This week, the student focused on developing synthesis tables to summarize the studies identified as relevant to answering their clinical question. They synthesized the variables of interest, levels of evidence, and impact of interventions across studies. Next week, they will reassess their clinical question and determine an appropriate theoretical framework to guide their study. They completed a discussion posting summarizing two studies pertinent to their proposal, including the level of evidence and study design. They also discussed how they will incorporate patient preferences and clinical expertise into their project proposal.

1. Topic Graduate Project in Nursing
Topic: Graduate Project in NursingOrder Description Please go over the 5 previous weeks,
as you will be the one I will work with to complete all my project.Give me quality work, I
have more coming upWeek 5 OverviewOver the past two weeks, you collected evidence to
answer the PICOT question you wrote to guide the search of the literature. You then
appraised that evidence using the rapid critical appraisal tools and created an Evaluation
Table for your “ keeper” studies. This week, you will synthesize the evidence in the
Evaluation Table to determine best evidence as a basis for your project. Synthesis table
templates to assist you can be found in Appendix E in your text (Melnyk & Fineout-Overholt,
2011). The Word document template versions are also available in Week 3 Overview.
Synthesizing the evidence involves determining the levels of evidence, the variables of
interest, and the impact of the interventions across the studies, which should now be
referred to as the “ body of evidence,” a term used to refer to the results from the
Evaluation Table. Creating several Synthesis Tables may be required in order for you to
fully understand the best evidence for your quality improvement project proposal. This
synthesis will determine what intervention you will use to facilitate change and improve
outcomes. Patient preferences and clinical expertise are important to consider. As you
synthesize the body of evidence, viewing it from an expert’ s perspective is crucial. Benner
and Leonard (in Melnyk & Fineout-Overholt, 2011) provide practical suggestions for
assessing bias in research. That approach along with solid clinical judgment is essential to
making decisions regarding your body of evidence. Remember when your math teacher
encouraged you to look at your work from a practical perspective, asking yourself, “ does it
make sense?” It is important that you look at the body of evidence from that perspective at
this juncture.• Demonstrate synthesis of the knowledge and skills acquired in preceding
graduate nursing core and specialty curriculum content. • Integrate this synthesis in the
creation of a scholarly project of either an evidenced-based practice proposal or a research
proposal that generates new nursing knowledge. • Incorporate evidence-based research
methods, scientific writing, and critical thinking demonstrative of graduate level
professional nursing practice. Benner, P. E., & Leonard, V. W. (2011). Patient concerns,
choices, and clinical judgment in evidence-based practice. In B. M. Melynk, & E. Fineout-
Overholt (Eds.), Evidence-based practice in nursing & healthcare (2nd ed.). Philadelphia:
Lippincott Williams & Wilkins.SUMMARY This week, you focused on development of the
Synthesis Table(s) and described the studies of interest in narrative terms for Part 3 of your
project proposal. Next week you will reassess your clinical question to begin the study

2. phase of your evidence-based practice project proposal. In addition, you will determine the
appropriate theoretical framework(s) to guide your study.Assignment 1: Discussion As you
work on your capstone project proposal, you may want to share your progress with your
peers and instructor and seek or provide guidance or share insights. By Tuesday, January 5,
2016, go to the Discussion Area and post responses to the discussion question. All
responses should be posted to the appropriate topic in this Discussion Area. It is important
to support what you say with relevant citations in the APA format from both the course
materials and outside resources. Include the South University online library in your
research activities utilizing not only the nursing resource database, but also those
pertaining to education, business, and human resources. Assignment 1: Discussion This
week the discussion focuses on creating a Synthesis Table(s) as a means to summarize and
organize the body of evidence from the Evaluation Table. The Synthesis tables will be
included in your formal proposal in the Appendix. In the body of the paper, you will
describe the “ keeper” studies in narrative format. For this discussion, include the
following: • Share your approach to synthesizing the evidence. What were the variables of
interest you identified? • Learning to write in a scholarly fashion requires that you are able
to succinctly summarize an article in a sentence or two and cite it appropriately using APA
format. In this discussion, practice summarizing 2 articles you have identified from the
Synthesis Table as pertinent to your proposal. Include the level of evidence, study design,
and evidence of rigor. Use appropriate APA citation in text and references. Incorporate
feedback from peers and faculty in your Dropbox assignment for this week. • In addition to
research studies, patient preference and clinical expertise should also be considered.
Discuss how you will incorporate these important perspectives into your project proposal.
DISCUSSION COMPLETED Synthesizing evidence for this project has been like piecing a
puzzle. Breaking it down into each section is surely making it a bit easier. Although, the
evidence table was very time consuming, it has made synthesizing the evidence much easier
to create summaries, as the ones that follow. According to Melynk and Fineout-Overholt
(2011) synthesizing the evidence is not to produce new knowledge as much as the goal, it is
to synthesize what is already known. Buthorne (2013) implemented a review of literature
that addressed end of life (EOL) decisions and discussions, comparing satisfaction and
quality of EOL experience. They discovered that families that had the conversation and
made decisions known had greater satisfaction of loved ones death. They concluded that
more education is needed on both the healthcare and patient sides of conversation,
regarding choices and communication skills. The level of evidence is IV and there is
evidence of rigor. The second article by Fabro, Schaffer and Scharton (2014) is a qualitative
and quantitative study stressing the importance of implementing class sessions for nursing
students on palliative or end-of-life care. The level of evidence is a IV whereas a Nursing
Education Simulation Framework, which was developed for designing, implementing, and
evaluating simulations for nurses and EOL was used (Fabro, Schaffer & Scharton, 2014); the
framework consisted of five major components that served as a guide for planning,
implementing, and evaluating the EOL simulation scenario. For instance, two scenarios
about an EOL hospital experience were developed for an elective EOL course in a
baccalaureate nursing program, replacing a four-hour EOL observation experience that was

3. part of the course in previous years. The authors concluded that students evaluation from
elective course/scenario from nursing school compared to new graduate nurses from just
four-hour experience, indicated that they were more satisfied with their learning
experiences and they reported an increased level of confidence in their ability to care for
dying patients. Thus, Fabro and his colleagues (2014) added that end-of life nursing courses
should be inculcated in nursing institutions; it can effectively prepare nurses to provide
safe, effective palliative care by exposing them to a variety of clinical scenarios in a
supportive learning environment. These articles that I found pertinent to include have been
supportive of my proposed EOL guide to nursing education. Implementation would enhance
EOL comfort and quality of experience for patient, family and healthcare provider.
References Buthorne, L. (2013). Advocating for Advance Directives: A Review of Literature
in End-of-Life Decision-Making. Med-Surg Matters, 22(2), 20-22 3p Fabro, K., Schaffer, M., &
Scharton, J. (2014). The Development, Implementation, and Evaluation of an End-of-Life
Simulation Experience for Baccalaureate Nursing Students. Nursing Education Perspectives,
35(1), 19-25 7p. doi:10.5480/11-593.1 Melnyk, B. M., & Fineout-Overholt, E. (2015).
Evidence-Based Practice in Nursing and Healthcare (3rd ed.). Philadelphia, PA: Wolters
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