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Literature Review Overview

What is a Literature Review? Why Are They Important?

A literature review is important because it presents the "state of the science" or accumulated knowledge on a specific topic. It summarizes, analyzes, and compares the available research, reporting study strengths and weaknesses, results, gaps in the research, conclusions, and authors’ interpretations.

Tips and techniques for conducting a literature review are described more fully in the subsequent boxes:

• Literature review steps
• Strategies for organizing the information for your review
• Literature reviews sections
• In-depth resources to assist in writing a literature review
• Templates to start your review
• Literature review examples

Literature Reviews vs Systematic Reviews

Systematic Reviews are NOT the same as a Literature Review:

Literature Reviews:

• Literature reviews may or may not follow strict systematic methods to find, select, and analyze articles, but rather they selectively and broadly review the literature on a topic
• Research included in a Literature Review can be "cherry-picked" and therefore, can be very subjective

Systematic Reviews:

• Systemic reviews are designed to provide a comprehensive summary of the evidence for a focused research question
• rigorous and strictly structured, using standardized reporting guidelines (e.g. PRISMA, see link below)
• uses exhaustive, systematic searches of all relevant databases
• best practice dictates search strategies are peer reviewed
• uses predetermined study inclusion and exclusion criteria in order to minimize bias
• aims to capture and synthesize all literature (including unpublished research - grey literature) that meet the predefined criteria on a focused topic resulting in high quality evidence

Literature Review Steps

Graphic used with permission: Torres, E. Librarian, Hawai'i Pacific University

1. Choose a topic and define your research question

• Try to choose a topic of interest. You will be working with this subject for several weeks to months.
• Ideas for topics can be found by scanning medical news sources (e.g MedPage Today), journals / magazines, work experiences, interesting patient cases, or family or personal health issues.
• Do a bit of background reading on topic ideas to familiarize yourself with terminology and issues. Note the words and terms that are used.
• Develop a focused research question using PICO(T) or other framework (FINER, SPICE, etc - there are many options) to help guide you.
• Run a few sample database searches to make sure your research question is not too broad or too narrow.
• If possible, discuss your topic with your professor. 

2. Determine the scope of your review

The scope of your review will be determined by your professor during your program. Check your assignment requirements for parameters for the Literature Review.

• How many studies will you need to include?
• How many years should it cover? (usually 5-7 depending on the professor)
• For the nurses, are you required to limit to nursing literature?

3. Develop a search plan

• Determine which databases to search. This will depend on your topic. If you are not sure, check your program specific library website (Physician Asst / Nursing / Health Services Admin) for recommendations.
• Create an initial search string using the main concepts from your research (PICO, etc) question. Include synonyms and related words connected by Boolean operators
• Contact your librarian for assistance, if needed.

4. Conduct searches and find relevant literature

• Keep notes as you search - tracking keywords and search strings used in each database in order to avoid wasting time duplicating a search that has already been tried
• Read abstracts and write down new terms to search as you find them
• Check MeSH or other subject headings listed in relevant articles for additional search terms
• Scan author provided keywords if available
• Check the references of relevant articles looking for other useful articles (ancestry searching)
• Check articles that have cited your relevant article for more useful articles (descendancy searching). Both PubMed and CINAHL offer Cited By links
• Revise the search to broaden or narrow your topic focus as you peruse the available literature
• Conducting a literature search is a repetitive process. Searches can be revised and re-run multiple times during the process.
• Track the citations for your relevant articles in a software citation manager such as RefWorks, Zotero, or Mendeley

5. Review the literature

• Read the full articles. Do not rely solely on the abstracts. Authors frequently cannot include all results within the confines of an abstract. Exclude articles that do not address your research question.
• While reading, note research findings relevant to your project and summarize. Are the findings conflicting? There are matrices available than can help with organization. See the Organizing Information box below.
• Critique / evaluate the quality of the articles, and record your findings in your matrix or summary table. Tools are available to prompt you what to look for. (See Resources for Appraising a Research Study box on the HSA, Nursing , and PA guides )
• You may need to revise your search and re-run it based on your findings.

6. Organize and synthesize

• Compile the findings and analysis from each resource into a single narrative.
• Using an outline can be helpful. Start broad, addressing the overall findings and then narrow, discussing each resource and how it relates to your question and to the other resources.
• Cite as you write to keep sources organized.
• Write in structured paragraphs using topic sentences and transition words to draw connections, comparisons, and contrasts.
• Don't present one study after another, but rather relate one study's findings to another. Speak to how the studies are connected and how they relate to your work.

Organizing Information

Options to assist in organizing sources and information :

1. Synthesis Matrix

• helps provide overview of the literature
• information from individual sources is entered into a grid to enable writers to discern patterns and themes
• article summary, analysis, or results
• thoughts, reflections, or issues
• each reference gets its own row
• mind maps, concept maps, flowcharts
• at top of page record PICO or research question
• record major concepts / themes from literature
• list concepts that branch out from major concepts underneath - keep going downward hierarchically, until most specific ideas are recorded
• enclose concepts in circles and connect the concept with lines - add brief explanation as needed

3. Summary Table

• information is recorded in a grid to help with recall and sorting information when writing
• allows comparing and contrasting individual studies easily
• purpose of study
• methodology (study population, data collection tool)

Efron, S. E., & Ravid, R. (2019). Writing the literature review : A practical guide . Guilford Press.

Literature Review Sections

• Lit reviews can be part of a larger paper / research study or they can be the focus of the paper
• Lit reviews focus on research studies to provide evidence
• New topics may not have much that has been published

* The sections included may depend on the purpose of the literature review (standalone paper or section within a research paper)

Standalone Literature Review (aka Narrative Review):

• presents your topic or PICO question
• includes the why of the literature review and your goals for the review.
• provides background for your the topic and previews the key points
• Narrative Reviews: tmay not have an explanation of methods.
• include where the search was conducted (which databases) what subject terms or keywords were used, and any limits or filters that were applied and why - this will help others re-create the search
• describe how studies were analyzed for inclusion or exclusion
• review the purpose and answer the research question
• thematically - using recurring themes in the literature
• chronologically - present the development of the topic over time
• methodological - compare and contrast findings based on various methodologies used to research the topic (e.g. qualitative vs quantitative, etc.)
• theoretical - organized content based on various theories
• provide an overview of the main points of each source then synthesize the findings into a coherent summary of the whole
• present common themes among the studies
• compare and contrast the various study results
• interpret the results and address the implications of the findings
• do the results support the original hypothesis or conflict with it
• provide your own analysis and interpretation (eg. discuss the significance of findings; evaluate the strengths and weaknesses of the studies, noting any problems)
• discuss common and unusual patterns and offer explanations
•  stay away from opinions, personal biases and unsupported recommendations
• summarize the key findings and relate them back to your PICO/research question
• note gaps in the research and suggest areas for further research
• this section should not contain "new" information that had not been previously discussed in one of the sections above
• provide a list of all the studies and other sources used in proper APA 7

Literature Review as Part of a Research Study Manuscript:

• Compares the study with other research and includes how a study fills a gap in the research.
• Focus on the body of the review which includes the synthesized Findings and Discussion

Literature Review Examples

Check out the following articles as examples for formatting a literature review.

• Breastfeeding initiation and support: A literature review of what women value and the impact of early discharge (2017). Women and Birth : Journal of the Australian College of Midwives
• Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: A literature review (2017). Journal of Racial and Ethnic Health Disparities

• Vitamin D deficiency in individuals with a spinal cord injury: A literature review (2017). Spinal Cord

Resources for Writing a Literature Review

These sources have been used in developing this guide.

Resources Used on This Page

Aveyard, H. (2010). Doing a literature review in health and social care : A practical guide . McGraw-Hill Education.

Purdue Online Writing Lab. (n.d.). Writing a literature review . Purdue University. https://owl.purdue.edu/owl/research_and_citation/conducting_research/writing_a_literature_review.html

Torres, E. (2021, October 21). Nursing - graduate studies research guide: Literature review. Hawai'i Pacific University Libraries. Retrieved January 27, 2022, from https://hpu.libguides.com/c.php?g=543891&p=3727230

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Nursing Literature Review Example: Research Guides and Tips

Introduction

A nursing literature review is a crucial component of academic research in the field of nursing. It involves a comprehensive and systematic examination of the existing body of literature relevant to a specific research question or topic.

The nursing literature review serves as the foundation for understanding the current state of knowledge, identifying gaps in the research, and guiding the development of a research study. By critically analyzing and synthesizing the scholarly literature, nursing professionals and students can gain valuable insights into the latest trends, best practices, and emerging issues in the field.

The purpose of this article is to provide nursing students and professionals with research tips, formatting guidelines, and nursing literature review examples to help you navigate the process effectively.

What is a Literature Review?

A literature review is a detailed analysis and synthesis of the scholarly literature related to a specific topic or research question. It involves the collection, evaluation, and integration of research studies, articles, and other relevant sources to gain a comprehensive understanding of the current state of knowledge in a particular field. In the context of nursing, a nursing literature review is a crucial component of the research process, as it helps to identify the gaps in the research, highlight the key concepts, and provide a solid foundation for the research methodology .

Literature Reviews vs Systematic Reviews

While literature reviews and systematic reviews are both types of research articles, they differ in their approach and scope. A literature review typically provides a broad overview of the existing research studies, whereas a systematic review follows a more structured and comprehensive methodology to identify, evaluate, and synthesize all available evidence on a specific research question. For example, a literature review on the “Factors Influencing Nursing Turnover” may provide a general summary of the research on this topic, while a systematic review on the same topic would follow a rigorous protocol to systematically search, select, and analyze all relevant studies to draw more definitive conclusions.

Synthesizing the Literature

One of the key aspects of a nursing literature review is the ability to synthesize the research findings from multiple sources. This involves identifying the main ideas, patterns, and relationships among the literature, and then integrating them into a cohesive and meaningful narrative. For example, when reviewing the literature on the effectiveness of nurse-led interventions for hypertension management, the researcher might identify common themes such as the importance of patient education , the role of nurse-led care coordination, and the impact of organizational factors on the success of these interventions.

Key Questions for a Literature Review

When conducting a nursing literature review, it is important to consider the following key questions:

• What is the specific research question or topic being addressed?
• What are the main concepts and theories related to the topic?
• What are the gaps in the existing research?
• What are the strengths and weaknesses of the research studies reviewed?
• How do the research findings relate to the nursing practice and patient outcomes?

Steps for Writing a Literature Review

• Start with your research question: Clearly define the research question or topic that will guide your literature review. For example, “What is the impact of nurse staffing levels on patient outcomes in acute care settings?”
• Search the literature: Utilize relevant databases (e.g., CINAHL , PubMed, Cochrane Library) to retrieve and select the research studies and articles that are relevant to your research question. Use a combination of keywords, subject terms, and boolean operators to conduct a comprehensive literature search.
• Read & evaluate: Carefully read and evaluate the quality of the research studies, considering factors such as methodology, sample size, statistical analysis, and potential biases. Use an evidence matrix to organize the key information and facilitate the synthesis of the literature.
• Finalize results: Organize the research studies into themes or categories, and synthesize the findings to identify patterns, gaps, and contradictions in the literature. This step involves analyzing and comparing the different perspectives and research approaches represented in the literature.
• Write & revise: Compose a clear and well-structured literature review that presents the key findings, discusses the implications for nursing practice, and suggests areas for future research. Revise your writing to ensure that it is cohesive, well-supported, and effectively communicates the significance of your literature review.

Format of a Literature Review

A nursing literature review typically follows a standardized format that includes the following sections:

• Introduction: Provide an overview of the research question or topic, the importance of the literature review, and the structure of the review. This section should engage the reader and set the stage for the literature review .
• Body: Organize the review into sections or themes, each addressing a specific aspect of the research question. Synthesize the research findings, compare and contrast the studies, and identify the gaps in the literature. Use subheadings to clearly delineate the different sections of the literature review.
• Conclusion: Summarize the key findings of the literature review, discuss the implications for nursing practice, and suggest areas for future research. This section should provide a coherent and compelling conclusion to the literature review.
• References: Include a comprehensive list of citations for all the sources used in the literature review, formatted according to the appropriate citation style (e.g., APA, MLA , Chicago).

Nursing Literature Review Examples

• “The Impact of Nurse Staffing on Patient Outcomes in Acute Care Settings: A Systematic Literature Review” (Aiken et al., 2020)

This comprehensive systematic literature review examines the relationship between nurse staffing levels and a variety of patient outcomes in acute care settings. The researchers conducted a thorough search of relevant databases, including CINAHL, PubMed, and the Cochrane Library, to identify high-quality studies addressing this important topic.

After applying rigorous inclusion and exclusion criteria, the authors reviewed 30 studies that met their quality standards. These studies represented a diverse range of acute care settings, including hospitals, intensive care units, and emergency departments , across multiple countries. The researchers carefully evaluated each study’s methodology, sample size, and statistical analysis to assess the overall strength and validity of the evidence.

In synthesizing the findings, the review revealed that higher nurse staffing levels were consistently associated with better patient outcomes. Specifically, the literature indicated that increased nurse staffing was linked to lower mortality rates, higher patient satisfaction, and improved quality of care indicators, such as reduced rates of hospital-acquired infections and pressure ulcers. Several studies also highlighted the importance of appropriate skill mix, with an optimal balance of registered nurses, licensed practical nurses, and nursing assistants.

However, the authors also identified important gaps and limitations in the existing research. Many of the included studies were observational in nature, making it difficult to establish clear causal relationships. Additionally, there was significant heterogeneity in the way nurse staffing and patient outcomes were measured across the different studies. The reviewers called for more research to elucidate the specific mechanisms by which nurse staffing influences patient outcomes, as well as the potential moderating effects of factors such as work environment, nurse experience, and organizational characteristics.

Overall, this systematic literature review provides compelling evidence for the critical role of nurse staffing in ensuring positive patient outcomes in acute care settings. The findings underscore the need for healthcare organizations to prioritize adequate nurse staffing as a key strategy for improving the quality and safety of patient care. The review also highlights the importance of conducting high-quality, methodologically rigorous studies to further our understanding of this complex relationship.

• “Factors Influencing Nursing Turnover: A Systematic Review of the Literature” (Roche et al., 2015)

Nursing turnover is a significant challenge faced by healthcare organizations globally, with negative consequences for patient care, organizational efficiency, and the nursing profession as a whole. To better understand the multifaceted factors contributing to this complex issue, Roche and colleagues conducted a comprehensive systematic review of the literature.

The researchers systematically searched several databases, including MEDLINE, CINAHL, and PsycINFO, to identify relevant studies published between 2000 and 2014. After applying strict inclusion criteria, they included 73 studies in their final analysis, representing a diverse range of nursing settings, such as hospitals, long-term care facilities, and community-based healthcare organizations.

The review adopted a socio-ecological framework to organize and synthesize the findings, examining factors influencing nursing turnover at the individual, interpersonal, organizational, and societal levels. At the individual level, the literature highlighted the importance of job satisfaction, work-life balance, and personal characteristics, such as age and career stage. Interpersonal factors included the quality of relationships with colleagues and supervisors, as well as perceptions of teamwork and collaboration.

At the organizational level, the reviewers identified several key drivers of nursing turnover, including workload, access to resources, compensation and benefits, opportunities for professional development, and organizational culture. Societal factors, such as the overall nursing workforce supply, public perception of the nursing profession, and the broader economic climate, were also found to influence turnover rates.

The authors noted that many of these factors are interrelated and can have cascading effects on each other. For example, high workloads and poor work environments can lead to burnout and job dissatisfaction, which in turn increase the likelihood of nurses leaving their positions.

Based on their synthesis of the literature, Roche et al. proposed a comprehensive framework for understanding nursing turnover, highlighting the need for targeted, multilevel interventions to address this complex issue. The review underscores the importance of fostering positive work environments, providing adequate support and resources for nurses, and addressing broader societal factors that contribute to nursing shortages and high turnover rates.

This systematic review represents a significant contribution to the nursing literature, offering a nuanced and evidence-based perspective on the factors influencing nursing turnover. The findings can inform the development of effective retention strategies and help healthcare organizations create more sustainable and supportive work environments for nursing professionals.

• “The Effectiveness of Nurse-Led Interventions for Hypertension Management in Primary Care: A Systematic Review and Meta-Analysis” (Baral et al., 2021)

Hypertension is a prevalent and often poorly managed chronic condition, with significant implications for patient health and healthcare system costs. In recent years, there has been growing interest in the role of nurse-led interventions in the management of hypertension , particularly in primary care settings. To synthesize the available evidence on the effectiveness of these interventions, Baral and colleagues conducted a comprehensive systematic review and meta-analysis.

The researchers systematically searched multiple databases, including MEDLINE, EMBASE, and the Cochrane Library, to identify relevant randomized controlled trials (RCTs) and quasi-experimental studies published up to 2020. After a rigorous screening and selection process, they included 27 studies in their final analysis, representing a total of 12,578 participants from primary care settings across various countries.

The included studies evaluated a range of nurse-led interventions, such as educational programs, self-management support, medication management, and care coordination. The reviewers used the Cochrane risk-of-bias tool to assess the methodological quality of the studies and ensure the validity of the findings.

The meta-analysis revealed that nurse-led interventions were effective in improving both systolic and diastolic blood pressure outcomes, with statistically significant reductions observed in the intervention groups compared to control groups. Subgroup analyses suggested that interventions incorporating patient education, care coordination, and self-management support were particularly effective in lowering blood pressure.

However, the reviewers also noted significant heterogeneity in the included studies, with variations in the specific components of the nurse-led interventions, the intensity and duration of the programs, and the patient populations. Additionally, the long-term sustainability and cost-effectiveness of these interventions remained largely unclear, highlighting the need for further research in these areas.

Despite these limitations, the findings of this systematic review and meta-analysis provide compelling evidence for the potential of nurse-led interventions in the management of hypertension in primary care settings. The review underscores the valuable role that nurses can play in delivering comprehensive, patient-centered care and empowering individuals to better manage their hypertension.

The authors emphasize the importance of continued research to further elucidate the optimal design and implementation of nurse-led hypertension management programs, as well as their long-term clinical and cost-effectiveness. By building on this evidence base, healthcare organizations can leverage the expertise and accessibility of nursing professionals to improve hypertension control and ultimately enhance patient outcomes in primary care.

Top Tips for Doing Your Literature Review

When conducting a nursing literature review, consider the following top tips:

• Choose a fascinating topic: Select a research question or topic that interests you and aligns with your academic or professional goals. This will help you stay motivated and engaged throughout the review process.
• Be selective: Focus on high-quality, peer-reviewed research studies and articles that are directly relevant to your research question . Avoid the temptation to include every source you find, as this can lead to an unfocused and unwieldy literature review.
• Make the library your friend: Utilize your university library’s resources, including databases, librarians, and citation management tools, to efficiently retrieve and organize your literature. Librarians can provide valuable guidance on search strategies and resource selection.
• Go through the abstracts of relevant articles that have been published before: Skim the abstracts of relevant articles to quickly identify the key findings and determine the relevance to your research. This can save you time and help you focus your review on the most pertinent sources.
• Improvise: Be flexible and adaptable in your literature search and review process, as you may encounter unexpected findings or need to adjust your approach along the way. Remain open-minded and willing to explore new directions that could enhance your understanding of the topic.

Nursing literature review is a crucial component of the research process in the field of nursing. By reviewing and synthesizing the existing literature, researchers can identify the gaps in the research, highlight the key concepts, and provide a solid foundation for the research methodology. The process of conducting a nursing literature review requires dedication, critical thinking, and attention to detail, but the rewards can be substantial, both for the researcher and the nursing profession as a whole.

If you require further assistance with writing a nursing literature review, our team of academic writing experts is here to help. We offer customized services to guide you through the entire process, from topic selection to final revisions. Contact us today to learn more about our nursing literature review writing services.

• What is the difference between a literature review and a meta-analysis? A literature review provides a broad, qualitative synthesis of the existing research on a topic, while a meta-analysis is a statistical technique that quantitatively combines the results of multiple studies to arrive at an overall effect size. Meta-analyses require a more rigorous, systematic approach to identifying, selecting, and analyzing the relevant research.
• How do I choose relevant databases for my nursing literature review? When selecting databases for a nursing literature review, it’s important to consult with a librarian who can provide guidance on the most appropriate discipline-specific databases, such as CINAHL for nursing, PubMed for biomedical literature, and Cochrane Library for systematic reviews. Using a combination of relevant databases will help ensure a comprehensive literature search.
• What is the importance of the evidence matrix  in a literature review? The evidence matrix is a crucial tool for organizing and synthesizing the literature. It allows researchers to systematically document key information from each study, such as the research question, methodology, and quality assessment. This matrix facilitates the identification of patterns, gaps, and contradictions in the existing research.
• How can I ensure my literature review is up-to-date and comprehensive? To keep your literature review current and comprehensive, it’s important to conduct periodic searches to identify any newly published research. Additionally, you can use forward and backward citation tracking to identify related studies that may have been missed in the initial search. This iterative approach helps ensure that your review reflects the most recent and relevant evidence on the topic.

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Nursing: How to Write a Literature Review

• Traditional or Narrative Literature Review

Getting started

1. start with your research question, 2. search the literature, 3. read & evaluate, 4. finalize results, 5. write & revise, brainfuse online tutoring and writing review.

• RESEARCH HELP

The best way to approach your literature review is to break it down into steps.  Remember, research is an iterative process, not a linear one.  You will revisit steps and revise along the way.  Get started with the handout, information, and tips from various university Writing Centers below that provides an excellent overview.  Then move on to the specific steps recommended on this page.

• UNC- Chapel Hill Writing Center Literature Review Handout, from the University of North Carolina at Chapel Hill.
• University of Wisconsin-Madison Writing Center Learn how to write a review of literature, from the University of Wisconsin-Madison.
• University of Toronto-- Writing Advice The Literature Review: A few tips on conducting it, from the University of Toronto.
• Begin with a topic.
• Understand the topic. 
• Familiarize yourself with the terminology.  Note what words are being used and keep track of these for use as database search keywords. 
• See what research has been done on this topic before you commit to the topic.  Review articles can be helpful to understand what research has been done .
• Develop your research question.  (see handout below)
• How comprehensive should it be? 
• Is it for a course assignment or a dissertation? 
• How many years should it cover?
• Developing a good nursing research question Handout. Reviews PICO method and provides search tips.

Your next step is to construct a search strategy and then locate & retrieve articles.

•  There are often 2-4 key concepts in a research question.
• Search for primary sources (original research articles.)
• These are based on the key concepts in your research question.
• Remember to consider synonyms and related terms.
• Which databases to search?
• What limiters should be applied (peer-reviewed, publication date, geographic location, etc.)?

Review articles (secondary sources)

Use to identify literature on your topic, the way you would use a bibliography.  Then locate and retrieve the original studies discussed in the review article. Review articles are considered secondary sources.

• Once you have some relevant articles, review reference lists to see if there are any useful articles.
• Which articles were written later and have cited some of your useful articles?  Are these, in turn, articles that will be useful to you? 
• Keep track of what terms you used and what databases you searched. 
• Use database tools such as save search history in EBSCO to help.
• Keep track of the citations for the articles you will be using in your literature review. 
• Use RefWorks or another method of tracking this information. 
• Database Search Strategy Worksheet Handout. How to construct a search.
• TUTORIAL: How to do a search based on your research question This is a self-paced, interactive tutorial that reviews how to construct and perform a database search in CINAHL.

The next step is to read, review, and understand the articles.

• Start by reviewing abstracts. 
• Make sure you are selecting primary sources (original research articles).
• Note any keywords authors report using when searching for prior studies.
• You will need to evaluate and critique them and write a synthesis related to your research question.
• Consider using a matrix to organize and compare and contrast the articles . 
• Which authors are conducting research in this area?  Search by author.  
• Are there certain authors’ whose work is cited in many of your articles?  Did they write an early, seminal article that is often cited?
• Searching is a cyclical process where you will run searches, review results, modify searches, run again, review again, etc. 
• Critique articles.  Keep or exclude based on whether they are relevant to your research question.
• When you have done a thorough search using several databases plus Google Scholar, using appropriate keywords or subject terms, plus author’s names, and you begin to find the same articles over and over.
• Remember to consider the scope of your project and the length of your paper.  A dissertation will have a more exhaustive literature review than an 8 page paper, for example.
• What are common findings among each group or where do they disagree? 
• Identify common themes. Identify controversial or problematic areas in the research. 
• Use your matrix to organize this.
• Once you have read and re-read your articles and organized your findings, you are ready to begin the process of writing the literature review.

2. Synthesize.  (see handout below)

• Include a synthesis of the articles you have chosen for your literature review.
• A literature review is NOT a list or a summary of what has been written on a particular topic. 
• It analyzes the articles in terms of how they relate to your research question. 
• While reading, look for similarities and differences (compare and contrast) among the articles.  You will create your synthesis from this.
• Synthesis Examples Handout. Sample excerpts that illustrate synthesis.

Regis Online students have access to Brainfuse. Brainfuse is an online tutoring service available through a link in Moodle. Meet with a tutor in a live session or submit your paper for review.

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• Volume 19, Issue 1
• Reviewing the literature
• Article Text
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• Joanna Smith 1 ,
• Helen Noble 2
• 1 School of Healthcare, University of Leeds , Leeds , UK
• 2 School of Nursing and Midwifery, Queens's University Belfast , Belfast , UK
• Correspondence to Dr Joanna Smith , School of Healthcare, University of Leeds, Leeds LS2 9JT, UK; j.e.smith1{at}leeds.ac.uk

https://doi.org/10.1136/eb-2015-102252

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Implementing evidence into practice requires nurses to identify, critically appraise and synthesise research. This may require a comprehensive literature review: this article aims to outline the approaches and stages required and provides a working example of a published review.

Are there different approaches to undertaking a literature review?

What stages are required to undertake a literature review.

The rationale for the review should be established; consider why the review is important and relevant to patient care/safety or service delivery. For example, Noble et al 's 4 review sought to understand and make recommendations for practice and research in relation to dialysis refusal and withdrawal in patients with end-stage renal disease, an area of care previously poorly described. If appropriate, highlight relevant policies and theoretical perspectives that might guide the review. Once the key issues related to the topic, including the challenges encountered in clinical practice, have been identified formulate a clear question, and/or develop an aim and specific objectives. The type of review undertaken is influenced by the purpose of the review and resources available. However, the stages or methods used to undertake a review are similar across approaches and include:

Formulating clear inclusion and exclusion criteria, for example, patient groups, ages, conditions/treatments, sources of evidence/research designs;

Justifying data bases and years searched, and whether strategies including hand searching of journals, conference proceedings and research not indexed in data bases (grey literature) will be undertaken;

Developing search terms, the PICU (P: patient, problem or population; I: intervention; C: comparison; O: outcome) framework is a useful guide when developing search terms;

Developing search skills (eg, understanding Boolean Operators, in particular the use of AND/OR) and knowledge of how data bases index topics (eg, MeSH headings). Working with a librarian experienced in undertaking health searches is invaluable when developing a search.

Once studies are selected, the quality of the research/evidence requires evaluation. Using a quality appraisal tool, such as the Critical Appraisal Skills Programme (CASP) tools, 5 results in a structured approach to assessing the rigour of studies being reviewed. 3 Approaches to data synthesis for quantitative studies may include a meta-analysis (statistical analysis of data from multiple studies of similar designs that have addressed the same question), or findings can be reported descriptively. 6 Methods applicable for synthesising qualitative studies include meta-ethnography (themes and concepts from different studies are explored and brought together using approaches similar to qualitative data analysis methods), narrative summary, thematic analysis and content analysis. 7 Table 1 outlines the stages undertaken for a published review that summarised research about parents’ experiences of living with a child with a long-term condition. 8

• View inline

An example of rapid evidence assessment review

In summary, the type of literature review depends on the review purpose. For the novice reviewer undertaking a review can be a daunting and complex process; by following the stages outlined and being systematic a robust review is achievable. The importance of literature reviews should not be underestimated—they help summarise and make sense of an increasingly vast body of research promoting best evidence-based practice.

• ↵ Centre for Reviews and Dissemination . Guidance for undertaking reviews in health care . 3rd edn . York : CRD, York University , 2009 .
• ↵ Canadian Best Practices Portal. http://cbpp-pcpe.phac-aspc.gc.ca/interventions/selected-systematic-review-sites / ( accessed 7.8.2015 ).
• Bridges J , et al
• ↵ Critical Appraisal Skills Programme (CASP). http://www.casp-uk.net / ( accessed 7.8.2015 ).
• Dixon-Woods M ,
• Shaw R , et al
• Agarwal S ,
• Jones D , et al
• Cheater F ,

Twitter Follow Joanna Smith at @josmith175

Competing interests None declared.

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NURS 3750 - Nursing Honors Project (Neil): Literature Reviews

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Nursing Literature Reviews

What is a Literature (Lit) Review? 

A Literature Review is Not: 

• a quick summary of sources
• a grouping of broad, unrelated sources
• a compilation of everything that has ever been written on a topic
• a literature criticism or book review

So, what is it then?

A literature review is an integrated analysis-- not just a summary-- of scholarly writings that are related directly to your research question.  That is, it represents the literature that provides background information on your topic and shows a correspondence between those writings and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

Adapted from:  https://libguides.uwf.edu/c.php?g=215270&p=4439026  by Hillary Fox, University of West Florida,  hfox @uwf.edu.

Creating a Literature Review using the Matrix Method: 

A matrix review allows you to quickly compare and contrast articles in an easy to read format. It can help you to easily spot differences and similarities between journal articles and your nursing research topic. Review matrices are especially helpful for health sciences literature reviews that cover the scope of research over a given amount of time. 

Most literature reviews are set up in this format: 

Chart adapted from the book below: 

• Check out the e-book above for more help in creating a literature review matrix. 

Steps for Conducting a Literature Review

1. Choose Your Topic

• Review your PICO question and think about your central research question. To review the PICO process, please see Kerry Sewell's LibGuide on this subject. 

2. Decide on the scope of your review

• How many studies do you need to look at? 
• How comprehensive should it be? 
• How many years should it cover? (Dr. Larson usually prefers articles no older than 5 years)

3. Select the databases you want to use to conduct your searches (See the Databases Tab Above!)

4. Conduct your searches and find the literature. (Keep track of your searches)

• Review the abstracts and conclusions carefully. This will help you decide which articles actually fit the criteria you are looking for. 
• Write down the keywords you used and where you found them. 
• Use RefWorks to keep track of your citations. (Email me  - [email protected] -  if you need help!) 

5. Review the Literature (This will probably be the most time consuming part)

• What was the research question of the study you are reviewing?  What were the authors trying to discover? 
• Was the research funded by a company or source that could influence the findings? (Such as Colgate® sponsoring a toothpaste study?)
• What were the research methodologies? Analyze the paper's literature review, the samples and variables used, the results and conclusions. Does the research seem to be complete? Could it have been conducted more soundly? What questions does it raise? 
• If there are conflicting studies, why do you think that is? 
• How are the authors of the paper viewed in the field? Has this study been cited by other publications? 

Literature Review Examples

Remember, a lit review provides an intelligent overview of the topic. There may or may not be a method for how studies are collected or interpreted. Lit reviews aren't always labeled specifically as "literature reviews," they may often be embedded with other sections such as an introduction or background. 

• Mentes, J.C., Salem, N., & Phillips, L.R. (2017). Ethnocultural gerontological nursing. An integrative literature review. Journal of Transcultural Nursing, 28(1), 79-97.  https://journals.sagepub.com/doi/pdf/10.1177/1043659615601483
• Rosa, D.F., Carvalho, M.V., & Pereira, N.R, et al. (2019). Nursing care for the transgender population: genders from the perspective of professional practice. Revista Brasilerira de Enfermagem, 72 (Suppl 1), 299-306.  http://www.scielo.br/pdf/reben/v72s1/0034-7167-reben-72-s1-0299.pdf
• Dahlke, S.A., Hunter, K.F., Negrin, K. (2019). Nursing practice with hospitalized older people: Safety and harm. International Journal of Older People Nursing, 14 (1), e1220.  https://onlinelibrary.wiley.com/doi/full/10.1111/opn.12220

Adapted from:  https://libguides.uwf.edu/c.php?g=215270&p=4439026  by Hillary Fox, University of West Florida, [email protected].

Carrie Forbes, MLS

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Good Place to Start: Citation Databases

Interdisciplinary Citation Databases:

A good place to start your research  is to search a research citation database to view the scope of literature available on your topic.

TIP #1: SEED ARTICLE Begin your research with a "seed article" - an article that strongly supports your research topic.  Then use a citation database to follow the studies published by finding articles which have cited that article, either because they support it or because they disagree with it.

TIP #2: SNOWBALLING Snowballing is the process where researchers will begin with a select number of articles they have identified relevant/strongly supports their topic and then search each articles' references reviewing the studies cited to determine if they are relevant to your research.

BONUS POINTS: This process also helps identify key highly cited authors within a topic to help establish the "experts" in the field.

Begin by constructing a focused research question to help you then convert it into an effective search strategy.

• Identify keywords or synonyms
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• Which database(s) to search
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Seminal Works: Search Key Indexing/Citation Databases

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TIP – How to Locate Seminal Works

• DO NOT: Limit by date range or you might overlook the seminal works
• DO: Look at highly cited references (Seminal articles are frequently referred to “cited” in the research)
• DO: Search citation databases like Scopus, Web of Science and Google Scholar

Web Resources

What is a literature review?

A literature review is a comprehensive and up-to-date overview of published information on a subject area. Conducting a literature review demands a careful examination of a body of literature that has been published that helps answer your research question (See PICO). Literature reviewed includes scholarly journals, scholarly books, authoritative databases, primary sources and grey literature.

A literature review attempts to answer the following:

• What is known about the subject?
• What is the chronology of knowledge about my subject?
• Are there any gaps in the literature?
• Is there a consensus/debate on issues?
• Create a clear research question/statement
• Define the scope of the review include limitations (i.e. gender, age, location, nationality...)
• Search existing literature including classic works on your topic and grey literature
• Evaluate results and the evidence (Avoid discounting information that contradicts your research)
• Track and organize references
• How to conduct an effective literature search.
• Social Work Literature Review Guidelines (OWL Purdue Online Writing Lab)

What is PICO?

The PICO model can help you formulate a good clinical question. Sometimes it's referred to as PICO-T, containing an optional 5th factor. 

Search Example

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What is a Literature Review?

A literature review is an essay that surveys, summarizes, links together, and assesses research in a given field. It surveys the literature by reviewing a large body of work on a subject; it summarizes by noting the main conclusions and findings of the research; it links together works in the literature by showing how the information fits into the overall academic discussion and how the information relates to one another; it assesses the literature by noting areas of weakness, expansion, and contention. This is the essentials of literature review construction by discussing the major sectional elements, their purpose, how they are constructed, and how they all fit together.

All literature reviews have major sections:

• Introduction: that indicates the general state of the literature on a given topic;
• Methodology: an overview of how, where, and what subject terms used to conducted your search so it may be reproducable
• Findings: a summary of the major findings in that field;
• Discussion: a general progression from wider studies to smaller, more specifically-focused studies;
• Conclusion: for each major section that again notes the overall state of the research, albeit with a focus on the major synthesized conclusions, problems in the research, and even possible avenues of further research.

In Literature Reviews, it is Not Appropriate to:

• State your own opinions on the subject (unless you have evidence to support such claims).  
• State what you think nurses should do (unless you have evidence to support such claims).
• Provide long descriptive accounts of your subject with no reference to research studies.
• Provide numerous definitions, signs/symptoms, treatment and complications of a particular illness without focusing on research studies to provide evidence and the primary purpose of the literature review.
• Discuss research studies in isolation from each other.

Remember, a literature review is not a book report. A literature review is focus, succinct, organized, and is free of personal beliefs or unsubstantiated tidbits.

• Types of Literature Reviews A detailed explanation of the different types of reviews and required citation retrieval numbers

Outline of a Literture Review

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Literature Review

Literature review steps.

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Lit Review Templates

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A literature review is an essay or part of an essay that summarizes and analyzes research in a particular discipline. It assess the literature by reviewing a large body of studies on a given subject matter. It summarizes by pointing out the main findings, linking together the numerous studies and explaining how they fit into the overall academic discussion on that subject. It critically analyzes the literature by pointing out the areas of weakness, expansion, and contention. 

Literature Review Sections:

• Introduction: indicates the general state of the literature on a given subject.
• Methodology: states  where (databases), how (what subject terms used on searches), and what (parameters of studies that were included); so others may recreate the searches and explain the reasoning behind the selection of those studies.
• Findings: summary of the major findings in that subject.
• Discussion: a general progression from broader studies to more focused studies.
• Conclusion: for each major section that again notes the overall state of the research, albeit with a focus on the major synthesized conclusions, problems in the research, and even possible avenues for further research.
• References: a list of all the studies using proper citation style. 

Literature Review Tips:

• Beware of stating your own opinions or personal recommendations (unless you have evidence to support such claims).
• Provide proper references to research studies.
• Focus on research studies to provide evidence and the primary purpose of the literature review.
• Connect research studies with the overall conversation on the subject.
• Have a search strategy planner and log to keep you focused.

Literature reviews are not a book reports or commentaries; make sure to stay focused, organized, and free of personal biases or unsubstantiated recommendations.

Literature Review Examples:

• Lemetti, T., Stolt, M., Rickard, N., & Suhonen, R. (2015). Collaboration between hospital and primary care nurses: a literature review. International Nursing Review , 62 (2), 248-266. doi:10.1111/inr.12147  

1. Choose a topic and define your research question.

Your literature review should be guided by a focus research question.   Consider PICO and FINER criteria for developing a research question.

• Make sure your research question is not too broad or too narrow. Do a couple of pre-searches to see what information is out there and determine if it is a manageable topic.
• Identify the main concepts of your research question and write down terms that are related to them. Keep a list of  terms that you can use when searching.
• If possible, discuss your topic with your professor. 

2. Decide on the scope of your review.

Check with your assignment requirements and your professor for parameters of the Literature Review.

• How many studies are you considering?
• How comprehensive will your literature review be?
• How many years should it cover? 

3. Select appropriate databases to search.

Make a list of the databases you will search. 

• Don't forget to look at books, dissertations or other specialized databases .
• Contact your librarian to make sure you are not missing any vital databases for that topic.

4. Conduct searches and find relevant literature.

As you are searching in databases is important to keep track and notes as you uncover information.

• Read the abstracts of research studies carefully instead of just downloading articles that have good titles.
• Write down the searches you conduct in each database so that you may duplicate or avoid unsuccessful searches again.
• Look at the bibliographies and references of research studies you find to locate others .
• Look for subject terms or MeSH terms that are associated with the  research studies you find and use those terms in more searches.
• Use a citation manager such as Zotero or Endnote Basic to keep track of your research citations.

5. Review the literature. 

As you are reading the full articles ask the following questions when assessing studies:

• What is the research question of the study?
• Who are the author(s)? What are their credentials and how are they viewed in their field?
• Has this study been cited?; if so, how has it been analyzed?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.  Does the research seem to be complete?  What further questions does it raise?
• Are there any conflicting studies; if so why?

Throughout the process keep careful notes of your searches and findings so it is easier to put it together when it comes to the writing part.

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What are Systematic Reviews? (3 minutes, 24 second YouTube Video)

Systematic Literature Reviews: Steps & Resources

These steps for conducting a systematic literature review are listed below . 

Also see subpages for more information about:

• The different types of literature reviews, including systematic reviews and other evidence synthesis methods
• Tools & Tutorials

Literature Review & Systematic Review Steps

• Develop a Focused Question
• Scope the Literature  (Initial Search)
• Refine & Expand the Search
• Limit the Results
• Download Citations
• Abstract & Analyze
• Create Flow Diagram
• Synthesize & Report Results

1. Develop a Focused   Question 

Consider the PICO Format: Population/Problem, Intervention, Comparison, Outcome

Focus on defining the Population or Problem and Intervention (don't narrow by Comparison or Outcome just yet!)

"What are the effects of the Pilates method for patients with low back pain?"

Tools & Additional Resources:

• PICO Question Help
• Stillwell, Susan B., DNP, RN, CNE; Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek, PhD, RN, CPNP/PMHNP, FNAP, FAAN; Williamson, Kathleen M., PhD, RN Evidence-Based Practice, Step by Step: Asking the Clinical Question, AJN The American Journal of Nursing : March 2010 - Volume 110 - Issue 3 - p 58-61 doi: 10.1097/01.NAJ.0000368959.11129.79

2. Scope the Literature

A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature. 

Eligible studies may be located by searching in:

• Background sources (books, point-of-care tools)
• Article databases
• Trial registries
• Grey literature
• Cited references
• Reference lists

When searching, if possible, translate terms to controlled vocabulary of the database. Use text word searching when necessary.

Use Boolean operators to connect search terms:

• Combine separate concepts with AND  (resulting in a narrower search)
• Connecting synonyms with OR  (resulting in an expanded search)

Search:  pilates AND ("low back pain"  OR  backache )

Video Tutorials - Translating PICO Questions into Search Queries

• Translate Your PICO Into a Search in PubMed (YouTube, Carrie Price, 5:11) 
• Translate Your PICO Into a Search in CINAHL (YouTube, Carrie Price, 4:56)

3. Refine & Expand Your Search

Expand your search strategy with synonymous search terms harvested from:

• database thesauri
• reference lists
• relevant studies

Example: 

(pilates OR exercise movement techniques) AND ("low back pain" OR backache* OR sciatica OR lumbago OR spondylosis)

As you develop a final, reproducible strategy for each database, save your strategies in a:

• a personal database account (e.g., MyNCBI for PubMed)
• Log in with your NYU credentials
• Open and "Make a Copy" to create your own tracker for your literature search strategies

4. Limit Your Results

Use database filters to limit your results based on your defined inclusion/exclusion criteria.  In addition to relying on the databases' categorical filters, you may also need to manually screen results.  

• Limit to Article type, e.g.,:  "randomized controlled trial" OR multicenter study
• Limit by publication years, age groups, language, etc.

NOTE: Many databases allow you to filter to "Full Text Only".  This filter is  not recommended . It excludes articles if their full text is not available in that particular database (CINAHL, PubMed, etc), but if the article is relevant, it is important that you are able to read its title and abstract, regardless of 'full text' status. The full text is likely to be accessible through another source (a different database, or Interlibrary Loan).  

• Filters in PubMed
• CINAHL Advanced Searching Tutorial

5. Download Citations

Selected citations and/or entire sets of search results can be downloaded from the database into a citation management tool. If you are conducting a systematic review that will require reporting according to PRISMA standards, a citation manager can help you keep track of the number of articles that came from each database, as well as the number of duplicate records.

In Zotero, you can create a Collection for the combined results set, and sub-collections for the results from each database you search.  You can then use Zotero's 'Duplicate Items" function to find and merge duplicate records.

• Citation Managers - General Guide

6. Abstract and Analyze

• Migrate citations to data collection/extraction tool
• Screen Title/Abstracts for inclusion/exclusion
• Screen and appraise full text for relevance, methods, 
• Resolve disagreements by consensus

Covidence is a web-based tool that enables you to work with a team to screen titles/abstracts and full text for inclusion in your review, as well as extract data from the included studies.

• Covidence Support
• Critical Appraisal Tools
• Data Extraction Tools

7. Create Flow Diagram

The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow diagram is a visual representation of the flow of records through different phases of a systematic review.  It depicts the number of records identified, included and excluded.  It is best used in conjunction with the PRISMA checklist .

Example from: Stotz, S. A., McNealy, K., Begay, R. L., DeSanto, K., Manson, S. M., & Moore, K. R. (2021). Multi-level diabetes prevention and treatment interventions for Native people in the USA and Canada: A scoping review. Current Diabetes Reports, 2 (11), 46. https://doi.org/10.1007/s11892-021-01414-3

• PRISMA Flow Diagram Generator (ShinyApp.io, Haddaway et al. )
• PRISMA Diagram Templates  (Word and PDF)
• Make a copy of the file to fill out the template
• Image can be downloaded as PDF, PNG, JPG, or SVG
• Covidence generates a PRISMA diagram that is automatically updated as records move through the review phases

8. Synthesize & Report Results

There are a number of reporting guideline available to guide the synthesis and reporting of results in systematic literature reviews.

It is common to organize findings in a matrix, also known as a Table of Evidence (ToE).

• Reporting Guidelines for Systematic Reviews
• Download a sample template of a health sciences review matrix  (GoogleSheets)

Steps modified from: 

Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.   Medical Education , 46 (10), 943–952.

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