Identification and Evaluation of Literature for Proposed Intervention
PLEASE THIS ORDER IS THE PART II OR THE ORDER# 00131858, IT HAS TO BE WRITING BY THE SAME WRITER THAT WROTE THE ORE 00131858.
THE ORDER 00131858 WILL BE CRITIQUE BY MY INSTRUCTION, THESE CRITIQUE WILL BE USED FOR THIS PART II ASIGNMENT
PLEASE BE PATIENT.
This is the Part II of identifying primary research articles that support the intervention for your proposed DPI Project.
General Requirements
Use revised "Literature Evaluation Table – DPI Intervention" from Topic 2 to complete this assignment.
Refer to "Levels of Evidence in Research," located in the Class Resources.
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.
Learners will submit this assignment using the assignment dropbox in the digital classroom. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.
Directions
Using your "Literature Evaluation Table – DPI Intervention" from Topic 2, make the changes or revisions specified in the instructor feedback and complete the final table.
The final table must include:
PICOT-D question.
Table 1: Five primary quantitative research articles that support your intervention. Two of the articles must come from the United States or Canada. Three additional articles from any of the following countries: United Kingdom, Denmark, India, New Zealand, Germany, or Australia.
Table 2: Ten primary or secondary quantitative research studies that provided additional support for your intervention or some aspect of your intervention. These four articles may come from any of the 133 countries listed on the "International Compilation of Human Research Standards."
Table 3: The nursing and change theory you selected from DNP-815A.
Table 4: The clinical guidelines that align to the DPI Project, if applicable. Include the primary quantitative research in Table 1.
You will use the articles and information from your DNP-820A - Literature Evaluation Table in Topic 6, where you will write a synthesis of the literature. Be sure to review all instructor feedback for this assignment and make any necessary changes or revisions.
Attachments
Learner Name:
Instructions: Use this table to evaluate and record the literature gathered for your DPI Project. Refer to the assignment instructions for guidance on completing the various sections. Empirical research articles must be published within 5 years of your anticipated graduation date. Add or delete rows as needed.
PICOT-D Question:: In adult patients with type 1 diabetes mellitus (T1DM), what is the impact of continuous glucose monitoring (CGM), in comparison to standard self-monitoring of blood glucose (SMBG) levels in reducing hypoglycemic events, enhancing glycemic control, minimizing avoidable hospital readmissions or admissions, and supporting value/cost-effectiveness?
Table 1: Primary Quantitative Research – Intervention (5 Articles)
APA Reference
(Include the GCU permalink or working link used to access the article.)
Research Questions/ Hypothesis, and Purpose/Aim of Study
Type of Primary Research Design
Research Methodology
* Setting/Sample (Type, country, number of participants in study)
* Methods (instruments used; state if instruments can be used in the DPI project)
* How was the data collected?
Interpretation of Data
(State p-value: acceptable range is p= 0.000 – p= 0.05)
Outcomes/
Key Findings
(Succinctly states all study results applicable to the DPI Project.)
Limitations of Study and Biases
Recommendations for Future Research
Explanation of How the Article Supports Your Proposed Intervention
Polonsky, W. H., Hessler, D., Ruedy, K. J., & Beck, R. W. (2017). The impact of continuous glucose monitoring on markers of quality of life in adults with type 1 diabetes: further findings from the DIAMOND randomized clinical trial. Diabetes Care, 40(6), 736-741. Retrieved from https://care.diabetesjournals.org/content/40/6/736.abstract
Assess CGM versus SMBG and its impact on the quality of life.
RCT level 1
DIAMOND (Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes). An RCT from the USA with a sample of 158 adults. Participants filled quality of life measures that assessed different variables like hypoglycemic fear, diabetes distress (DDS), health status (EQ-5D-%L), and overall well-being(WHO-5). Linear regression was used to compare changes over time. The instruments can be used in the DPI project.
hypoglycemic confidence (P < 0.001)
diabetes distress (P < 0.001)
well-being (P = 0.01)
hypoglycemic fear (P = 0.02)
CGM leads to improvement in quality of life measures like hypoglycemic confidence and diabetes distress. However, it does not improve measures linked to health status and well-being. It is linked with the most quality of life outcomes and not the glycemic outcomes.
Only focuses on adults who rely on multiple daily injections of insulin.
The study participants are also racially homogeneous, e.g., mostly educated whites.
A short trial period of 24 weeks
Include a diverse sample, e.g., teens
It offers insights about CGM and how it improves glycemic control, demonstrates cost-effectiveness, and prevents hospital admission/readmission.
Feig, D. S., Donovan, L. E., Corcoy, R., Murphy, K. E., Amiel, S. A., Hunt, K. F., ... & Pragnell, M. (2017). Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPT): a multicentre international randomised controlled trial. The Lancet, 390(10110), 2347-2359. Retrieved from /science/article/pii/S0140673617324005
Determine the effectiveness of CGM on obstetric, maternal glucose control, and health outcomes of the unborn baby.
RCT level 1
The quantitative RCT study relies on a sample of 325 women aged between 18-40 years with type 1 diabetes. The article is from the USA. The data was obtained via CGM. The instrument involves the control and experimental group. In addition, ANOVA statistical analysis was used to compare the different therapies. The same instruments might not apply to the DPI project since it will not rely on an experiment.
p=0·0171
CGM is beneficial during pregnancy since it is linked to better neonatal outcomes, which can be due to lower levels of exposure to maternal hyperglycemia. CGM is most applicable among women who are undergoing intensive insulin therapy, and self-monitoring is hard.
The study uses HbA1c as the primary outcome even though the levels can be impacted by gestational changes in anemia, red cell deviations, and using iron supplements. Other issues include withdrawals, lost or missing samples, delivery before full-term or pregnancy losses, making it harder to determine the magnitude of the differences.
Focus on data about the frequency of CGM and its link to glucose control.
Proves that CGM improves glycemic control, minimizes instances of hypoglycemic events, and reduces rates of hospital readmissions.
DeSalvo, D. J., Miller, K. M., Hermann, J. M., Maahs, D. M., Hofer, S. E., Clements, M. A., ... & T1D Exchange and DPV Registries. (2018). Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative. Pediatric Diabetes, 19(7), 1271-1275. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/pedi.12711
To evaluate the change in the rate of intermittent scanning CGM or pediatric real-time use over five years by comparing the German and US diabetes exchange registry.
Level 2 Cohort studies
Data from a registry consisting of participants who are less than 18 years. The article is from Germany. The sample comprised 29,007 participants in 2011 and 29150 participants in 2016. Linear and logistic regression modeling was used. The instrument can be used in the DPI project since it relies on data from registry participants.
P < 0.001
CGM is linked to lower mean HbA1c irrespective of the insulin delivery mode (injection only or pump only)
Data regarding the brand of CGM and consistency of use among participants were not available.
There is a need to consider clinical protocols and costs of CGM that can be a barrier to use.
The article shows that CGM benefits pediatric patients since self-monitoring cannot be helpful, especially if parents are expected to conduct the procedure.
Kristensen, K., Ögge, L. E., Sengpiel, V., Kjölhede, K., Dotevall, A., Elfvin, A., ... & Berntorp, K. (2019). Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies. Diabetologia, 62(7), 1143-1153. Retrieved from https://link.springer.com/article/10.1007/s00125-019-4850-0
Analyze patterns of CGM and how it impacts adverse composite outcomes among pregnant women with type I diabetes
Level 2 Cohort studies
An observational cohort study involving 186 women from Sweden.
Instrument – different in means using differences in medians using U test and unpaired t-test. The instrument can be used in the DPI project.
Data was obtained using glucose readings from CGM devices.
p values <0.05
High glucose levels lead to a higher risk of adverse neonatal outcomes and are large for gestational age (LGA)
Since it is observational, it is not possible to make causal inferences.
The women also used two brands of CGM, either iCGM (intermittently viewed (i) CGM) or rtCGM (real-time (rt) CGM), which affects the measurements of glycemic variability.
Use a single brand of CGM to improve the consistency of results.
Improve generalizability by including a diverse number of women who are not of European descent.
It shows that CGM might not be optimal during pregnancy, and there is a need for supportive approaches to aid in prandial insulin changes. The study also shows the benefits of different CGM systems, i.e., rtCGM has more benefits.
Raviteja, K. V., Kumar, R., Dayal, D., & Sachdeva, N. (2019). Clinical efficacy of professional continuous glucose monitoring in improving glycemic control among children with type 1 diabetes mellitus: an open-label randomized control trial. Scientific reports, 9(1), 1-8. Retrieved from /articles/s41598-019-42555-6
Assess the effectiveness of insulin dose adjustments in improving glycemic control
Level 1 RCT
The study from India relies on a sample of children (30-intervention group, 33- control group) under seven years old with type I diabetes.
Instrument – Median, Mean (SD), and Range were determined for the descriptive data. In addition, Mann-Whitney U-test and T-test were used to examine differences between the intervention and control groups.
`P-value < 0.05
SMBG along with CGM improves glycemic control.
Not generalizable for children with poot glucose control where the HbA1c level is less than 12%
Increase number of participants
Compares SMBG and CGM when combined or when SMBG is used alone.
Table 2: Additional Primary and Secondary Quantitative Research (10 Articles)
APA Reference
(Include the GCU permalink or working link used to access the article.)
Research Questions/ Hypothesis, and Purpose/Aim of Study
Type of Primary or Secondary Research Design
Research Methodology
* Setting/Sample (Type, country, number of participants in study)
* Methods (instruments used; state if instruments can be used in the DPI project)
* How was the data collected?
Interpretation of Data
(State p-value: acceptable range is p= 0.000 – p= 0.05)
Outcomes/
Key Findings
(Succinctly states all study results applicable to the DPI Project.)
Limitations of Study and Biases
Recommendations for Future Research
Explanation of How the Article Supports Your Proposed DPI Project
Palese, A., Fabbro, E., Casetta, A., & Mansutti, I. (2016). First or second drop of blood in capillary glucose monitoring: Findings from a quantitative study. Journal of Emergency Nursing, 42(5), 420-426. Retrieved from /science/article/abs/pii/S0099176716300095
Evaluate the blood glucose differences between the initial and second drop of blood obtained from the same site in a patient diagnosed with type I diabetes.
Level 1 RCT
The quantitative study is set in Italy and relies on a sample of 195 participants who have type I diabetes. The study used an inferential and descriptive statistical analysis for the distributed variables. Therefore, the instruments can be used in the DPI project. The data was obtained by collecting blood samples from participants.
P < .001
The initial drop of blood from the patient is helpful for clinical decision-making, even though it tends to have a lower blood glucose level. The blood glucose value of the second drop tends to be higher.
The outcomes were limited based on the set protocols, e.g., 6 mg/dL
Future tests should focus on how the glucose concentration affects the differences between the first and second drops of blood.
The study shows the importance of CGM since it leads to more accurate results about blood glucose levels. Self-monitoring often relies on the first drop of blood which is not accurate.
Baron, J., Hirani, S., & Newman, S. (2015). A mobile telehealth intervention for adults with insulin-requiring diabetes: early results of a mixed-methods randomized controlled trial. JMIR research protocols, 4(1), e27. Retrieved from /pmc/articles/PMC4376177/
Assess the use of mobile telehealth as an intervention and determine if supplementing it with standard care leads to improved quality of life.
RCT level 1
Mixed-method design using parallel RCT and qualitative interviews. The study is based in the United Kingdom and uses a sample of 81 subjects (45-intervention group, 36-control group).
Instrument- Linear regressions which can also be used in the DPI project
Data was collected using questionnaires and interviews.
P=.05
MTH use declines with time. However, participants can benefit more from consistent usage.
The low number of participants
Focus on variables that would improve compliance towards telehealth training
Telehealth is vital in supporting self-monitoring of blood glucose
Battelino, T., Liabat, S., Veeze, H. J., Castaneda, J., Arrieta, A., et al. (2015). Routine use of continuous glucose monitoring in 10 501 people with diabetes mellitus. Diabetic Medicine, 32(12), 1568-1574. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26042926/
Analyze CGM use and determine usage in sensor-augmented pump therapy.
RCT level 1
Data
The quantitative study from Slovenia uses data obtained from a case link database comprising of 10,501 participants.
Instrument – data analyses of sensor data that cannot be used in the DPI project
P < 0.0001
Sensors use during the initial month of therapy determines discontinuation. Patient education is beneficial.
Comparison of different sensors
Focus on effectiveness if sensor use is combined with CGM
Sensor use involves self-monitoring of blood glucose. The article shows how usage during the initial month determines adherence.
Zhou, Y., Deng, H., Liu, H., Yang, D., Xu, W., Yao, B., ... & Weng, J. (2020). Protocol: Effects of novel flash glucose monitoring system on glycaemic control in adult patients with type 1 diabetes mellitus: protocol of a ...
👀 Other Visitors are Viewing These APA Essay Samples:
-
Nursing Research Critique
4 pages/≈1100 words | No Sources | APA | Health, Medicine, Nursing | Research Paper |
-
CONHCP: Doctor Of Nursing Practice Final PICOT-D Approval
1 page/≈275 words | No Sources | APA | Health, Medicine, Nursing | Research Paper |
-
Next-Generation Sequencing Technology: Antimicrobial Resistance
18 pages/≈4950 words | No Sources | APA | Health, Medicine, Nursing | Research Paper |