How to Write a Literature Review in Nursing: Search, Matrix and Synthesis

A literature review in nursing does not simply list what has been written. It brings together the best available research on a focused question, judges its quality and shows what it means for practice. It is the engine of capstones, DNP projects, evidence-based practice papers and research proposals.

This guide gives you a method, from question to final draft, that you can follow for a course paper or a larger project.

What a literature review is for

A good review does three jobs.

1. It shows what is known. It summarizes the evidence on your question.
2. It shows how strong the evidence is. It judges quality and consistency.
3. It shows what is missing or what to do. It identifies gaps and implications for practice or further study.

For a capstone, the review also justifies your intervention. The reader should finish it understanding why your plan is reasonable.

Step 1: Start with a focused question

Write your PICOT question first. It tells you what to search for and what to leave out. A broad topic such as "pain management" will produce thousands of results. A question about nurse-led education and postoperative pain in adults gives you something manageable. PICOT questions explained shows how to write one.

Step 2: Plan your search

Before you type, plan.

• Choose databases. CINAHL is central for nursing, with PubMed and MEDLINE for broader biomedical literature and the Cochrane Library for systematic reviews. Your institution may provide others.
• List key concepts and synonyms. For example, older adults, elderly and geriatric; falls and falling.
• Use subject headings and keywords. Databases have controlled vocabulary, such as CINAHL Headings and MeSH, which find articles however authors phrase things.
• Combine terms. Use AND to narrow, OR to widen with synonyms, and quotation marks for phrases.
• Set limits. Peer-reviewed, English language, human subjects, and a date range, often the last five to ten years.

Keep a search log with the database, date, search string and number of results. Programs and reviewers often ask to see it.

Step 3: Screen and select

Work in rounds.

1. Remove duplicates.
2. Screen titles and abstracts against your inclusion and exclusion criteria.
3. Read full texts of those that remain.
4. Record reasons for excluding studies.
5. Check reference lists of key articles for studies you missed.

Write your criteria in advance: population, setting, design, outcomes and date. This keeps you consistent and helps you explain your choices.

Step 4: Build a synthesis matrix

A matrix is a table that lets you compare studies at a glance. Typical columns include:

The matrix becomes your working tool. When you start writing, you will use it to see patterns instead of rereading every article.

Step 5: Appraise the quality

Not every published study is equally trustworthy. Use a checklist suited to the design, such as those from the Joanna Briggs Institute or CASP, or the tools your program prefers. Ask about sample size, how participants were selected, whether bias was controlled, whether outcomes were measured well and whether the conclusions follow from the data. How to appraise nursing research covers these questions.

Record your judgment in the matrix, and let it shape how much weight you give each study.

Step 6: Find the themes

Read across your matrix and look for patterns.

• Which interventions or findings appear repeatedly?
• Where do studies agree, and where do they disagree?
• Do differences relate to population, setting or method?
• What outcomes are measured most often?
• What is missing?

Group studies under three to five themes. Each theme becomes a section of your review.

Step 7: Plan the structure

A typical structure for a course or capstone review is:

1. Introduction: the problem, the question and the scope.
2. Search method: a brief description of databases, terms and criteria.
3. Body: organized by theme.
4. Discussion: what the evidence says overall, its strength and gaps.
5. Conclusion: implications for practice or for your project.

Organize the body by ideas, not by article. That is the difference between a list and a review.

Step 8: Write with synthesis

Compare how a summary and a synthesis read.

Summary: Smith (2021) studied hourly rounding on a surgical unit and found fewer falls. Jones (2020) studied rounding in long-term care and found a reduction in falls. Lee (2022) examined rounding in medical units and found no change.

Synthesis: Evidence on hourly rounding is mixed. Two studies in surgical and long-term care settings reported fewer falls (Jones, 2020; Smith, 2021), while a study on medical units found no change (Lee, 2022). The difference may reflect staffing levels or how consistently rounds were done, which suggests that implementation matters as much as the intervention.

The second version groups the studies, compares them and offers an interpretation. A resource such as this nursing literature review guide shows another way to lay out the sections once you have your themes.

Step 9: Cite correctly

Most nursing programs use APA style. Use in-text citations for every claim from a source, keep a reference list in order and check details such as DOIs. Paraphrase in your own words, and keep quotations short and rare. A reference manager can help you stay consistent.

Step 10: Revise

Reread your draft with these questions.

1. Does every paragraph make a point that relates to the question?
2. Do I compare studies, or only describe them?
3. Have I explained the strength of the evidence?
4. Have I noted limitations and gaps honestly?
5. Does the conclusion follow from the review?
6. Are the sources current, relevant and cited correctly?

Ask a classmate or writing center tutor to read it. If they cannot tell what your question is, revise the introduction.

Managing the workload

A review can feel enormous, so break it into small, scheduled tasks. A workable plan for a course paper might be a week for the question and search, a week for screening and reading, a week for the matrix and themes and a week for drafting and revising. For a capstone, stretch each stage but keep the same order.

Work in short, regular sessions. Reading three articles carefully and filling in the matrix is more productive than skimming ten and remembering nothing. Save every PDF with a consistent file name, and note the citation details as you go so you are not hunting for them later.

Writing the introduction and conclusion

Write the introduction last, once you know what the evidence says. State the problem in a few sentences, give the scope and question, and say how the review is organized. For the conclusion, answer the question directly. What does the evidence suggest, how confident are you, and what should happen next in practice or in your project? Avoid introducing new studies at this point, and keep the tone measured so that you claim only what the evidence supports.

Common weaknesses

• Listing studies one by one. Organize by theme.
• Too many weak sources. Prefer stronger, more relevant ones.
• No search description. Readers need to know how you found studies.
• Ignoring conflicting results. Address them directly.
• No link to practice. Explain what the evidence means for your setting.
• Outdated sources without reason.

Final thoughts

A strong nursing literature review is focused, systematic and analytical. Start with a clear question, document your search, compare studies in a matrix, judge their quality and write by theme. If you do, you will not only satisfy an assignment but also build a case for change that others can trust.