Over the next two decades, 78 million Americans will grow old.  That’s the largest number ever in the US. 

At present, there are around 16,000 nursing homes with 1.7 million beds and about a 15 percent vacancy rate. (See: CDC – Resources on Nursing Home Care). 

Clearly, unless the nation undertook a massive building program, there will be many, many more old people than the number of available LTC beds.  

So what are we going to do with all the geezers like me? 

Are LTC beds the only place to put us?  Are there other alternatives that are more cost-efficient?  Given issues of quality  — either perceived or actual —  in many LTCs, do we really even want to keep traditional nursing homes as an option?  What might old people really want?   What are younger people willing to support financially?  What role might pharmaceutical products have in managing age-related issues? What would be the best way for people to age out into death?  

What role does culture play in this discussion?  How do other nations address this issue?

As we think about answers to those questions, there is another level of analysis that looks at the ethics of old age. For example, do you think that everyone has the right to use all the Medicare services they want – regardless of the decisions made about their health when they were younger? In other words, should all old people share an equal right to Federally supported healthcare even if they did not share the same level of responsibility in their earlier choices regarding food, exercise, drugs, and alcohol? 

A second question to consider is whether or not the Government should have any voice in restricting one’s personal choices about dying.  Should everyone have the right to die when they want to, regardless of the situation or reasons?  (Consider researching Compassion and Choices Organization for more insight) Who and how should an end-of-life decision be made when the person is not in possession of their full faculties? 

Lots to ponder this week…

Consideration: This is a repeated story but still useful for this discussion. In the late 1800’s statisticians estimated based on population growth the US would be completely covered, inches deep in horse manure. They did not anticipate the automobile. Similarly, if you went back 120 years and asked farmers what they needed most they would likely say; “a bigger horse that ate fewer oats” they did not account for new technology like a tractor or combine.

When thinking critically about the need for services for the growth in the elderly population perhaps “building more beds” is as fallacious as assuming more horses. What new innovation on the horizon will change the demand forecasting? 

Part I: Confidentiality and Patient’s Rights

In your opinion. 

• Why do you think that confidentiality is such an important part of patient rights? Give an example, either professional or personal, which illustrates why this right is so important to protect. 

 Part II: Using Ethical Frameworks to Make Decisions

Apply what you know.

The readings provide an overview of two ethical frameworks to use in decision-making in the healthcare setting. Let’s unpack the ethical dilemma(s) presented in the emerging genre of real-time hospital dramas. In one of the first episodes of a real-time hospital drama, a wife allegedly initially found out about her husband’s death when she watched an episode of a real-time hospital drama in which his death was televised. Although his face was blurred out, his wife was able to recognize him in the episode.

Let’s look at an episode of a real-time hospital drama. You can choose any episode that you wish, below is just a sample of one. Episodes can be found in many areas including Hulu and Amazon Prime.

• Television Series: Boston Med. (2010). Season 1 Episode 08. (Summary) (Links to an external site.) (Transcripts) (Links to an external site.)

I’ll guide us through our questions. We will discuss the questions as a group, starting with the first question:

1. Decide with your classmates what are the ethical dilemmas presented in this type of series? Consider in your answer the initial episode where the man’s death was allegedly televised. 
2. Discuss who are the stakeholders? Remember to consider individuals, families, communities, and organizations in your answer. 
3. Come to a consensus on what your recommendations would be to address the ethical dilemmas that you, as a class, have identified. Consider and include each applicable component below in your response: 
   • Ethical principles
   • Ethical theories
   • PYTHON principle
   • Six step process (Doherty & Purtilo) for ethical decision-making
   • Laws pertaining to confidentiality and/or patient rights

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.USE MEDICATION ERRORS AS THE CLINICAL ISSUE
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
Chapter 3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N
Note: You will access this article from the Walden Library databases.

Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79
Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58
Note: You will access this article from the Walden Library databases.

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e
Note: You will access this article from the Walden Library databases.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/jbisearchhelp

Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp

Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/72670

Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/healthevide

Use this order for the Assignment:

Part 3: PPT Presentation: Advanced Levels of Clinical Inquiry and Systematic Reviews

• Title Page: 1 slide
• Introduction paragraph and purpose statement: 1 slide
• PPT Presentation: 6- to 7-slides
• Conclusion: 1 slide
• References

The PPT title page, introduction paragraph and purpose statement, conclusion, and references do not count toward the 6- to 7-slide PPT presentation slide requirement. References can be single spaced but make sure that there is enough space between the references so that it is clear where each reference starts and ends.

Find a study published in a nursing journal between 2010 and 2018 that is described a s a pilot study. 

1- Provide a brief description about the article. 

2-Do you think the study really is a pilot study, or do you think this label was used inappropriately? Make sure to describe what the Pilot Study is during your discussion.

3-Search forward for a larger subsequent study to evaluate your response. 

In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project
2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
6. A proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

My CAPSTONE project is about DIABETES

I attached my last Capstone paper to get some ideas from it