Slides and Speaker Notes Essay

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Evidence-Based Practice, or EVB, is a strategy that uses research, quality control measures, and other forms of evaluation data in order to improve practice methods within the healthcare setting.

EVB utilizes innovative clinical research study findings, survey results from both patients and healthcare providers, expert opinions, and quality improvement data to demonstrate a need for change and generate the most potentially successful strategy to improve the quality of care.

The procedures used within any application of EVB practices are guided by a clear mission and vision statement that directly reflect a need for improvement or other problem area.

Teams within the healthcare setting must be willing to search for and use evidence to help facilitate change.

Slide

Today, there are more Americans living with and at risk for diabetes than ever before in this nation's history.

Over 29 million Americans deal with diabetes on a daily basis. Many might think that most of these individuals are older; yet an alarming 17 million of those affected by diabetes are between the ages of 40 to 60, which is typically considered middle adulthood.

Unfortunately, the number of diabetes cases is only continuing to increase, with alarming rates predicted for the near future.

Yet, diabetes is a condition that is considered very manageable by health practitioners around the world. In fact, it is one of the most manageable health concerns that Americans face today.

So, why is it still such a problem? How are there so many new cases of diabetes each year if it is considered to be so manageable?

Clearly, there are issues that are clearly not being taken seriously in terms of healthcare practice and lifestyle choices.

Slide 3

There are a number of stakeholders that are affected by diabetes and the practice of managing diabetes care.

First and foremost, there are the patients themselves. They are directly affected by treatment options and coaching on lifestyle and healthcare decisions that can be impacted and improved by EVB.

Then, there are the support groups that work with patients to help them get through their condition. Therapists, counselors, fellow patients, and training groups all work to help generate a plan for lifestyle choices and help individual patients stick to that plan.

Family and friends of diabetes patients are similar in the fact that they provide support for the patient. They are also impacted by changes in the health of the patient.

Finally, there are physicians and other healthcare professionals whose behavior and actions are directly impacted by changes in the procedures involved with diabetes management.

Slide 4

PICOT is a framework that helps pose questions to guide EVB.

Using these questions, healthcare professionals can explore new treatment and practice routes that may provide better options for the stakeholders involved.

These different questions will provide a better perspective about how to address key challenges, manageability and the capacity to adjust with them in the longer term.

Slide 5:

Many who suffer from diabetes attempt to manage their condition primarily on their own.

Although self-management is essential, it is best when it is augmented with peer management and support groups.

Studies show that individuals with stronger support groups have better management skills and hold themselves more accountable for reaching their healthcare goals (Fisher, 2012).

Additionally, many patients lack the education they need to understand the true nature of their condition.

They often do not have experience with diabetes and many fail to seek the education they need to be more effective in managing their disease (Saydah 2013).

Finally, in many cases there are inflexible healthcare practices that do not take into account the unique aspects of the individual's life and circumstances.

This often deters individuals from seeking the support and education that would benefit their treatment in the long run.

Slide 6:

The study searched electronic databases in order to explore the evidence being produced by recent clinical research in order to drive changes in diabetes policy management.

Studies with Type 2 diabetes using blood glucose monitoring using evidence-based guidelines were chosen. Additionally, systematic reviews and health technology assessments were included as selection criteria.

The study uses the AGREE ("Appraisal of Guidelines Research and Evaluation") (Xie & Wang, 2012 p 160) instrument 11 to evaluate the quality of individual studies. The study uses the scientific merit, strength and limitation to carry out the evaluation. During the search, the researcher identifies a total of 314 articles and after screening the abstracts and titles, the study selects 10 potential articles for a full review.

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Slide 7:

Campell (2012)

The study evaluates the effectiveness of diabetes empowerment on self-care behaviors and medication adherence in adults suffering with type 2 diabetes. The paper emphasizes the effectiveness of empowerment for the management of diabetes.

The strength of the article is that it uses multiple regression using the quantitative technique for the analysis. Its weakness was that the authors did not include the variable of self-care in the analysis.

Fisher (2012)

The author identifies a self-management as effective tool to reduce the risks of diabetes.

The strength of the articles is the multivariate analysis used for the analysis that assists in delivering valid results. However, the weakness of the article is that the author only use the sample population in developing results.

National Diabetes Statistics Report (2014)

The report estimates number of people suffering from diabetes in the United States. The strength of the report is that it shows that 9.3% (29.1 Million) of the U.S. population are suffering from diabetes. Moreover, the report reveals both the direct and indirect costs of diabetes.

However, the report does not provide diabetes data for each ethnic group.

Saydah (2013)

The study reveals the relationship between mortality and socio-economic status of diabetes patients. The paper uses the education and financial wealth of people to determine their socio-economic status.

The paper has been able to demonstrate that the socio-economic status is a strong predictor of diabetes because poor health and diet can be linked to diabetes.

The weakness of the article is that it does not reveal the relationships of socio-economic status of each ethnic group and diabetes prevalent in the United States.

Garg & Shah (2014)

The "sodium -- glucose co-transporter 2 inhibitors" (Garg, & Shah, 2014 p 119) serve as a new therapeutic technique to manage the diabetes because of its potential method to reduce body weight.

The strength of the article is that the authors demonstrate the effectiveness of the new technique to manage diabetes.

However, the effectiveness of the inhibitors are short-term if the patients cease to use them for diabetes management. Moreover, the authors do not compare the outcomes of the new technique with the traditional methods for managing diabetes.

Ajala, English, & Pinkney (2013)

The authors demonstrate that blood glucose reduction can induce weight loss, which consequently reduce the cardiovascular risks for people suffering from type 2 diabetes.

The weakness of the article is that it focuses mainly on quantitative technique for the analysis.

Nancy, Petry, Eda, et al. (2015)

The paper reveals that adolescents suffering from diabetes have difficulties to carry out the tasks to decrease the glucose in the body in order to manage diabetes. However, the study maintains that physical exercise, and weight reduction are the effective strategy to manage diabetes among adults.

The shortcoming of the research is that it only uses the adolescent as the subject population and excludes the adults despite that the authors mention the adult in the study.

Kirk, Arcury, Ip, et al. (2014).

The study evaluates the relationships between health correlations and diabetes self-management among demographic of rural older adults.

The study uses the interviews to collect data from white, African-Americans, and American Indian female and male adults suffering from diabetes. Using the 34-item DSC (Diabetes Symptom Checklist), the results have been able to reveal that daily self-foot checks, and self-monitoring glucose can be effective tools for diabetes management.

The shortcoming of the paper is that the authors do not compare the effectiveness of self-management of diabetes with management carried out by healthcare professionals.

Moskowitz, Thom, Hesslet, et al. (2013)

It was concluded in this article that the peer health coaching for uncontrolled diabetes with bad self-management has an excellent outcome on glycemic control and lowering AIC.

King, Glasgow, Toobert, et. al. (2010).

The findings shows laying an emphasis on promoting self-efficacy, problem solving, and social-environmental support will improve self-management of diabetes.

Quinn, Royak-Schaler, Lende. et. al. (2011).

The study show the patient's role as a decision maker in their care, will leads to a better outcomes in diabetes management.

Slide 8:

The prime objective of this proposal is to design the DSME ("diabetes self-management education") to motivate and encourage patients to involve in their diabetes self-care for the improvement of hypoglycemic control

The diabetes self-care education is an on-going process that facilitates patients' self-knowledge as well as enhancing diabetes self-care. The DSME is very critical for the diabetes.....

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