Single Peer-Reviewed Research Article Critique Relevant to Advanced Nursing Practice

  This research was carried out by 3 researchers who have experience in conducting research studies based on their level of qualification. Rona Parker is a registered nurse RN with a Masters Degree in Education and a PhD who presently work as an Assistant Dean and Associate Professor at the School of Osteopathic Medicine, University of the Incarnate Word, Texas. Her colleague Mary Jane Jones is a RN with a PhD and a Professor at the BG Lillian Dunlap Professor Emerita of Nursing at the same University in Texas. The 3^rd researcher is Linda Hook who has a Masters in Nursing, Advanced Public Health Nurse (APHN-BC), and MSHP. She works as an instructor at the IIa Faye Miller School of Nursing and Health Professions.

 The title of the article did not explicitly state the study population but inferences can be made that it involves patients with diabetes because of the inclusion of the word glycemic control. The other stated variable is the Nurse Practitioner (NP) and the interprofessional collaborative practice team which demonstrated a correlational study. The abstract indentified the key components of the study that included the background and purpose of the study, the design including the sample, conclusion and the implications for nursing practice.

Steps in the Research Process

Problem – the problem surrounds glycemic control of patients with diabetes and the ability of the NP and interprofessional team to improve clinical outcomes. Glycemic control has been a challenge for many patients living with diabetes and contributes to several micovascular and macrovascular complications which potentially increases the risk of premature death from these complications. According to Parker et al, (2016), inorder for patients to fully benefit from the health care services and be more successful at controlling their blood sugar their care should be addressed from the point of initial care with the provider and with involvement from the interprofessional team. With this model of care facilitated by the NP, each member of the team can maximize their interventions to improve patient outcome.

Purpose– The problem was to identify differences of blood sugar control of patients at risk when treated by a NP and an interprofessional collaborative practice team inclusive of the NP within a one year period. (Parker, 2016).

Review of Literature- The authors reviewed a total of 24 articles, of which 10 were under 5 years, 9 under 10 years and 4 over 10 years, which demonstrated that these references were current in relation to the time of study. Parker et al, (2016) reviewed previous study on the improved effects that nurse /manager trained in diabetes management had on diabetes control within a short time span, but not much evidence on overall outcome. They also looked at 3 studies that mentioned the involvement of self-management. Another that dealt with improvement in glycemic control with more frequent contact from health care providers, and another that looked at the effects of involving a case manager to self- management education program. Parker et al, (2016) believes that the result of some previous studies may have been affected negatively based on the confusion of the meaning of disease management, care coordination and what is involved in collaborative intervention. It is important when looking at a study to understand the contextual meaning of certain terminologies hence the reason for inclusions of some of these terms with their definition in the study.

Study Framework

Research Question- The authors states two research questions which were:- 1) “What are the differences in glycemic control among patients with at-risk diabetes cared for by a nurse practitioner only and those who received additional follow-along care by an interprofessional team ?”(Parker et al, 2016). 2) Are there differences in pre-post glycemic control among patients with at-risk diabetes who are followed by an Interprofessional Education and Collaborative Practice (IPECP) Faculty Team for two or more visits by two of more disciplines?”(Parker et al, 2016).

Variables: At risk patients with diabetes who had HgbA1C between 7-9% (moderate) and high risk > 9%.

Design: Typically the pretest-posttest research design would include an intervention group and a control group for both pretest and post test. (Sutherland, 2017, Quantitative Methodology: Interventional Designs and Methods). But in this study the authors decided to use the pre-post design without the control group where they looked at the result of glycemic control in at-risk patients with diabetes who was either treated by the NP only and those treated by the interprofessional team at a clinic within the community. (Parker, et al, 2016). Here below is a diagrammatic representation of the research design-pre-post test without a control group.