How to Write a Nursing Literature Review: Search, Synthesize & Argue

What a Literature Review Is Actually For

A nursing literature review is not a summary of articles you read. It is an argument: a claim, backed by synthesized evidence, that a particular gap exists in knowledge or practice, that existing evidence points in a particular direction, or that a specific intervention is (or is not) supported by current research.

The difference between a literature review that earns an A and one that earns a C is this: the A paper argues a position and uses evidence to support it. The C paper describes articles without forming a view. By the end of your literature review, the reader should know exactly what the evidence shows, what remains uncertain, and why your capstone project, PICOT question, or clinical recommendation is warranted.

Types of Literature Reviews in Nursing

For most nursing capstone and graduate assignments, you are writing an integrative literature review: a synthesized, thematically organized review of peer-reviewed evidence. You do not need to follow PRISMA unless your program specifically requires a systematic review format.

Building a Systematic Search Strategy

Even for an integrative review, your search should be documented and reproducible. Describe which databases you searched, the terms used, any filters applied, and how many results were returned and retained.

Key Nursing Databases

• CINAHL (Cumulative Index to Nursing and Allied Health Literature): The primary database for nursing literature. Indexes over 5,000 nursing and allied health journals. Start here.
• PubMed/MEDLINE: Broad biomedical database. Essential for clinical, pharmacological, and interdisciplinary evidence.
• Cochrane Library: Systematic reviews of interventions. Highest-quality synthesized evidence. Search this for your specific intervention.
• PsycINFO: Mental health and psychiatric nursing topics.
• Embase: European clinical literature; useful for pharmacology and international evidence.

Building Your Search String

Use Boolean operators (AND, OR, NOT) to combine search terms. Use MeSH (Medical Subject Headings) in PubMed and subject headings in CINAHL for more precise results.

Inclusion and Exclusion Criteria

Define these before you search, not after. Typical criteria for nursing literature reviews:

• Include: Peer-reviewed journals; published within 5 years; English language; adult population (or specify pediatric/geriatric if relevant); primary research or systematic reviews
• Exclude: Opinion pieces, editorials, dissertations (unless required); non-English (unless translated); studies with populations not applicable to your clinical setting

Levels of Evidence

Your literature review should acknowledge the quality of evidence cited. The most commonly used hierarchy in nursing is Melnyk and Fineout-Overholt's Levels of Evidence (2019):

In your literature review, note the level of each study. If your review relies heavily on Level VI–VII evidence, acknowledge this as a limitation and recommend future higher-level research. Strong reviews cite multiple Level I–III sources.

How to Synthesize (Not Summarize)

This is the most important skill in writing a literature review. Synthesis means identifying what multiple sources collectively show — patterns, contradictions, gaps, and conclusions that emerge across the literature.

Step 1: Read with a synthesis matrix

Create a table: rows are your sources, columns are key themes (e.g., intervention type, sample size, outcomes, setting, level of evidence). Reading into this matrix forces you to compare sources rather than read them in isolation.

Step 2: Identify themes, not sources

Organize your review around themes (topics) not around sources (one paragraph per article). Common thematic structure for nursing reviews:

1. Background / epidemiology of the problem
2. Risk factors and affected populations
3. Evidence for Intervention A
4. Evidence for Intervention B (comparison)
5. Implementation challenges and barriers
6. Gaps in the literature

Structure of a Standalone Literature Review

When assigned as a standalone paper (not a chapter of a capstone), the structure is:

1. Introduction (10%): Establish the clinical problem, state the review's purpose and PICOT question or focus, identify databases and date ranges searched.
2. Body — Thematic Sections (70%): 3–5 thematic sections, each arguing a point using synthesized evidence. Subheadings required at graduate level.
3. Gaps and Limitations (10%): What the literature does not address. Where more research is needed. Methodological weaknesses in available studies.
4. Conclusion (10%): Summary of what the evidence shows. Clinical recommendations based on the review. Implications for nursing practice or future research.

Common Mistakes in Nursing Literature Reviews

• One source per paragraph: The surest sign of summary, not synthesis. Each paragraph should draw from multiple sources.
• Not addressing contradictory evidence: If studies conflict, acknowledge it and explain the possible reasons (different populations, settings, interventions). Ignoring contradictions weakens your argument.
• Not stating a position: The conclusion must make a recommendation based on the evidence. "More research is needed" alone is insufficient — state what the current evidence supports, then note where gaps remain.
• Using sources older than 5 years for clinical evidence: Guidelines, drug protocols, and clinical research older than 5 years are generally excluded (unless foundational theory). Date filters are mandatory.
• No search methodology described: At graduate level, describe your search: "A systematic search of CINAHL, PubMed, and Cochrane was conducted using the terms… Filters applied… X articles were retained for final review."