Why Nursing Uses APA 7
APA (American Psychological Association) style is the standard citation format for nursing, psychology, social work, and health sciences. The 7th edition, published in 2020, introduced significant changes from the 6th edition including simplified DOI formatting, new guidance on inclusive language, removal of running heads from student papers, and updated rules for electronic sources.
Your faculty will notice if you mix 6th and 7th edition rules. The most common giveaway is using "Retrieved from" before a URL (6th edition) or placing the location after a publisher name in book references — both eliminated in APA 7.
Key Changes in APA 7 (vs. 6th Edition)
✓ Running head removed from student papers (still required for manuscripts submitted for publication)
✓ DOI format changed: now uses https://doi.org/ prefix, no "doi:" label
✓ "Retrieved from" no longer used before URLs or DOIs
✓ Up to 20 authors now listed in references (was 7)
✓ Publisher location removed from book references
✓ New guidance on inclusive and bias-free language
Page Format Requirements
Every APA 7 student paper must follow these formatting rules:
- Font: 12-pt Times New Roman, 11-pt Calibri, 11-pt Arial, or 10-pt Lucida Sans Unicode. Your institution may specify — default to 12-pt Times New Roman.
- Margins: 1 inch (2.54 cm) on all sides
- Spacing: Double-spaced throughout — including references and block quotes. No extra spacing between paragraphs.
- Indentation: 0.5-inch indent for each new paragraph (use Tab key, not spaces)
- Page numbers: Top right header on every page, including the title page
- Title page: Course name, professor's name, institution, assignment due date, and author note (if required)
Heading Levels
APA 7 uses five heading levels. Most nursing papers use Levels 1–3. The first text paragraph after a heading is not indented in APA 7.
| Level | Format | Example |
|---|---|---|
| 1 | Bold, Centered, Title Case | Literature Review |
| 2 | Bold, Flush Left, Title Case | Nursing Interventions for Pressure Injury Prevention |
| 3 | Bold, Indented, Title Case, Period. | Repositioning Protocols. Text begins here… |
| 4 | Bold Italic, Indented, Title Case, Period. | Hourly Rounding Evidence. Text begins here… |
| 5 | Italic, Indented, Title Case, Period. | Two-Hour Repositioning. Text begins here… |
In-Text Citations
Every fact, statistic, paraphrase, or direct quote borrowed from another source requires an in-text citation. APA 7 uses the author–date format.
Paraphrase (most common in nursing papers)
Direct Quote
Multiple Authors
| Authors | First Citation | Subsequent Citations |
|---|---|---|
| 1 author | (Smith, 2023) | (Smith, 2023) |
| 2 authors | (Smith & Jones, 2023) | (Smith & Jones, 2023) |
| 3+ authors | (Smith et al., 2023) | (Smith et al., 2023) |
| Group/organization | (American Nurses Association [ANA], 2022) | (ANA, 2022) |
No Author
Use the first few words of the title (in italics for journals/books, in quotation marks for articles/chapters) plus the year: ("Hospital Readmission Rates," 2023).
Secondary Source (citing a source you read about in another source)
Avoid secondary citations when possible — track down the original source. When unavoidable: (Original Author, Year, as cited in Secondary Author, Year). Only the secondary source goes in the reference list.
Reference List Formatting
The reference list starts on a new page, titled "References" (bold, centered, no quotation marks). Entries are alphabetized by first author's last name, double-spaced, and use a hanging indent (first line flush left, subsequent lines indented 0.5 inch).
Journal Article with DOI
Journal Article without DOI (with URL)
Book
Chapter in Edited Book
Government / Organization Report
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Your references must come from peer-reviewed nursing journals or authoritative clinical organizations. Avoid Wikipedia, general health websites, or sources older than 5 years (unless a foundational theory or historical context requires them).
| Source Type | Examples | Access |
|---|---|---|
| Peer-reviewed nursing journals | Journal of Nursing Scholarship, Nursing Research, American Journal of Nursing, Journal of Advanced Nursing | CINAHL, PubMed, your library |
| Clinical practice guidelines | AHA, CDC, WHO, AACN, NDNQI, The Joint Commission guidelines | Organization websites (free) |
| NANDA-I taxonomy | Herdman & Kamitsuru (2021) — NANDA 12th edition | Purchase or library access |
| Cochrane Reviews | Systematic reviews on nursing interventions | cochranelibrary.com |
| Government health agencies | CDC, NIH, AHRQ, CMS, Institute for Healthcare Improvement | Free online |
Common APA 7 Mistakes in Nursing Papers
Inclusive Language in APA 7
APA 7 expanded guidance on bias-free, inclusive language. Key rules for nursing papers:
- Use "patient" or "client" rather than "the diabetic" or "the schizophrenic" — person-first language separates identity from diagnosis
- Use "older adults" rather than "the elderly" or "seniors"
- Use gender-neutral language; "they/them" is acceptable as singular when gender is unknown or nonbinary
- Specify racial/ethnic groups with precision — avoid vague terms like "minority" or "non-white"
- Use "participants" or "people" not "subjects" when referring to research participants (unless quoting a source that uses that term)
Frequently Asked Questions
Do student nursing papers require a running head in APA 7?
No. APA 7 removed the running head requirement for student papers. Only manuscripts submitted to journals for publication still require running heads. If your professor requires one, follow their instructions — syllabus overrides APA defaults.
Can I cite the nursing textbook instead of the original study?
Avoid it. Textbooks cite primary research, and citing the textbook is a secondary citation. Instructors expect you to find and cite the original study. Use CINAHL, PubMed, or your library's databases to locate the source.
How old can my sources be?
Most nursing programs require sources published within the last 5 years for current evidence. Theoretical frameworks (Nightingale, Watson, Orem) and foundational clinical texts may be older. Check your assignment rubric — many explicitly require "within 5 years" for research sources.
Should I use ampersand (&) or "and" in citations?
Ampersand (&) inside parentheses: (Smith & Jones, 2022). Spell out "and" in running text: "Smith and Jones (2022) found that…"