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PICOT

Nursing Research

Jerrina
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PICOT

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  1. PICO(T) PRESENTATION TO PROFESSIONAL PEERS JERRINA HARRIS SCHOOL OF NURSING AND HEALTH SCIENCES, CAPELLA UNIVERSITY NURS-FPX4025 RESEARCH AND EVIDENCE-BASED DECISION MAKING DR. KIESER OCTOBER 15, 2025

  2. DIAGNOSIS OVERVIEW Diabetic ketoacidosis (DKA) in children with Type 1 diabetes represents a life-threatening emergency with mortality rates of 0.15-0.31% (Meseret et al., 2024). Vulnerable populations, including non-English-speaking families and those with lower socioeconomic status, experience disproportionately higher rates of severe DKA episodes. Complications include cerebral edema, acute kidney injury, and cardiovascular compromise. Healthcare disparities have a significant impact on outcomes, with delayed recognition contributing to increased severity and prolonged hospitalizations

  3. PICOT QUESTION In children with Type 1 diabetes from vulnerable populations (P), do evidence-based early recognition and prevention strategies (I), compared to standard care (C), reduce severe DKA incidence (O) within 6-12 months (T)?

  4. EVIDENCE SUMMARY Hepprich et al. (2023) surveyed adults with T1D in specialized clinics and found that one-third were unfamiliar with DKA, nearly half could not identify its symptoms or causes, and most never tested for ketones. These gaps show that without structured education, even well- resourced patients remain at risk, supporting the need for early recognition strategies to reduce severe DKA. The ISPAD guidelines by Glaser et al. (2022) advise the use of standardized prevention strategies that focus on the early detection of symptoms, educating the family, and training healthcare professionals. These are evidence-based guidelines that can be used in the implementation of systematic prevention strategies among vulnerable populations

  5. EVIDENCE SUMMARY In an article by Batwa et al. (2022), the authors examined the registration of Saudi Arabian children with new-onset T1D and discovered that 25 children were presenting with DKA and that most of the children had severe and complicated cases. The significance of this rate of diagnosis lies in the fact that it suggests a lack of prevention possibilities and the necessity of community-based education, such as the detection of the condition at the early stages within the at-risk age groups of the population.

  6. EVIDENCE-BASED CARE STEPS 1. Distribute multilingual materials in the form of culturally competent education curricula. 2. Develop community outreach of health workers to the at-risk families. 3. Implement standardized early warning measures that have objective warning signs. 4. Train healthcare providers about cultural competency and health disparities. 5. Follow up and interact with families and monitor the outcome.

  7. EVIDENCE-BASED CARE STEPS The evidence that is present regarding the possibility of certain prevention interventions that would address the issues of language barriers and socioeconomic factors would significantly reduce severe DKA events and thus would result in improved outcomes of vulnerable pediatric populations with Type 1 diabetes.

  8. REFERENCES Batwa, M., Alharthi, L., Ghazal, R., Alsulami, M., Slaghour, R., Aljuhani, R., & Bakhsh, A. (2022). Diabetic Ketoacidosis at the Onset of Type 1 Diabetes Mellitus Among Children and Adolescents in Jeddah, Saudi Arabia: A Study from the Emergency Department. Cureus. https://doi.org/10.7759/cureus.24456 Glaser, N., Fritsch, M., Priyambada, L., Rewers, A., Cherubini, V., Estrada, S., Wolfsdorf, J. I., & Codner, E. (2022). ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatric Diabetes, 23(7), 835–856. https://doi.org/10.1111/pedi.13406

  9. REFERENCES Hepprich, Roser, P., Stiebitz, S., Felix, B., Schultes, B., Schmitz, D., Rutishauser, J., Schubert, S., Aberle, J., & Gottfried Rudofsky. (2023). Awareness and knowledge of diabetic ketoacidosis in people with type 1 diabetes: a cross-sectional, multicenter survey. BMJ Open Diabetes Research & Care, 11(6), e003662–e003662. https://doi.org/10.1136/bmjdrc-2023-003662 Meseret, F., Muluken, S., Gebru Gebi, T., & Embiale Yigrem, T. (2024). Treatment Outcome and Associated Factors among Type 1 Diabetic Children Admitted with DKA in Bahir Dar City Public Referral Hospital, Northwest, Ethiopia: A Cross-sectional Study. Global Pediatric Health, 11. https://doi.org/10.1177/2333794x241248320

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