Reception Desk

Nursing Students

This page is for nursing resources and research guides housed in Dr. Charles F. Grabske Library on the Graceland University Independence campus. The library is Monday through Friday from 8 a.m. to 5 p.m.

 

The Grabske Library is named after Graceland graduate Dr. Charles F. Grabske, Sr., who served on Graceland’s board of trustees from 1932-1951. The library was previously located at the Columbia Independence Regional Health Center.

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Nursing Student Resources

Helpful Searching Tips

Before you start searching, be clear on what you're searching for. There are a variety of methods that can help structure your question.

PICO is an acronym used for patient-centered problems based on four areas of knowledge and action:

  1. Patient or Problem

  2. Intervention, cause or prognosis

  3. Comparison or Control

  4. Outcome or results

 

Here's an example query: "Treatment of osteoporosis with raloxifene instead of calcium for hip fractures"

 Patient/Problem

(Aspect 1)

 Intervention

(Aspect 2)

 Comparison

(Aspect 3)

 Outcome

(Aspect 4)

Woman with osteoporosis

Raloxifene

SERM*

Compared to:

  • Vitamin D

  • Calcium

  • Placebo

Reduction in fractures:

  • Hip

  • Wrist

This method is designed to make a valid, successful decision based on the skills and knowledge of the clinician as well as the values of the patient. Ultimately, the clinician/searcher aims to find clinically relevant evidence among the enormous amount of medical literature.

Levels of Evidence

Critically-appraised individual articles and synopses include:

Filtered evidence:

  • Level I: Evidence from a systematic review of all relevant randomized controlled trials.

  • Level II: Evidence from a meta-analysis of all relevant randomized controlled trials.

  • Level III: Evidence from evidence summaries developed from systematic reviews

  • Level IV: Evidence from guidelines developed from systematic reviews

  • Level V: Evidence from meta-syntheses of a group of descriptive or qualitative studies

  • Level VI: Evidence from evidence summaries of individual studies

  • Level VII: Evidence from one properly designed randomized controlled trial

Unfiltered evidence:

  • Level VIII: Evidence from nonrandomized controlled clinical trials, nonrandomized clinical trials, cohort studies, case series, case reports, and individual qualitative studies.

  • Level IX: Evidence from opinion of authorities and/or reports of expert committee

Two things to remember:

1. Studies in which randomization occurs represent a higher level of evidence than those in which subject selection is not random.

2. Controlled studies carry a higher level of evidence than those in which control groups are not used.

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