Evidence-Based Nursing Practice in Diabetes Care

Running head: Healthcare Nursing Assignment
-
HEALTHCARE NURSING ASSIGNMENT
-Importance of Training Nurses to Educate Diabetes Type 2 Patients
Name of the Student
Name of the University
Author Note

1Healthcare Nursing Assignment
Introduction:
The article discusses the importance of increasing the comfort level of nurses in their
ability to teach patients who have been discharged from the care facility, so that they are able
to care for themselves better. This outcome has been identified through a PICO analysis;
there the selected population included type two diabetes patients, recently discharged from
acute care. The selected intervention was training of the nurses on how to educate patients
on their diet, exercise routine, medication, insulin therapy and regular checkups.
Comparison of the selected population was done with patients who have not been educated
by the nurses or those who are not following the recommended practices in diabetes control.
The goal and plan of the article is to discuss how the comfort of the nurses can be improved
so that they are able to adequately educate their patients, which can be evidenced by the
patient’s ability to identify and manage their conditions and prevent any secondary
complications.
Coppola (2015) suggested that Therapeutic Patient Education (TPE) can play a
vital role in the treatment and management of diabetes. This is supported by several trials that
show patient education to cause improvement in clinical, lifestyle and psycho-social
outcomes of the patients with type 2 diabetes. TPE are designed to educate the patients in self
management and adapting to or coping with their treatment regimen. This is important for
self management and to maintain the quality of the long term care and avoid complications.
The aim is to produce a therapeutic effect that is additional to the other treatments (like
pharmacological and medical) (euro.who.int, 2018)
Pros and Cons of Evidence Based Practice:
Several benefits have been associated with Evidence Based Practice that can facilitate
improvement in the quality of care, foster professional development and leadership as well as

2Healthcare Nursing Assignment
improve clinical competence and build influence. These aspects have been discussed below
in details. However, Rosenberg and Donald (1995) pointed out certain drawbacks of evidence
based practice. Firstly, EVP takes a long time to learn, practice and develop mastery over.
This is a significant constraint in busy healthcare setups where time is a luxury most
healthcare personnel can’t afford. Secondly, the infrastructure needed for implementing EBP
requires extensive monetary investment, as it entails purchase and maintenance of different
information technology hardware and applications to support EVP. Thirdly, EVP can cause
frustrations among practitioners, especially the young and inexperienced ones, since gaps in
knowledge are highlighted by the process. Fourthly, screening the litrerature to identify the
relevant one can also be very challenging, and if not indexed propely can be nightmarish for
the researcher. Finally, EVP can challenge the authority of senior clinicians and healthcare
professionals, as it can lead to identification of gaps in their knowledge, and can highlight the
necessity for them to use newer strategies for care. Professionals who are already set in their
practice can find adapting to the new system to be very challenging.
Few other challenges of EVP include, the unavailability of the ‘best available
evidence’ for a particular scenario (like novel techniques or technologies), the requirement of
the professionals to be always up to date and have necessary skills for searching and
analyzing evidence, and the outlook of the management to use EBP to reduce staffing
expense, and hire inexperienced professionals (cebma.org, 2018).
However, despite these disadvantages, EVP provides several advantages which have
been discussed below:
Discussion:
1. Application of evidence-based research:

3Healthcare Nursing Assignment
Type 2 diabetes is caused when the cells of the body stops responding or shows a reduced
responsiveness insulin hormone. This condition is also known as insulin resistance. Due to
this resistance, the pancreas starts producing excess insulin to remove the excess glucose in
the blood. However, due to prolonged resistance, the insulin is unable to sufficiently control
the blood glucose level, due to which it rises. A state of pre-diabetes occurs before diabetes
type 2 sets in. Evidence of diabetes can be found through a blood test (Cdc.gov, 2018).
The importance of evidence based research (EBR) or Evidence Based Practice (EBP)
in healthcare and nursing has been implicated by several authors. Ellis (2016) pointed out that
evidence based approach enables access, critique and application of information uncovered
through researches into practice. Therefore, nurses should embrace all opportunities for
lifelong learning, so that specific skills can be developed in the identification and analysis of
evidences, which can foster growth in the career. LoBiondo-Wood (2017) also supported
this view, with the opinion that nursing practice is always challenged with the requirement to
constantly expand the ‘comfort zone’ of the nurses through the development of new
approaches to health issues, old or new, and designing innovative strategies or
interventions for healthcare. Through evidence based practice, nurses should be able to
collect, evaluate and integrate evidences from researches, combine them with their clinical
expertise, and understanding of the patient to make clinical decision for the patient.
Furthermore EBP can improve patient safety, clinical outcomes, and also decrease
healthcare cost and fluctuation in the health outcomes (Black et al., 2015).
Different barriers (individual and organizational) that prevent proper utilization of
research data by nurses have been identified by the studies by Black et al. (2015). The
individual barriers include: knowledge gaps in research and critique process, lack of
awareness of studies or researches, unsporting co-workers and a perception of the lack of
authority to implement a change in clinical practice, and implementation of EBP.

4Healthcare Nursing Assignment
Organizational barriers can include: shortage of time, accessibility to research information
and research tools. Furthermore, providence of support, research mentors or educators can
facilitate the utilization of researches.
Studies from across the globe also highlight similar challenges and facilitators to EBP.
Studies in Oman by Ammouri et al. (2014) suggested that continued education and
minimizing the barriers are vital to allow the implementation of EBP in clinical care.
Furthermore, increased involvement in EBP also has shown to foster a positive attitude
towards it, and helps to reduce the challenges. Norwegian studies by Stokke et al. (2014)
showed that the knowledge of the nurses as well as their participation in EBP facilitates its
implementation. This highlights the necessity of the nurses to maintain sufficient and up to
date knowledge on clinical practices and research studies and methods. The importance of
research training to clinicians or nurses, in the implementation of EBP was suggested by
Black et al. (2015).
The learning objectives focusing on evidence based research can help to reduce the
knowledge gaps, improve awareness of research and critique methods for evaluation of
information and therefore help to increase participation, improve confidence of the nurses
and foster a positive outlook towards EBP. Studies by Varaei et al. (2013) also support
similar views. It can also be understood, that more knowledge possessed by the nurses can
ensure better education being given to the patients.
2. Quality improvement approach using reference outcome:
Improvement in the quality of the education given to the patients can be attained
through an increased understanding of deferent aspects of the disease or dysfunction. Such
aspects can include the pathophysiology, aetiology, treatment, management and prevention,
as well as pharmacological aspects (Benner, 2012). Fumić, Marinović, Braian (2014)

5Healthcare Nursing Assignment
supported the idea that through continuous education, the quality of healthcare can be
improved. Batalden and Davidoff (2017) suggested that efforts that can improve patient
outcomes, system performance and professional development can improve the quality of the
care. Also, both Moor’s and Miller’s model keeps knowledge as an important step towards
clinical performance or competence (nursecredentialing.org, 2014). Continuous education has
been considered to have positive effects on patient outcomes and improve their executive
performance, as well as lead to professional development.
The American Diabetes Association recommends the following strategies for improving care
for diabetes patients:
 Setting up a communication that is patient centered, and keeps the preference of
the patient into account. Also assessment of literacy and numeracy and
addressing of any cultural barriers is important.
 Evidence based guidelines should be used for clinical decisions and treatment,
and should take into account the preference as well as the co morbidities and
prognosis.
 Components of the Chronic Care Model should be used to align the care with.
This can help to ensure a positive communication between the provider and
patient.
 Utilizing care based on support team, community support and involvement,
patient registries and tools for decision support whenever possible to provide care
for the patients.
(diabetesjournals.org, 2016)
Additionally, three themes that can enable positive outcomes have been identified by
American Diabetes Association as: Patient Centeredness, Support throughout life and