NURS FPX 4025 Assessment 4

Presenting Your PICO(T) Process Findings to Your Professional Peers

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Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

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Presenting Your PICO (T) Process Findings to Your Professional Peers

Diabetic ketoacidosis (DKA) is a severe complication disease linked with diabetes that requires immediate treatment. In establishing the point of care for DKA, adults with DKA could have worse outcomes if there are delays and inconsistent care (Li et al., 2024). Nurses have a significant role to play in early care and control, and consequently, this research examines whether a special nursing training program in DKA is beneficial in terms of better treatment, fewer complications, and reduced hospital stay in comparison with the common manner that nurses are taught. The aim of such an evaluation is to determine whether structured nursing education has a difference in the consequences of adult patients admitted with DKA.

Outcomes, Risks, and Complications

Diabetic ketoacidosis (DKA) occurs when diabetics have excess ketones in their bodies because they become insulin-deficient and therefore require fat instead of glucose as energy. The build-up of the ketones in the blood poses a dangerous condition called metabolic acidosis. Lack of timely and appropriate treatment of DKA may lead to such complications as swelling of the brain, kidney problems, or even death (CDC, 2024). It is important to understand the symptoms and act rapidly to enhance survival and reduce the later issues. Properly organized nursing training enables nurses to receive the information and confidence to observe the initial symptoms, treat them, and take good care of the patients.

DKA can cause several severe health risks to adult patients when it is not addressed promptly and in a proper manner. Other circumstances, such as the presence of another health issue, such as hypertension, poor glycemic regulation, and the lack of access to healthcare, may exacerbate patient recovery (CDC, 2024). Additionally, the disparities in quality of health care offered to the rural and underserved communities at various levels exacerbate morbidity and mortality. Nurses, since they are available in inpatient and emergency environments, can impact the DKA care by examining the patients appropriately and responding promptly (Li et al., 2024). Structured education of nurses in the management of DKA and fluid replacement, insulin therapy, monitoring electrolytes, and educating patients would standardize the care, but the errors, delays, and complications might be reduced.

It is indicative that, with regular and specialized training on the management of complex conditions like DKA, the quality of care provided by nurses becomes much better (Li et al., 2024). Patients are assisted with quick stabilization, reduced ICU and hospitalization periods. Moreover, formal training can fill in the current loopholes in service provision, especially in the community where healthcare inequality is a problem. Developing nursing skills via targeted education not only maximizes clinical results but also helps to increase the entire healthcare system to become more competence in addressing diabetic crises.

PICOT Question

In adult patients with diabetic ketoacidosis (DKA) (P), how does structured nursing education on DKA management (I), compared to no structured education (C), affect the normalization of blood glucose and ketone levels (O) within the first 24 hours of hospital treatment (T)?

• Population: Adults with DKA
• Intervention: Structured nursing education on DKA management
• Comparison: No structured education
• Outcome: Affect the normalization of blood glucose and ketone levels
• Timeframe: 24 hours of hospital treatment

Alignment with the PICO(T) Framework

The selected PICOT question reveals a definite intention to treat diabetic ketoacidosis (DKA) in adults more effectively, as it is an emergency that must be addressed immediately and proficiently. Adults with DKA are considered the key patients since the risks of complications, including electrolyte problems, metabolic acidosis, and death, are severe. The main intervention in the case will consist of structured courses that can assist the nurses in gaining confidence and knowledge in their management of diabetic ketoacidosis (Alenazy et al., 2024). Nowadays, the existence of different standards in nursing results in delays in observed signs of DKA, the administration of insulin, and the adequate maintenance of fluids and electrolytes.

The difference is in the standard care provided without any special training of DKA that may vary across the institutions and may not be based on the latest guidelines/evidence. The actual improvement is observed in the patients admitted to the ICU less often; in this way, the possibility of complications is minimized, and the metabolic difficulties are surmounted more quickly. Evaluation of the outcomes of nursing interventions is supposed to be performed within 24 hours of the diagnosis since it is a significant period for patients with DKA (Alenazy et al., 2024). Considering the patient outcomes, the PICOT question brings in the positive aspects of structured nursing interventions in the quick healing and proper intervention in DKA.

Summary of Evidence

As Alenazy et al. (2024) recorded, an immediate and appropriate response to certain critical conditions can improve the situation of the patient. The presence of DKA implies that nursing activities should be structured, coordinated, and implemented immediately. With well-trained and educated nurses regarding DKA, the signs are noticed at the initial stage, and proper care is provided, resulting in minimizing the risk of complications. Urgent treatment in the form of fluids, insulin, and electrolytes should be provided to the patient, as even a short treatment delay may cause additional issues and complicate their condition further.

According to Oldland et al. (2020), even during the working process, spending time on the provision of structured education helps health practitioners to meet new standards in the nursing field. Longo et al. (2024) have noted that the interpretation of each case, the prudent choice of patients, and risk monitoring are significant in carrying out complicated treatment procedures. DKA needs nurses to observe patients who deteriorate, maintain laboratory results, and act in case the situation becomes more severe. Synthesizing the findings of these studies indicates that nurses who are well-trained in the field of DKA benefit patients more and make better decisions during the process of the first 24 hours of diagnosis, as the PICOT question suggests. It is assumed that providing specific training to physicians in hospitals will contribute to the reduction of the number of ICU admissions, stabilization of the metabolism of patients, and better management of victims with DKA.

Creliability and Relevance of the Evidence

It has been demonstrated that it is better to get proper nursing training at a young age, so that there is a greater capacity to cope with acute conditions like diabetic ketoacidosis (DKA). As the authors of the article Alenazy et al. (2024) describe, prompt measures on the part of nurses can contribute to the minimization of wait time during treatment and the overall improvement of patients, so there is no need to wait to take such steps during the management of DKA cases. Oldland et al. (2020) highlighted the following protocols that need to be learned by students, and nursing education should assist in memorizing such guidelines. Longo et al. (2024) suggest that insulin and fluids should be used safely in diabetes by ensuring safety in medicines and constant observation of the patient. Based on evidence-based practices, nurses would be in a better position to detect and respond to the symptoms at an early stage, and this would enhance the patient outcome in the provision of DKA.

Answer to the PICO(T) Question Based on Evidence Analysis

The research shows that the timely intervention by the nurses enhances patient outcomes under the acute cases since the treatment is initiated promptly and complications are prevented. Experienced nurses should administer insulin and fluids at an early stage to prevent severe complications in diabetic ketoacidosis (DKA). Moreover, Alenazy et al. (2024) have observed the effectiveness of early treatment in reducing the damage to the organism and its importance in the DKA management to reduce the time period of high sugar levels and increased acidity in diabetes. According to Oldland et al. (2020), shaped protocols should be used since they can help students provide safe and appropriate care. Longo et al. (2024) emphasized the value of monitoring and awareness of medication safety to prevent various complications in people with DKA, including hypoglycemia. All these studies indicate that the structured teaching of nurses would result in improved patient outcomes and more rapid recovery during the initial 24 hours of DKA treatment.

Assumptions

It is hoped that the onset of nursing intervention through education may allow the prevention of the complications of DKA because the sugar problems may be identified and corrected immediately. It presupposes that nurses with the appropriate training will be able to control insulin and fluid administration during the initial period of treatment, either at home or in the hospital. There are numerous populations under study, and the evidence has acknowledged that the fairness of receiving healthcare can influence outcomes (Jerreat, 2020). It also implies that delay in treating DKA can be counterproductive because it implies that prompt plans led by nurses are required to assist patients to get better.

Key Steps of Care Based on Evidence

To initiate timely treatment, nurses should be able to identify the symptoms of DKA. According to a study by Alenazy et al. (2024), early detection of blood sugar and ketones can help avoid the deterioration of DKA when it is too late. In case the symptoms appear, physicians are supposed to initiate maintenance of blood sugar and fluid by administration of insulin and fluids. Oldland et al. (2020) have discovered that through medical support provided early to the pets, the risk of such problems as acidosis and fluid loss is lower, thus resulting in faster recovery. Longo et al. (2024) described the fact that individuals need to understand the impact of their medications and adhere to the most suitable dosages to avoid developing hypoglycemia.

Constant monitoring of the patient and rushing them to the hospital at any time is a way of ensuring that the patient remains stable. The task of the nursing personnel is to check patients regularly and provide immediate treatment in case of emergencies, including electrolyte imbalances or increased brain pressure. Hospitalized patients can get high-level care, and they are continuously monitored (Edholm et al., 2020). Promptness of the nursing staff in initiating care and frequent visits to the patients results in patients recovering quickly and being discharged sooner. Providing the early DKA care guidelines and arranging nurse-led education for them can enable more individuals in remote locations to access timely care.

Conclusion

Handing over the duty of early treatment of DKA to the nurses will make the patients feel good, as they are quick in responding to the needs of the patient and correcting the metabolic disturbances at the earliest stages of their emergence. It has been proven that such an approach to addressing the level of blood sugar will prevent acidosis and dehydration, will result in a decreased hospital presence of patients, and will assist underserved individuals in receiving the proper care. Well-trained and trained nurses will be required to achieve the desirable outcomes, as well as well-established protocols on who should safely treat the patients.

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