State the population and setting being addressed Introduction to the Literature Review on the topic 5 5 5 Section II: Review of Literature Includes most of the major studies conducted on the topic, including but not limited to, recent literature (last 5-7 years)-a minimum of 10 articles is required. Includes primarily research studies, systematic reviews and guidelines addressing the practice question you wish to address Similar/discrepant research findings discussed 10 10 5 Section III: Critique and Synthesis Critiques the results and findings of the key studies. Describes the weaknesses in existing studies and identifies important gaps in the literature Conceptually organized based on type of articles or findings 5 5 Succinctly summarizes and synthesizes findings 15 5 Section IV: Further Research Identifies what ideas need to be further researched 5 Preparation References congruent with initial proposal, i.e. PICOT Ideas organized & clearly expressed/headings used appropriately, no more than 8 pages Paraphrases the review with few quotes from original sources Limit direct quotes. Grammar, sentence structure is correct Adheres to APA format/style and/or Plagiarism (Plagiarism source material not adequately paraphrased; direct quotes not identified; source material not referenced. *Plagiarized papers will be given a grade of zero and could result in failure of the course) 1 5 5 5 5 5 Comments Points Achieved Running head: LITERATURE REVIEW Clinical Practice Question and Literature Review Essay Literature Review XXXXX XXXXX Name of University 1 2 LITERATURE REVIEW Literature Review The incidence of diabetes, both type 1 and type 2, have increased significantly over the years (Mayer-Davis et al., 2017). A diagnosis of diabetes increases the risk for many health problems. To prevent health complications from diabetes, it is essential to maintain controlled blood glucose levels. The use of continuous glucose monitors by type 1 diabetics have shown significant improvement in blood glucose control (Foster, Miller, Tamborlane, Bergenstal, & Beck, 2016). Introduction and Question Diabetics are predisposed to having an increased risk in the development of infection, coronary artery disease, peripheral vascular disease, cerebrovascular disease, nephropathy, and lower-extremity amputations (Clement et al., 2004). Type 1 diabetics have absolute insulin deficiency due to autoimmune B-cell destruction (American Diabetes Association, 2017) which makes it impossible to maintain controlled blood glucose levels without insulin and frequent blood glucose checks. The practice question to be addressed in this article is, in patients with Type 1 Diabetes, how does the use of a continuous glucose monitor, when compared to conventional self- monitoring of blood glucose levels, affect A1C levels and glycemic control in a time period of 3 months? The population addressed is type 1 diabetics. The setting addressed includes outside of hospitalization. Patients having type 1 diabetes will use a continuous glucose monitor to selfrecord blood glucose levels over a 3 month period. The independent variables include the use of a continuous glucose monitor. The dependent variables include A1C levels and glycemic control. A1C levels and overall glycemic control will be accessed after the 3 month period of using a continuous glucose monitor. 3 LITERATURE REVIEW Review of Literature In a study completed by Bailey, Chang, and Christiansen (2014) it is shown that the accuracy of continuous glucose monitors is equivalent to the measurement of blood glucose levels through the use of a glucometer. Clinical Practice Question and Literature Review Essay Miller et al. (2015) stated that only 30% of type 1 diabetics in America meet the goal hemoglobin A1C level of 7.5%. With a constant and continuous measurement of blood glucose levels, it is easier to manage blood sugar levels thus improving hemoglobin A1C levels. Continuous glucose monitors consist of a subcutaneous sensor with an attached transmitter that reports glucose levels and trends to the patient via a handheld monitor (Lind et al., 2017). Before continuous glucose monitors, diabetics had to check blood glucose levels through regular self-measured capillary finger sticks multiple times a day, every day. In recent years, diabetics have been given the option of continuous glucose monitoring. In a randomized clinical trial by Beck et al. (2017) it is shown that in adults with type 1 diabetes, the use of a continuous glucose monitor significantly decreased hemoglobin A1C levels in comparison to their usual regimen of self-monitoring. Similar research findings are shown in a study completed by Foster et al., (2016) where the use of a continuous glucose monitor resulted in lower A1C levels in type 1 diabetic participants than in the participants not using a continuous glucose monitor. Discrepant research findings included patients who did not complete the study due to device-related problems (Lind et al., 2017). Glycemic Control Improved glycemic control also includes preventing episodes of hypoglycemia. In a study completed by Demir, O?zen, C?etin, Darcan, and Go?ks?en (2019), it is shown that the use of a continuous glucose monitor is helpful in diagnosing impaired awareness of hypoglycemia and LITERATURE REVIEW 4 helps improve glucose variability. In one study, it was found that the use of a continuous glucose monitor produced significant reductions in the risk of hypoglycemic episodes by nearly 33% to 50% in comparison to those without a continuous glucose monitor (Rodbard, 2017). Overall, it is safe to say the use of a continuous glucose monitor decreases glucose variability. Patients are able to be alerted by an alarm when blood glucose levels are starting to fall as well as when blood glucose levels are rising. Maintaining blood glucose levels is vital in preventing complications. Long term hyperglycemia will result in many negative health outcomes and complications. Clinical Practice Question and Literature Review Essay Type 1 diabetics are predisposed to having an increased risk of premature death which mainly results from kidney and cardiovascular complications (Mohammedi et al., 2016). Kidney and cardiovascular complications although not completely avoidable, can be reduced with controlled blood glucose levels and in-range A1C levels. Hypoglycemia, even for a short period of time, can also result in negative health outcomes such as seizures, unconsciousness or even death (Steineck, Ranjan, Nørgaard, & Schmidt, 2017). An ideal safe range of blood glucose levels is between 70-180mg/dl (Vettorettie & Facchinetti, 2019). Continuous glucose monitoring sensors can measure blood glucose levels in the subcutaneous tissue every 5 minutes (Vettorettie & Facchinetti, 2019). This makes it easier for type 1 diabetics to track their blood glucose level trends. The other method of blood glucose measurement, conventional self-monitoring of blood glucose levels, only measures blood glucose levels 3 to 4 times a day including before breakfast, before lunch, before dinner, and before bed (Vettorettie & Facchinetti, 2019). Having the continuous glucose monitor gives the diabetic patient the control to improve blood glucose 5 LITERATURE REVIEW variability much simpler than before thus preventing the frequency of hyperglycemia and hypoglycemia. For diabetic patients, one of the reasons that prevent them from adherence to intensive insulin treatment regimens is the fear of hypoglycemia (Steineck et al., 2017). To decrease this fear, the use of a continuous glucose monitor would help. A potential disadvantage of a continuous glucose monitor would be the stress of glucose information overload as well as the alarms that come from changing blood glucose levels (Steineck et al., 2017). A discrepant finding regarding detection of hypoglycemia would be that in one study there was a false hypoglycemia alert rate of 53.3% in the use of continuous glucose monitors (Zijlstra, Heise, Nosek, Heinemann, & Heckermann, 2012). Critique and Synthesis Regarding improved A1C levels, the results and findings of the studies show there is overall a huge improvement in A1C levels in patients that adhere to the use of a continuous glucose monitor. Clinical Practice Question and Literature Review Essay The continual monitoring of blood glucose levels allows type 1 diabetics the ability to Beck et al. ( 2017) mentioned that in their study, type 1 diabetes who used a continuous glucose monitor had a greater decrease in A1C levels but that further research was needed to determine long-term effectiveness, adverse effects and clinical outcomes of patients. Regarding glycemic control, the studies reviewed have found that the use of a continuous glucose monitor show significant improvements in glycemic control in comparison to glycemic control without a continuous glucose monitor. The PICOT question would still benefit from the initial proposal although there are some areas that might improve the research. For example, a larger sample size and a more diverse demographic including participants from different countries. 6 LITERATURE REVIEW Gaps in Literature Important gaps in the literature pertain to the cost and affordability of continuous glucose monitors. There is no conversation regarding insurance coverage on continuous glucose monitors for type 1 diabetic patients. The literature also lacked any discussion of access and availability of continuous glucose monitors to those in low poverty and high risk populations. Further Research Ideas to be further researched include the efficacy of continuous glucose monitoring in type 1 diabetic child-bearing women. It would be beneficial to research if pregnancy has any effect on the accuracy of continuous glucose monitoring. It would also be beneficial to further research the long-term effects of continuous glucose monitoring to see if the rates of negative health outcomes such as lower-limb amputations decline in comparison to type 1 diabetics that do not use continuous glucose monitoring. 7 LITERATURE REVIEWClinical Practice Question and Literature Review Essay References American Diabetes Association. (2017). 2. Classification and diagnosis of diabetes. Diabetes care, 40(Supplement 1), S11-S24. Bailey, T. S., Chang, A., & Christiansen, M. (2014). Clinical accuracy of a continuous glucose monitoring system with an advanced algorithm. Journal of diabetes science and technology, 9(2), 209-214. Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., Haller, S., & Toschi, E. (2017). Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. Jama, 317(4), 371-378. Clement, S., Braithwaite, S. S., Magee, M. F., Ahmann, A., Smith, E. P., Schafer, R. G., & Hirsch, I. B. (2004). Management of diabetes and hyperglycemia in hospitals. Diabetes care, 27(2), 553-591. Demir, G., Özen, S., Çetin, H., Darcan, ?., & Go?ks?en, D. (2019). Effect of Education on Impaired Hypoglycemia Awareness and Glycemic Variability in Children and Adolescents with Type 1 Diabetes Mellitus. Journal of Clinical Research in Pediatric Endocrinology, 11(2), 189195. https://doi.org/10.4274/jcrpe.galenos.2019.2019.0009 Foster, N. C., Miller, K. M., Tamborlane, W. V., Bergenstal, R. M., & Beck, R. W. (2016). Continuous glucose monitoring in patients with type 1 diabetes using insulin injections. Diabetes Care, 39(6), e81. Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., & Pihoker, C. (2017). Incidence trends of type 1 and type 2 diabetes among youths, 20022012. New England Journal of Medicine, 376(15), 1419-1429. LITERATURE REVIEW 8 Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., & Tamborlane, W. V. (2015). Current state of type 1 diabetes treatment in the US: updated data from the T1D Exchange clinic registry. Diabetes care, 38(6), 971-978. Rodbard, D. (2017). Clinical Practice Question and Literature Review Essay Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes technology & therapeutics, 19(S3), S-25. Steineck, I., Ranjan, A., Nørgaard, K., & Schmidt, S. (2017). Sensor-augmented insulin pumps and hypoglycemia prevention in type 1 diabetes. Journal of diabetes science and technology, 11(1), 50-58. Vettoretti, M., & Facchinetti, A. (2019). Combining continuous glucose monitoring and insulin pumps to automatically tune the basal insulin infusion in diabetes therapy: a review. BioMedical Engineering OnLine, 18(1), N.PAG. https://doi.org/10.1186/s12938019-0658-x Writing Instruction The topic of the paper is Among inpatient opioid use disorder patients (P), what is the effect of combining psychotherapy and pharmacotherapy treatment (I), compared with psychotherapy only treatment option (C) on relapse reduction and readmission (O) three months after discharge (T)? Where P = population, I=intervention, C=comparison, O=outcome, and T=time. PICOT 1. This is a formal paper in nursing that involves literature reviews, practice-question (in PICOT format), review of literature, critique, synthesis, and suggest further research. 2. Provided information for this writing are: a. b. c. d. e. f. Practice-question (in PICOT format) 10 plus articles references in APA version 7 provided. Two sample papers provided Writing template provided Writing rubric provided All you need to do is write according to the provided/attached writing template. 3. You will have to review at least 10 articles relevant to the practice question for this writing. See the attached rubrics for details on the content of the paper. 4. This is 8 pages maximum excluding the title page and reference page. APA version 7 (APA 7) must be used in citation and referencing. Cited sources (articles) must be within 5-7 years old of publication (that is from 2013 to 2020 only). Running head: LITERATURE REVIEW 1 Clinical Practice Question and Literature Review First-name Last-Name (student) College of Health Professions, Name of University Course code and name Instructors name Month, Year LITERATURE REVIEW 2 Introduction and Question Introduction to Literature Review Practice Question in PICOT format Population and Setting Review of Literature Major Studies on the Topic Primary Research Studies, Systematic Reviews and Guidelines Similar/Discrepant Research Findings Critique and Synthesis Critique of Results and Findings of Key Studies Weakness and Gaps in Existing Studies Conceptual Organization Based on Type of Articles or Findings Summaries and Synthesis of Findings Further Research LITERATURE REVIEW 3Clinical Practice Question and Literature Review Essay References Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer. 1 Discussion Board: Clinical Questions Name Institution Course Name Instructor Name Date 2 Discussion Board: Clinical Questions 1. Choose a problem or issue that you anticipate within your future advanced nursing role. Describe the problem in approximately five sentences. The resurgence of diabetes-related complications and mortality is one of the clinical issues that has significantly impacted the healthcare sector. Gee et al. (2019) showed that the growing health problems associated with diabetes emphasize the importance of a collaborative relationship between the patient and the inter-professional care team. Besides, Holly et al. (2019) found that diabetes self-management education can improve self-care management, as evidenced by 87% of the 6 Type 2 diabetes patients included in the study. It recommended interventions that would foster diabetes self-care. Furthermore, evidence suggests that resourceful information from health providers tailored to each diabetic patient is vital to an anticipated positive outcome, which reduces complications. 2. Next, based on the problem described in question one, formulate a clinical/practice question using the Population, Intervention, Comparison, Outcome, Time (PICOT) format. This question will drive the literature search for your issue. In the management of diabetes, do self-managed diabetes patients with resourceful information and support from their health care providers compared to diabetic patients who do not self-care have better outcomes in not developing diabetes-related complications and improved mortality within ten years of diagnosis? 3. Clinical Practice Question and Literature Review Essay To support and assist in choosing and writing your PICOT in question one (#1) of this discussion board, a minimum of 6-10 articles with at least one article being a quantitative design should have been reviewed. List the articles here as a response to 3 question three (#3). The articles should be in alphabetical order, and each article should be listed as a full reference using the APA (2020) format. American Diabetes Association. (2018) Lifestyle Management: Standards of Medical Care in Diabetes. https://care.diabetesjournals.org/node/53484.full (Links to an external site.) Eva, J.J., Kassab, W.Y., Neoh, F.C., Ming, C.L., Wong, Y.Y., Hameed, A.M., Hong, H.Y.,& Sarker, R.M. ( 2018) Self-care and self-management among adolescent T2DM patients: A review. Frontiers In Endocrinology. https://doi.org/10.3389/fendo.2018.00489 (Links to an external site.) Gee, P.J., Scarbrough, J., Bowker, D & Keller, T. (2019) Diabetes educators beliefs about patient self-management and strategies used to support persons with diabetes. Sage Journal.42 (2) 174-183. https://doi.org/10.1177/0145721718825356 (Links to an external site.) Gregg, E.W., Hora, L. & Benoit, S.R. (2019). Resurgence in diabetes-related complications. JAMA. 321(19) 1867-1868. doi:10.1001/jama.2019.3471 Holly, F., Narcisse, C., Long, M.R., Christopher, R., English, E., Haggard, D.L., Purvis, R.S. & McElfish, R.A.(2019). Clinical Practice Question and Literature Review Essay The effect of family diabetes self-management education on selfcare behaviors of Marshallese adults with type 2 diabetes. American Journal Of Health Behavior. 43(3)490-497. https://doi.org/10.5993/AJHB.43.3.4 (Links to an external site.) Marciano, L., Camerini, A. & Schulz, P.J. (2019). The role of health literacy in diabetes knowledge, self-care, and glycemic control: A meta-analysis. Journal Of General Internal Medicine. 34, 10071017 https://doi.org/10.1007/s11606-019-04832-y (Links to an external site.) 4 3. Choose one of the articles cited in question three (#3) of this discussion board that is a quantitative article and discuss the relationship of your selected quantitative article to your PICOT practice/clinical question. The quantitative research study by Gee et al. (2019) is a study that closely examined the outcome of diabetic patients who self-managed their diabetes with resourceful supports from health providers. This study directly addressed my PICOT question using a quantitative research method. During the quantitative research study, a descriptive cross-sectional study design of 225 diabetes educators beliefs toward self-management was assessed using the Clinician Support Patient Activation Measure (CS-PAM). Support strategies were assessed using the Clinician Self-Management Scale (SMS). The studys implications found that the provision of diabetes self-management education and support (DSMES) has proven to be effective in improving clinical ou . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10
Clinical Practice Question and Literature Review Essay
Clinical Practice Question and Literature Review Essay ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Clinical Practice Question and Literature Review Essay I need an explanation for this Nursing question to help me study. This is a formal paper that requires APA 7 for reference and citation. Paper MUST be 8 PAGES MAXIMUM, It is a continuation of a previous assignment. I have provided the foundation on which this paper will be built. Rubric must be followed STRICTLY to be successful. Paper needs 10 articles, I have provided 6 already. Extra 4 is needed Clinical Practice Question and Literature Review Essay rubric.docx sample_literature_review_1.docx writing_instruction.docx writing_template.docx my_completed_picot_assignment.docx Clinical Practice Question and Literature Review This is 20% of the total grade. The purpose of this assignment is to state your clinical/practice question (PICOT) and explore the literature pertaining to your clinical/practice problem. When conducting a literature review, the goal is to obtain a representative sample of the literature which describes the concepts related to the phenomenon of interest and the research results applicable to the clinical/practice question and identify what gaps need to be further researched. Please follow the rubric below. Paper length is no more than 8 pages excluding references and title page. Criteria Points Section I: Introduction and Question State the practice question you wish to address (include Independent Variable(s) and Dependent Variable(s) in PICOT format State the population and setting being addressed Introduction to the Literature Review on the topic 5 5 5 Section II: Review of Literature Includes most of the major studies conducted on the topic, including but not limited to, recent literature (last 5-7 years)-a minimum of 10 articles is required. Includes primarily research studies, systematic reviews and guidelines addressing the practice question you wish to address Similar/discrepant research findings discussed 10 10 5 Section III: Critique and Synthesis Critiques the results and findings of the key studies. Describes the weaknesses in existing studies and identifies important gaps in the literature Conceptually organized based on type of articles or findings 5 5 Succinctly summarizes and synthesizes findings 15 5 Section IV: Further Research Identifies what ideas need to be further researched 5 Preparation References congruent with initial proposal, i.e. PICOT Ideas organized & clearly expressed/headings used appropriately, no more than 8 pages Paraphrases the review with few quotes from original sources Limit direct quotes. Grammar, sentence structure is correct Adheres to APA format/style and/or Plagiarism (Plagiarism source material not adequately paraphrased; direct quotes not identified; source material not referenced. *Plagiarized papers will be given a grade of zero and could result in failure of the course) 1 5 5 5 5 5 Comments Points Achieved Running head: LITERATURE REVIEW Clinical Practice Question and Literature Review Essay Literature Review XXXXX XXXXX Name of University 1 2 LITERATURE REVIEW Literature Review The incidence of diabetes, both type 1 and type 2, have increased significantly over the years (Mayer-Davis et al., 2017). A diagnosis of diabetes increases the risk for many health problems. To prevent health complications from diabetes, it is essential to maintain controlled blood glucose levels. The use of continuous glucose monitors by type 1 diabetics have shown significant improvement in blood glucose control (Foster, Miller, Tamborlane, Bergenstal, & Beck, 2016). Introduction and Question Diabetics are predisposed to having an increased risk in the development of infection, coronary artery disease, peripheral vascular disease, cerebrovascular disease, nephropathy, and lower-extremity amputations (Clement et al., 2004). Type 1 diabetics have absolute insulin deficiency due to autoimmune B-cell destruction (American Diabetes Association, 2017) which makes it impossible to maintain controlled blood glucose levels without insulin and frequent blood glucose checks. The practice question to be addressed in this article is, in patients with Type 1 Diabetes, how does the use of a continuous glucose monitor, when compared to conventional self- monitoring of blood glucose levels, affect A1C levels and glycemic control in a time period of 3 months? The population addressed is type 1 diabetics. The setting addressed includes outside of hospitalization. Patients having type 1 diabetes will use a continuous glucose monitor to selfrecord blood glucose levels over a 3 month period. The independent variables include the use of a continuous glucose monitor. The dependent variables include A1C levels and glycemic control. A1C levels and overall glycemic control will be accessed after the 3 month period of using a continuous glucose monitor. 3 LITERATURE REVIEW Review of Literature In a study completed by Bailey, Chang, and Christiansen (2014) it is shown that the accuracy of continuous glucose monitors is equivalent to the measurement of blood glucose levels through the use of a glucometer. Clinical Practice Question and Literature Review Essay Miller et al. (2015) stated that only 30% of type 1 diabetics in America meet the goal hemoglobin A1C level of 7.5%. With a constant and continuous measurement of blood glucose levels, it is easier to manage blood sugar levels thus improving hemoglobin A1C levels. Continuous glucose monitors consist of a subcutaneous sensor with an attached transmitter that reports glucose levels and trends to the patient via a handheld monitor (Lind et al., 2017). Before continuous glucose monitors, diabetics had to check blood glucose levels through regular self-measured capillary finger sticks multiple times a day, every day. In recent years, diabetics have been given the option of continuous glucose monitoring. In a randomized clinical trial by Beck et al. (2017) it is shown that in adults with type 1 diabetes, the use of a continuous glucose monitor significantly decreased hemoglobin A1C levels in comparison to their usual regimen of self-monitoring. Similar research findings are shown in a study completed by Foster et al., (2016) where the use of a continuous glucose monitor resulted in lower A1C levels in type 1 diabetic participants than in the participants not using a continuous glucose monitor. Discrepant research findings included patients who did not complete the study due to device-related problems (Lind et al., 2017). Glycemic Control Improved glycemic control also includes preventing episodes of hypoglycemia. In a study completed by Demir, O?zen, C?etin, Darcan, and Go?ks?en (2019), it is shown that the use of a continuous glucose monitor is helpful in diagnosing impaired awareness of hypoglycemia and LITERATURE REVIEW 4 helps improve glucose variability. In one study, it was found that the use of a continuous glucose monitor produced significant reductions in the risk of hypoglycemic episodes by nearly 33% to 50% in comparison to those without a continuous glucose monitor (Rodbard, 2017). Overall, it is safe to say the use of a continuous glucose monitor decreases glucose variability. Patients are able to be alerted by an alarm when blood glucose levels are starting to fall as well as when blood glucose levels are rising. Maintaining blood glucose levels is vital in preventing complications. Long term hyperglycemia will result in many negative health outcomes and complications. Clinical Practice Question and Literature Review Essay Type 1 diabetics are predisposed to having an increased risk of premature death which mainly results from kidney and cardiovascular complications (Mohammedi et al., 2016). Kidney and cardiovascular complications although not completely avoidable, can be reduced with controlled blood glucose levels and in-range A1C levels. Hypoglycemia, even for a short period of time, can also result in negative health outcomes such as seizures, unconsciousness or even death (Steineck, Ranjan, Nørgaard, & Schmidt, 2017). An ideal safe range of blood glucose levels is between 70-180mg/dl (Vettorettie & Facchinetti, 2019). Continuous glucose monitoring sensors can measure blood glucose levels in the subcutaneous tissue every 5 minutes (Vettorettie & Facchinetti, 2019). This makes it easier for type 1 diabetics to track their blood glucose level trends. The other method of blood glucose measurement, conventional self-monitoring of blood glucose levels, only measures blood glucose levels 3 to 4 times a day including before breakfast, before lunch, before dinner, and before bed (Vettorettie & Facchinetti, 2019). Having the continuous glucose monitor gives the diabetic patient the control to improve blood glucose 5 LITERATURE REVIEW variability much simpler than before thus preventing the frequency of hyperglycemia and hypoglycemia. For diabetic patients, one of the reasons that prevent them from adherence to intensive insulin treatment regimens is the fear of hypoglycemia (Steineck et al., 2017). To decrease this fear, the use of a continuous glucose monitor would help. A potential disadvantage of a continuous glucose monitor would be the stress of glucose information overload as well as the alarms that come from changing blood glucose levels (Steineck et al., 2017). A discrepant finding regarding detection of hypoglycemia would be that in one study there was a false hypoglycemia alert rate of 53.3% in the use of continuous glucose monitors (Zijlstra, Heise, Nosek, Heinemann, & Heckermann, 2012). Critique and Synthesis Regarding improved A1C levels, the results and findings of the studies show there is overall a huge improvement in A1C levels in patients that adhere to the use of a continuous glucose monitor. Clinical Practice Question and Literature Review Essay The continual monitoring of blood glucose levels allows type 1 diabetics the ability to Beck et al. ( 2017) mentioned that in their study, type 1 diabetes who used a continuous glucose monitor had a greater decrease in A1C levels but that further research was needed to determine long-term effectiveness, adverse effects and clinical outcomes of patients. Regarding glycemic control, the studies reviewed have found that the use of a continuous glucose monitor show significant improvements in glycemic control in comparison to glycemic control without a continuous glucose monitor. The PICOT question would still benefit from the initial proposal although there are some areas that might improve the research. For example, a larger sample size and a more diverse demographic including participants from different countries. 6 LITERATURE REVIEW Gaps in Literature Important gaps in the literature pertain to the cost and affordability of continuous glucose monitors. There is no conversation regarding insurance coverage on continuous glucose monitors for type 1 diabetic patients. The literature also lacked any discussion of access and availability of continuous glucose monitors to those in low poverty and high risk populations. Further Research Ideas to be further researched include the efficacy of continuous glucose monitoring in type 1 diabetic child-bearing women. It would be beneficial to research if pregnancy has any effect on the accuracy of continuous glucose monitoring. It would also be beneficial to further research the long-term effects of continuous glucose monitoring to see if the rates of negative health outcomes such as lower-limb amputations decline in comparison to type 1 diabetics that do not use continuous glucose monitoring. 7 LITERATURE REVIEWClinical Practice Question and Literature Review Essay References American Diabetes Association. (2017). 2. Classification and diagnosis of diabetes. Diabetes care, 40(Supplement 1), S11-S24. Bailey, T. S., Chang, A., & Christiansen, M. (2014). Clinical accuracy of a continuous glucose monitoring system with an advanced algorithm. Journal of diabetes science and technology, 9(2), 209-214. Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., Haller, S., & Toschi, E. (2017). Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. Jama, 317(4), 371-378. Clement, S., Braithwaite, S. S., Magee, M. F., Ahmann, A., Smith, E. P., Schafer, R. G., & Hirsch, I. B. (2004). Management of diabetes and hyperglycemia in hospitals. Diabetes care, 27(2), 553-591. Demir, G., Özen, S., Çetin, H., Darcan, ?., & Go?ks?en, D. (2019). Effect of Education on Impaired Hypoglycemia Awareness and Glycemic Variability in Children and Adolescents with Type 1 Diabetes Mellitus. Journal of Clinical Research in Pediatric Endocrinology, 11(2), 189195. https://doi.org/10.4274/jcrpe.galenos.2019.2019.0009 Foster, N. C., Miller, K. M., Tamborlane, W. V., Bergenstal, R. M., & Beck, R. W. (2016). Continuous glucose monitoring in patients with type 1 diabetes using insulin injections. Diabetes Care, 39(6), e81. Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., & Pihoker, C. (2017). Incidence trends of type 1 and type 2 diabetes among youths, 20022012. New England Journal of Medicine, 376(15), 1419-1429. LITERATURE REVIEW 8 Miller, K. M., Foster, N. C., Beck, R. W., Bergenstal, R. M., DuBose, S. N., DiMeglio, L. A., & Tamborlane, W. V. (2015). Current state of type 1 diabetes treatment in the US: updated data from the T1D Exchange clinic registry. Diabetes care, 38(6), 971-978. Rodbard, D. (2017). Clinical Practice Question and Literature Review Essay Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes technology & therapeutics, 19(S3), S-25. Steineck, I., Ranjan, A., Nørgaard, K., & Schmidt, S. (2017). Sensor-augmented insulin pumps and hypoglycemia prevention in type 1 diabetes. Journal of diabetes science and technology, 11(1), 50-58. Vettoretti, M., & Facchinetti, A. (2019). Combining continuous glucose monitoring and insulin pumps to automatically tune the basal insulin infusion in diabetes therapy: a review. BioMedical Engineering OnLine, 18(1), N.PAG. https://doi.org/10.1186/s12938019-0658-x Writing Instruction The topic of the paper is Among inpatient opioid use disorder patients (P), what is the effect of combining psychotherapy and pharmacotherapy treatment (I), compared with psychotherapy only treatment option (C) on relapse reduction and readmission (O) three months after discharge (T)? Where P = population, I=intervention, C=comparison, O=outcome, and T=time. PICOT 1. This is a formal paper in nursing that involves literature reviews, practice-question (in PICOT format), review of literature, critique, synthesis, and suggest further research. 2. Provided information for this writing are: a. b. c. d. e. f. Practice-question (in PICOT format) 10 plus articles references in APA version 7 provided. Two sample papers provided Writing template provided Writing rubric provided All you need to do is write according to the provided/attached writing template. 3. You will have to review at least 10 articles relevant to the practice question for this writing. See the attached rubrics for details on the content of the paper. 4. This is 8 pages maximum excluding the title page and reference page. APA version 7 (APA 7) must be used in citation and referencing. Cited sources (articles) must be within 5-7 years old of publication (that is from 2013 to 2020 only). Running head: LITERATURE REVIEW 1 Clinical Practice Question and Literature Review First-name Last-Name (student) College of Health Professions, Name of University Course code and name Instructors name Month, Year LITERATURE REVIEW 2 Introduction and Question Introduction to Literature Review Practice Question in PICOT format Population and Setting Review of Literature Major Studies on the Topic Primary Research Studies, Systematic Reviews and Guidelines Similar/Discrepant Research Findings Critique and Synthesis Critique of Results and Findings of Key Studies Weakness and Gaps in Existing Studies Conceptual Organization Based on Type of Articles or Findings Summaries and Synthesis of Findings Further Research LITERATURE REVIEW 3Clinical Practice Question and Literature Review Essay References Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer. 1 Discussion Board: Clinical Questions Name Institution Course Name Instructor Name Date 2 Discussion Board: Clinical Questions 1. Choose a problem or issue that you anticipate within your future advanced nursing role. Describe the problem in approximately five sentences. The resurgence of diabetes-related complications and mortality is one of the clinical issues that has significantly impacted the healthcare sector. Gee et al. (2019) showed that the growing health problems associated with diabetes emphasize the importance of a collaborative relationship between the patient and the inter-professional care team. Besides, Holly et al. (2019) found that diabetes self-management education can improve self-care management, as evidenced by 87% of the 6 Type 2 diabetes patients included in the study. It recommended interventions that would foster diabetes self-care. Furthermore, evidence suggests that resourceful information from health providers tailored to each diabetic patient is vital to an anticipated positive outcome, which reduces complications. 2. Next, based on the problem described in question one, formulate a clinical/practice question using the Population, Intervention, Comparison, Outcome, Time (PICOT) format. This question will drive the literature search for your issue. In the management of diabetes, do self-managed diabetes patients with resourceful information and support from their health care providers compared to diabetic patients who do not self-care have better outcomes in not developing diabetes-related complications and improved mortality within ten years of diagnosis? 3. Clinical Practice Question and Literature Review Essay To support and assist in choosing and writing your PICOT in question one (#1) of this discussion board, a minimum of 6-10 articles with at least one article being a quantitative design should have been reviewed. List the articles here as a response to 3 question three (#3). The articles should be in alphabetical order, and each article should be listed as a full reference using the APA (2020) format. American Diabetes Association. (2018) Lifestyle Management: Standards of Medical Care in Diabetes. https://care.diabetesjournals.org/node/53484.full (Links to an external site.) Eva, J.J., Kassab, W.Y., Neoh, F.C., Ming, C.L., Wong, Y.Y., Hameed, A.M., Hong, H.Y.,& Sarker, R.M. ( 2018) Self-care and self-management among adolescent T2DM patients: A review. Frontiers In Endocrinology. https://doi.org/10.3389/fendo.2018.00489 (Links to an external site.) Gee, P.J., Scarbrough, J., Bowker, D & Keller, T. (2019) Diabetes educators beliefs about patient self-management and strategies used to support persons with diabetes. Sage Journal.42 (2) 174-183. https://doi.org/10.1177/0145721718825356 (Links to an external site.) Gregg, E.W., Hora, L. & Benoit, S.R. (2019). Resurgence in diabetes-related complications. JAMA. 321(19) 1867-1868. doi:10.1001/jama.2019.3471 Holly, F., Narcisse, C., Long, M.R., Christopher, R., English, E., Haggard, D.L., Purvis, R.S. & McElfish, R.A.(2019). Clinical Practice Question and Literature Review Essay The effect of family diabetes self-management education on selfcare behaviors of Marshallese adults with type 2 diabetes. American Journal Of Health Behavior. 43(3)490-497. https://doi.org/10.5993/AJHB.43.3.4 (Links to an external site.) Marciano, L., Camerini, A. & Schulz, P.J. (2019). The role of health literacy in diabetes knowledge, self-care, and glycemic control: A meta-analysis. Journal Of General Internal Medicine. 34, 10071017 https://doi.org/10.1007/s11606-019-04832-y (Links to an external site.) 4 3. Choose one of the articles cited in question three (#3) of this discussion board that is a quantitative article and discuss the relationship of your selected quantitative article to your PICOT practice/clinical question. The quantitative research study by Gee et al. (2019) is a study that closely examined the outcome of diabetic patients who self-managed their diabetes with resourceful supports from health providers. This study directly addressed my PICOT question using a quantitative research method. During the quantitative research study, a descriptive cross-sectional study design of 225 diabetes educators beliefs toward self-management was assessed using the Clinician Support Patient Activation Measure (CS-PAM). Support strategies were assessed using the Clinician Self-Management Scale (SMS). 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