Academic Methodology & EBP• 10 min read
How to Execute a High-Distinction PRISMA Systematic Literature Review in Nursing & Medicine
Step-by-step methodology for designing PICO questions, Boolean database search syntax, screening protocols, and CASP critical appraisal tables.
By Dr. Sophia Chen•Doctor of Nursing Practice (King's College London)•February 2, 2026
Key Academic Takeaways:
- Structure your clinical research question using PICO (Population, Intervention, Comparison, Outcome).
- Document transparent Boolean search strings across at least three major databases (PubMed, CINAHL, Cochrane).
- Provide a complete PRISMA 2020 4-stage flow diagram (Identification, Screening, Eligibility, Included).
- Use standardized CASP appraisal checklists to evaluate methodological quality and bias risk.
The Role of Systematic Reviews in Evidence-Based Practice
In clinical nursing and medical sciences, systematic literature syntheses represent the highest tier of the evidence pyramid. Unlike narrative reviews, a systematic review follows a pre-defined, reproducible protocol adhering to PRISMA 2020 guidelines.Step 1: PICO Question Formulation
- P (Population): Adult patients presenting with acute sepsis in emergency triage. - I (Intervention): Implementation of NEWS2 scoring protocols. - C (Comparison): Standard clinical judgment / traditional early warning scores. - O (Outcome): Time to antimicrobial delivery, 30-day mortality rate, ICU escalation.Step 2: Transparent Database Search Syntax
A robust search strategy combines MeSH headings and free-text keywords:("NEWS2" OR "National Early Warning Score 2") AND ("sepsis" OR "acute physiological deterioration") AND ("emergency department" OR "acute triage")
Step 3: Critical Appraisal Using CASP
Every included randomized controlled trial (RCT) or cohort study must be systematically appraised using the Critical Appraisal Skills Programme (CASP) checklist, evaluating selection bias, blinding, and statistical power.Need Help with Your Research?
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