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Chamberlain University
NR-702: DNP Project & Practicum I
Prof. Name
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EBP Question: [Insert EBP Question Here]
Date: [Insert Date Here]
The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Appendix G tool is a structured instrument created to facilitate the evaluation of individual evidence sources during the appraisal stage of an evidence-based practice (EBP) project. It enables healthcare professionals to summarize key aspects of each study, including the type of evidence, characteristics of the population studied, research findings, limitations, and the assigned evidence level with a quality rating. This systematic approach promotes transparency, reduces bias in evaluation, and makes it easier to compare findings across multiple sources, ensuring that recommendations are built upon strong and consistent evidence.
The following table highlights five peer-reviewed studies that examined the effectiveness of Diabetes Self-Management Education and Support (DSMES) interventions among patients with type 1 and type 2 diabetes. These studies provide insight into the outcomes, strengths, and limitations of DSMES programs, offering guidance for evidence-based decision-making in diabetes care.
Individual Evidence Summary for DSMES Interventions
| Article No. | Author & Date | Evidence Type | Sample, Sample Size & Setting | Study Findings | Limitations | Evidence Level & Quality |
|---|---|---|---|---|---|---|
| One | Bekele et al. (2020) | Systematic review & meta-analysis (Quantitative) | 16 RCTs retrieved from PubMed, Medline, Scopus, BioMed Central, and Cochrane Library | DSMES improved patients’ self-care behaviors, health-related knowledge, and quality of life, while reducing complications and healthcare expenditures. | Several included studies were older than five years, which raises concerns about data relevance. | Level I-A, High quality |
| Two | Nkhoma et al. (2021) | Systematic review & meta-analysis (Quantitative) | 39 studies with 6,861 participants; databases: PubMed, Cochrane, Web of Science, EMBASE, Scopus | Digital DSMES interventions showed significant improvements in HbA1c and diabetes knowledge, suggesting strong potential in glycemic management. | Digital illiteracy among older adults with limited access to technology was not addressed. | Level I-A, High quality |
| Three | Rohilla et al. (2021) | Umbrella review of systematic reviews (Quantitative) | 166 studies analyzed under PRISMA methodology | DSMES programs were associated with better self-care behaviors and improved glycemic outcomes for patients with type 1 diabetes. | Lack of strategies for sustaining adherence to lifestyle modifications. | Level I-A, High quality |
| Four | Romero-Castillo et al. (2022) | Pilot randomized controlled trial | 131 participants divided into intervention (n=69) and control (n=62) groups at Virgen Macarena & Virgen del Rocio Hospitals | DSMES intervention demonstrated improved glycemic control in type 1 diabetes, supporting clinical feasibility. | Limited generalizability due to small sample size and absence of follow-up adherence strategies. | Level II, High quality |
| Five | Tanaka et al. (2020) | Systematic review & meta-analysis of RCTs | 12 RCTs retrieved from Cochrane Library and related databases | DSMES enhanced health literacy and glycemic outcomes among adults newly diagnosed with type 2 diabetes. | Some studies relied on outdated findings, which reduced credibility. | Level I-A, High quality |
The Individual Evidence Summary Tool is designed to help EBP teams organize and document findings from each source during evidence appraisal. It ensures that relevant details such as study type, sample size, methodology, limitations, and quality rating are systematically recorded. This uniform structure promotes comparison and facilitates decision-making based on reliable data.
Header Information: Always include the EBP question and date for easy reference.
Article Numbering: Assign a unique number to each study to simplify cross-referencing.
Author and Date: Record the lead author and year of publication to maintain accuracy.
Evidence Type: Identify whether the research is an RCT, meta-analysis, systematic review, or qualitative study.
Sample and Setting: Provide a concise summary of the participants, sample size, and study environment.
Findings: Present results that are directly related to the EBP question under investigation.
Limitations: Note any biases, sample limitations, or gaps in study design.
Evidence Level and Quality: Assign each source an evidence hierarchy rating according to the JHNEBP framework to indicate its strength and reliability.
Bekele, B. B., Negash, S., Bogale, B., Tesfaye, M., Getachew, D., Weldekidan, F., & Balcha, B. (2020). The effectiveness of diabetes self-management education (DSME) on glycemic control among T2DM patients randomized control trial: Systematic review and meta-analysis protocol. Journal of Diabetes & Metabolic Disorders, 19(2), 1631–1637. https://doi.org/10.1007/s40200-020-00584-3
Nkhoma, D. E., Soko, C. J., Bowrin, P., Manga, Y. B., Greenfield, D., Househ, M., … & Iqbal, U. (2021). Digital interventions self-management education for type 1 and 2 diabetes: A systematic review and meta-analysis. Computer Methods and Programs in Biomedicine, 210, 106370. https://doi.org/10.1016/j.cmpb.2021.106370
Rohilla, L., Kaur, S., Duggal, M., Malhi, P., Bharti, B., & Dayal, D. (2021). Diabetes self-management education and support to improve outcomes for children and young adults with type 1 diabetes: An umbrella review of systematic reviews. The Science of Diabetes Self-Management and Care, 47(5), 332–345. https://doi.org/10.1177/26350106211031809
Romero-Castillo, R., Pabón-Carrasco, M., Jiménez-Picón, N., & Ponce-Blandón, J. A. (2022). Effects of a diabetes self-management education program on glucose levels and self-care in type 1 diabetes: A pilot randomized controlled trial. International Journal of Environmental Research and Public Health, 19(23), 16364. https://doi.org/10.3390/ijerph192316364
Tanaka, R., Shibayama, T., Sugimoto, K., & Hidaka, K. (2020). Diabetes self-management education and support for adults with newly diagnosed type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Journal of Diabetes Investigation, 11(4), 1152–1166. https://doi.org/10.1111/jdi.13241
