NURS-FPX4025 Assessment 2 Applying an EBP Model

NURS-FPX4025 Assessment 2 Applying an EBP Model – Applying an Evidence-Based Practice Model

Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus that is lifethreatening and requires timely identification and management to avoid serious morbidity and mortality. It is defined by hyperglycemia, ketosis, and metabolic acidosis caused by insulin deficiency and elevated counterregulatory hormones (Lizzo et al., 2023). Although several treatments have been developed, DKA continues to pose a major clinical challenge, being associated with a rise in hospitalizations and inconsistencies in clinical practice. Evidence-based practice (EBP) has become the norm in modern nursing practice, where relying on tradition or

routine is no longer acceptable. EBP ensures that clinical decisions are informed by the best available research, clinical expertise, and patient preferences, resulting in better patient outcomes. This paper discusses DKA as the chosen diagnosis, establishes a clinical problem that could be addressed through an EBP process, implements the ACE Star Model to operationalize the use of evidence, and determines the validity and applicability of the chosen academic sources.

Overview of Diabetic Ketoacidosis (DKA)

DKA is a disease that occurs due to a low level of insulin, leading to elevated blood glucose levels and the breakdown of fats to ketones, which cause metabolic acidosis (Centers for Disease Control and Prevention [CDC], 2024). It can happen in both type 1 and type 2 diabetes patients, and can be provoked by infection, missed insulin administration, or physiological stress. The typical symptoms that the patients tend to present with are polyuria, polydipsia, dehydration,

abdominal pain, and altered mental status. Otherwise, DKA may result in serious complications, such as coma and death. Management involves fluid resuscitation, insulin, and electrolyte replacement and management of the underlying cause. Maharjan et al. (2024) state that early diagnosis and proper treatment can considerably decrease mortality rates. Nevertheless, discrepancies in care provision are still an issue. All these gaps emphasize the importance of an

evidence-based approach in clinical practice to obtain optimal patient outcomes.

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Clinical Issue Requiring an Evidence-Based Approach

Among the issues associated with DKA, one of the most prominent issues that comes to light is the absence of standardization of early recognition and standardized management in the healthcare setting. Late diagnosis and variations in treatment regimens can lead to a greater number of complications, increased hospitalization, and higher health care costs. Of special interest is the emergency and acute care environment, where early intervention is critical and should be both timely and precise. This issue needs to be treated with the help of an EBP approach since it encourages the use of up-to-date and high-quality evidence to make clinical

decisions. Sieben and Ramanan (2025) suggest that clinical practice is uncertain, as much information remains unclear or of low quality regarding DKA management. In addition, Wysham et al. (2025) also note the high burden of DKA, such as higher morbidity and use of health care, especially in patients with type 2 diabetes. The use of an EBP approach can help healthcare providers to standardize care, decrease variability, and enhance patient outcomes.

NURS-FPX4025 Assessment 2 Applying an EBP Model – Description of the ACE Star Model

The ACE Star Model of Evidence-Based Practice is a systematic plan for applying research in practice. The specified model is particularly applicable to address the identified issue because it prioritizes the creation of evidence and its application in practice. The five steps incorporated in the model are knowledge discovery, evidence summary, translation into practice recommendations, integration into practice, and evaluation. Knowledge discovery entails the generation of new evidence by means of primary research studies. Evidence involves taking a summary of individual studies into a coherent understanding, typically through systematic

review or guidelines (Yuan et al., 2026). This evidence is then converted to practice recommendations, which help to translate the evidence into practical clinical recommendations. The integration into practice entails the implementation of these guidelines in healthcare facilities by means of changes to policies, education, and workflow. Finally, evaluation identifies the effectiveness of the changes in place by measuring patient outcomes and improvements where needed. The ACE Star Model is appropriate to this problem as it offers a clear pathway to go between research and practice so that the clinical care is informed by the most up-to-date

evidence.

Application of the ACE Star Model to DKA

The ACE Star Model of the identified problem started with the step of knowledge

discovery, during which related research on DKA management was identified. The databases

(such as PubMed, CINAHL, and Cochrane Library) were searched using keywords such as

DKA, insulin therapy in DKA, and fluid management in DKA. One of the challenges that was

faced during this phase was sifting through the vast amount of literature to come up with the

most recent and quality studies. During the evidence summary phase, the identified studies were

critically evaluated and summarized to reveal important findings. Umpierrez et al. (2024)

provide specific recommendations on DKA management, emphasizing early diagnosis and

conventional care. Wysham et al. (2025) point out the high burden of DKA, while Sieben and

Ramanan (2025) point out gaps in the current body of evidence in particular areas, such as

adjunct treatment and electrolyte regulation.

The translation process involved the transformation of these findings into practice using

recommendations such as the need to adopt standardized insulin administration and fluid

resuscitation guidelines, improve the early detection of symptoms, and the need to improve

patient education. The practice integration implies collaboration of healthcare providers, staff

education, and institutional policies. The possible challenges are resistance to change and lack of

resources, but they can be overcome by providing education and leadership assistance. The

evaluation phase involves assessing how such interventions affect patient outcomes. The

effectiveness may be measured by such indicators as a decreased number of complications,

decreased hospitalization, and increased patient satisfaction. The ongoing assessment will keep

the clinical practices up to date with the existing evidence.

Analysis of Evidence Credibility and Relevance

The applicability and reliability of the selected resources play a key role in determining

whether the resources are useful in informing clinical practice or not. The article by Umpierrez et

al. (2024) is an extremely credible source since it is a consensus report developed by some of the

largest organizations focused on diabetes and is backed by an extensive review of the literature.

It can be directly applied to clinical practice as it provides specific and up-to-date

recommendations on how to deal with DKA. Wysham et al. (2025) provide a systematic

literature review that explores the burden of DKA in type 2 diabetes. The article is authoritative

as it has a rigorous methodology and incorporates a substantial number of studies. Its relevance

is manifested by the emphasis on the general effects of DKA, which implies the necessity of

preventive measures and a more effective management strategy. Sieben and Ramanan (2025)

present evidence and a gap mapping review that detail the areas to be filled by research. The

study is appropriate because of its methodological and comprehensive research process. It is

relevant as it assists in identifying the gaps in existing knowledge, which is needed to direct

future research and improve clinical practice. It offers distinct ideas on areas that need further

research, as compared to the other sources.

Conclusion

Diabetic ketoacidosis is a severe and complex condition that should be treated in a timely

and effective way to remove the complications and improve patient outcomes. The difference in

early diagnosis and prompt treatment emphasizes the importance of an evidence-based approach

to clinical practice. The ACE Star Model offers a systematic approach to evidence integration

into practice that allows healthcare providers to make effective decisions and introduce effective

interventions. Integration of the evidence-based practice results in enhanced patient safety,

outcomes improvement, and the formation of professional nursing practice.

References

Centers for Disease Control and Prevention [CDC]. (2024). About diabetic ketoacidosis.

Diabetes. https://www.cdc.gov/diabetes/about/diabetic-ketoacidosis.html

Lizzo, J. M., Goyal, A., & Gupta, V. (2023). Adult diabetic ketoacidosis. PubMed; StatPearls

Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560723/

Maharjan, J., Pandit, S., Johansson, K. A., Khanal, P., Karmacharya, B., Kaur, G., & Aryal, K.

K. (2024). Effectiveness of interventions for emergency care of hypoglycaemia and

diabetic ketoacidosis: A systematic review. Diabetes Research and Clinical Practice,

207(111078), 111078–111078. https://doi.org/10.1016/j.diabres.2023.111078

Sieben, N., & Ramanan, M. (2025). Research priorities for diabetic ketoacidosis: An evidence

and gap mapping review. Medical Sciences, 13(2), 53.

https://doi.org/10.3390/medsci13020053

Umpierrez, G. E., Davis, G. M., ElSayed, N. A., Fadini, G. P., Galindo, R. J., Hirsch, I. B.,

Klonoff, D. C., McCoy, R. G., Misra, S., Gabbay, R. A., Bannuru, R. R., & Dhatariya, K.

K. (2024). Hyperglycemic crises in adults with diabetes: A consensus report. Diabetes

Care, 47(8), 1257–1275. https://doi.org/10.2337/dci24-0032

Wysham, C., Bindal, A., Levrat‐Guillen, F., Kostadinova, D., & Poon, Y. (2025). A systematic

literature review on the burden of diabetic ketoacidosis in type 2 diabetes mellitus.

Diabetes, Obesity, and Metabolism. https://doi.org/10.1111/dom.16282

Yuan, R., Liu, L., Mi, J., Li, X., & Mao, S. (2026). Application of an ACE star model–based

evidence-based enteral nutrition management protocol in neurocritical care patients.

Frontiers in Nutrition, 13. https://doi.org/10.3389/fnut.2026.1786684

Instructions

Complete the following:

Consider your diagnosis from Assessment 1.

Explain an issue associated with this diagnosis that could benefit from an EBP approach.

Choose the EBP model you wish to implement.

Describe each step of the EBP model of your choice.

Apply the steps of the model to your search for evidence for your diagnosis issue, and describe how you applied them.

Locate at least three separate resources of evidence to assist with your diagnosis issue.

Analyze the credibility and relevance of each resource as it relates to your diagnosis.

This is a paper and should be 3–5 pages, not including the title page or reference page. The paper must be in APA format.