PICOT Question and Literature Search Essay
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem. For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-reviewed research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. Use the \"Literature Evaluation Table\" to complete this assignment. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study). The PICOT question will provide a framework for your capstone project. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are not required to submit this assignment to LopesWrite.
Summary of Clinical Issue. PICOT Question and Literature Search Essay
Diabetes mellitus is a common metabolic condition among children. Often, it first manifests with symptoms and signs of DKA. The most common type of diabetes in children is diabetes type 1. Poorly controlled glycemic levels often lead to complications such as kidney injury. Children who presents with DKA at the emergency department are at risk of having severe AKI due to dehydration. Untreated AKI worsens to stage 3 AKI whose medical intervention is dialysis. Dialysis is the process of removing waste product and the excess water from the body when the kidneys are unable to function properly. In most cases, patients undergoing through dialysis have poor glycemic control due to the kidney’s dysfunction. Dialysis is a procedure that takes days and months before the kidney is able to function again. Likewise, glycemic control involves continuous anti-diabetic drug intake to achieve the desired blood sugar levels. Patients with diabetes and undergoing dialysis undergo physical, emotional, and psychological distress. Their families undergo emotional torture and financial drain when taking care of them. The research topic is the prevalence of pediatric patients with diabetes undergoing dialysis and the challenges they undergo. This paper describes the research done both qualitative and quantitative study design, indicating the study method, the sample, research question and purpose.PICOT Question and Literature Search Essay
PICOT Question: Among pediatric patients diagnosed type 1 Diabetes Mellitus (P) does optimal glycemic control (I) compared to no glycemic control (C) prevent the likelihood of AKI and subsequent dialysis (O) within 12 weeks(T)?
|Criteria||Article 1||Article 2||Article 3|
|APA-Formatted Article Citation with Permalink||Hursh, B. E., Ronsley, R., Islam, N., Mammen, C., & Panagiotopoulos, C. (2017). Acute kidney injury in children with type 1 diabetes hospitalized for diabetic ketoacidosis. JAMA pediatrics, 171(5), e170020 e170020||Weissbach, A., Zur, N., Kaplan, E., Kadmon, G., Gendler, Y., & Nahum, E. (2019). Acute kidney injury in critically ill children admitted to the PICU for diabetic ketoacidosis. A retrospective study. Pediatric Critical Care Medicine| Society of Critical Care Medicine, 20(1), e10-e14.||Duong, U., Mehrotra, R., Molnar, M. Z., Noori, N., Kovesdy, C. P., Nissenson, A. R., & Kalantar-Zadeh, K. (2017). Glycemic control and survival in peritoneal dialysis patients with diabetes mellitus. Clinical Journal of the American Society of Nephrology, 6(5), 1041-1048.|
|How Does the Article Relate to the PICOT Question?||It discusses how patients in diabetes mellitus and DKA develop into acute kidney injury||DKA and diabetes type one are the common causes of severe acute kidney injury whose intervention is dialysis or intensive care||The article determines glycemic control levels of diabetic patients undergoing dialysis.|
|Quantitative, Qualitative (How do you know?)||This is a Quantitative study design because the researcher is using the number of patients with diabetes. The researcher is also using statistics during the study analysis.||This is a quantitative study because the researcher used the number of participants treated in the PICU.||This is a qualitative study because the researcher’s data involves the number of participants to collect data.|
|Purpose Statement||To determine the proportion of children hospitalized with DKA develop acute kidney injury and deranged biochemical markers.||The purpose of the study was to assess the outcome of patients admitted in PICU with diabetes ketoacidosis||The purpose of the study is to determine the control of blood sugar levels in patients undergoing dialysis.|
|Research Question||What is the number of pediatric patients with diabetes type 1 who present with DKA develop acute kidney injury?||The number of clinical variables and the outcomes severe acute kidney injury in children admitted in PICU due to DKA.||How is the glycemic control (HbA1c and random blood sugars) of a patient undergoing dialysis and the mortality rate|
|Outcome||AKI was defined by use of kidney disease with elevated serum creatinine levels||Out of the admitted patients due to DKA, 30% suffered severe AKI and went to PICU for dialysis.||High mortalities in patients undergoing dialysis were associated with poor glycemic control.|
(Where did the study take place?)
|The study was conducted at tertiary pediatrics hospital in British, Colombia, and Canada. BCCH||PICU of a tertiary university pediatric medical centre.||Pediatric patients treated in DAVita dialysis clinics.|
|Sample||The study sample was all patients below 18 years diagnosed with diabetes type 1 and DKA with all the medical records||The participants are the pediatric patients admitted in PICU due to DKA.||The participants of the study were diabetic patients undergoing dialysis at DAVita clinic|
|Method||Study method was the review of all medical records of the patients with diabetes type 1 and DKA.||The study method was retrospective study cohort||The study design was contemporary cohort|
|Key Findings of the Study||Majority of the children hospitalized with diabetes and DKA developed acute kidney injury and 64% met the criteria for severe AKI that needed urgent dialysis. Most of these cases were associated with sever acidosis and dehydration.||Out of the 82 patients hospitalized due to DKA, 30% had kidney injury. These patients had elevated sodium and random blood sugar levels with normal creatinine levels. All patients survived.||2798 patients were identified to be diabetic patients going through dialysis. 95% had higher chances of mortalities due to poorly controlled glycemic levels. Other causes of increased mortalities are cardiovascular diseases and anemia.|
|Recommendations of the Researcher||The researcher recommends that the clinician should consider AKI as a common complication of DKA and they should conduct a longitudinal study on other risk factors and long term implications.||It is recommended to do renal function test and serum electrolytes to all pediatric patients who presents with symptoms of DKA to prevent the severity of AKI.||The author recommends that clinicians should ensure that the glycemic control of the patient is good before starting peritoneal dialysis to avoid increased mortalities.|
|criteria||Article 4||Article 5||Article 6|
|APA-Formatted Article Citation with Permalink||St. George, S. M., Pulgarón, E. R., Ferranti, D., Agosto, Y., Toro, M. I., Ramseur, K. C., & Delamater, A. M. (2017). A qualitative study of cognitive, behavioral, and psychosocial challenges associated with pediatric type2 diabetes and kidney disease in ethnic minority parents and adolescents. The Diabetes Educator, 43(2), 180-189.||van der Borg, M. W. E., Verdonk, M. P., de Jong-Camerik, M. J., & Abma, M. T. A. (2021). How to relate to dialysis patients’ fatigue-perspectives of dialysis nurses and renal health professionals: a qualitative study. International Journal of Nursing Studies, 103884.||Khorsandi, F., Parizad, N., Feizi, A., & MaslakPak, M. H. (2020). How do parents deal with their children’s chronic kidney disease? A qualitative study for identifying factors related to parent’s adaptation. BMC nephrology, 21(1), 1-14.|
|How Does the Article Relate to the PICOT Question?||Majority of the parents with children suffering from diabetes and kidney disease undergo psychological problems especially in the phases of dialysis||Diabetic patients undergoing dialysis are often drained physically and emotionally. The relationship with nurses determines their outcome.||This article describes the role of parents when handling a patient with chronic illness and undergoing dialysis. Effects of the parent’s care on the patient outcome.|
|Quantitative, Qualitative (How do you know?)||It is a qualitative study because the research was conducted on ethnic minority group to determine the cognitive, behavioral, and psychological challenges.||It is a qualitative study design because the research was conducted based on professional impact of the nurses.||It is a qualitative study design because the research is conducted on p content analysis approach.|
|Purpose Statement||To explore the challenges of associated with having a diabetic patient undergoing dialysis||To determine the understanding of the nurses on dialysis related fatigue and how to handle the patients.||To determine the purpose of parents on the children with chronic illnesses|
|Research Question||What are the psychological challenges associated with pediatrics diabetes type two undergoing dialysis||What are the perspective of nurses on fatigue associated with dialysis and how to handle those patients||How the parents adaptations affects the health outcome of children with chronic illnesses|
|Outcome||Most of the parents and children had difficulties in making decisions on behavioral changes especially on taking medication||Nurses have a major role when dealing with patients both socially and emotionally.||Social support, family capabilities, and spiritual beliefs influenced parents adaptations and led to improved patient outcome|
(Where did the study take place?)
|The study was conducted in Hispania||The study was conducted in13 regional academic settings in Netherlands.||The study was conducted in shahid motahari pediatrics hospital Urmia in Iran|
|Sample||The participants were the parents and the young adolescents with diabetes||The participants of the study were nurses handling pediatrics patients undergoing dialysis||Participants were parents with children in with CKD undergoing dialysis.|
|Method||The study design was descriptive qualitative method that involved the family interviews and multifamily focus groups.||The study method was semi structured interviews conducted on the nurses.||The study method was face to face interviews|
|Key Findings of the Study||There are difficulties in navigating through emotions when handling diabetes treatment and dialysis. There are knowledge deficits in making cognitive, emotional, and psychological decisions.||The dialysis nurses have frequent contact with the patients and they play a major role on their well-being.||Majority of the participants were mothers because they have an important role of taking care of a child. Increasing access to knowledge about the diseases, emotional, and financial supports helped in coping with the child’s illness which improved their outcome|
|Recommendations of the Researcher||The researcher recommends that the clinician should evaluate family intervention and screening measures when treating patients with diabetes||The researcher recommends that there was need of training the nurses and other health care professionals about patient fatigue and how to handle them||The researcher recommends a study on the role of sibling’s intervention in adaption of the parents. They also recommended an intervention study to be designed and implemented|
Duong, U., Mehrotra, R., Molnar, M. Z., Noori, N., Kovesdy, C. P., Nissenson, A. R., & Kalantar-Zadeh, K. (2017). Glycemic control and survival in peritoneal dialysis patients with diabetes mellitus. Clinical Journal of the American Society of Nephrology, 6(5), 1041-1048.
Hursh, B. E., Ronsley, R., Islam, N., Mammen, C., & Panagiotopoulos, C. (2017). Acute kidney injury in children with type 1 diabetes hospitalized for diabetic ketoacidosis. JAMA pediatrics, 171(5), e170020 e170020
Khorsandi, F., Parizad, N., Feizi, A., & MaslakPak, M. H. (2020). How do parents deal with their children’s chronic kidney disease? A qualitative study for identifying factors related to parent’s adaptation. BMC nephrology, 21(1), 1-14.103884.
St. George, S. M., Pulgarón, E. R., Ferranti, D., Agosto, Y., Toro, M. I., Ramseur, K. C., & Delamater, A. M. (2017). A qualitative study of cognitive, behavioral, and psychosocial challenges associated with pediatric type2 diabetes and kidney disease in ethnic minority parents and adolescents. The Diabetes Educator, 43(2), 180-189.
van der Borg, M. W. E., Verdonk, M. P., de Jong-Camerik, M. J., & Abma, M. T. A. (2021). How to relate to dialysis patients’ fatigue-perspectives of dialysis nurses and renal health professionals: a qualitative study. International Journal of Nursing Studies, PICOT Question and Literature Search Essay
Weissbach, A., Zur, N., Kaplan, E., Kadmon, G., Gendler, Y., & Nahum, E. (2019). Acute kidney injury in critically ill children admitted to the PICU for diabetic ketoacidosis. A retrospective study. Pediatric Critical Care Medicine| Society of Critical Care Medicine, 20(1), e10-e14. PICOT Question and Literature Search Essay