Writing a Nursing Literature Search Strategy

What is a Search Strategy in a Nursing Literature Review?

A search strategy, specifically in nursing, is a planned, structured method for finding published literature in databases. Creating a search strategy requires identifying keywords from your PICOT question or clinical question, searching for synonyms/ Medical Subject Headings (MeSH), using Boolean operators (AND/OR) to develop search phrases, and defining inclusion-exclusion criteria.

Importance of a Search Strategy for Nursing Literature Review

Nursing evidence is scattered across clinical, allied-health, and social-science literature, and the same idea is described in many different ways. “Pressure injury,” “pressure ulcer,” “bedsore,” and “decubitus ulcer” all point to the same concept.  A structured search strategy is important in identifying all the relevant sources for answering the practice question.

 A well-built nursing literature search strategy delivers four things:

• Comprehensiveness: The process results in identifying relevant studies you would never reach with a single keyword, protecting your review from selection bias.
• Reproducibility: A documented strategy can be re-run and verified, which is a baseline expectation for evidence synthesis.
• Transparency: Showing your search demonstrates rigor to examiners, reviewers, and clinical decision-makers.

How to Write a Search Strategy for Nursing Literature Review

Here we answer: How do I write a search strategy for nursing? Building a search strategy can be done in the following steps:

1. Creating the PICOT question. Your clinical or review question should be in the Population, Intervention, Comparison, Outcome, and (where relevant) Time format.
   
   
2. Choosing the search concepts. The Population, Intervention, and Outcome provide the keywords that will be used.
   
   
3. Gathering controlled vocabulary and keywords. For each concept, identifying subject headings (MeSH or CINAHL Headings) plus every free-text synonym, abbreviation, and spelling variant is essential to determine the keywords. In MEDLINE and PubMed, these are MeSH (Medical Subject Headings); in CINAHL they are CINAHL Subject Headings. Searching a heading such as “Accidental Falls”[MeSH] retrieves every record indexed to that concept in one move. Most headings can be exploded to include narrower terms beneath them in the hierarchy.
   
   
4. Combining keywords with Boolean operators. There are three operators, and in most databases they must be typed in uppercase:
   OR: broadens. Use it between synonyms for the same idea: nurse OR nurses OR nursing.
   AND: narrows. Use it to require two different concepts together: falls AND nursing.
   NOT: excludes. Use sparingly; it can silently drop relevant records.
   Group synonyms in parentheses so the logic runs in the right order, and use quotation marks for exact phrases: (MH “Accidental Falls”) AND (“nurse led” OR nurs*).
   
   
5. Applying inclusion and exclusion criteria. Limits such as date range, language, age group, and study design are applied to ensure that the search phrases are focused.
   
   
6. Choosing relevant articles. Assessing the title and abstract of each article supports in identifying the most suitable studies to include in the literature search.

Nursing Literature Search Databases

Which databases should I search for a nursing literature review? No single database covers all nursing evidence, so a thorough review searches several and adapts the strategy to each one’s syntax.

• CINAHL is the single most important database for nursing evidence, with its own nursing-specific subject headings.
• Medline via EBSCOhost shares CINAHL’s field codes but uses MeSH as its controlled vocabulary rather than CINAHL Headings.
• PubMed indexes MEDLINE and is free to use. Advanced Search Builder allows searching using Subject headings; use [MeSH].

Nursing Literature Review Search Strategy Example

PICOT Question: In hospitalized older adults (P), do nurse-led fall-prevention programs (I), compared with usual care (C), reduce the incidence of inpatient falls (O) over 8 weeks?

Two concepts define this search most sharply: falls and nursing. For each, we gather a subject heading plus keyword synonyms, join synonyms with OR, and then combine the two concepts with AND. Below is an example of a search strategy.

A comprehensive literature search was conducted on electronic databases, namely, Web of Science, Medline, CINAHL, PubMed, and Cochrane. The keywords used in the search are nurse-ed, inpatient, falls, and older adults. Search phrases were created by combining the keywords using Boolean operators AND/OR. The search phrases used are: “Accidental Falls” OR fall* OR “fall prevention” OR falling AND older adults, “Nurses” OR “Nursing Staff, Hospital”[heading] OR  nurs* OR “nurse led” AND falls AND older adults. Articles were considered eligible for inclusion if they were published in the past five years, available in full text, and relevant to the project topic. Articles on falls other than in older adults and had nurse-led interventions were excluded from the literature search.

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