Appraisal Guide

APPENDIX C

Conclusions of a Systematic Review with Narrative Synthesis

Citation:

Assunção-Costa, L., Costa de Sousa, I., Alves de Oliveira, M. R., Ribeiro Pinto, C., Machado, J. F. F., Valli, C. G., & de Souza, L. E. P. F. (2022). Drug administration errors in Latin America: a systematic review. Plos One, 17(8), 0272123. https://doi.org/10.1371/journal.pone.0272123. 

Synopsis:

What organization or persons produced the systematic review (SR)? 

How many persons were involved in conducting the review?

There were 7 people involved in conducting this review.

What topic or question did the SR address?

The topic to address was to determine the frequency and nature of medication administration errors in Latin American hospitals.

How were potential research reports identified?

What determined if a study was included in the analysis?

How many studies were included in the review?

A total of 10 studies were conducted at 22 hospitals in this review. 

What research designs were used in the studies?

Seven cross-sectional studies, two “before and after” studies, one descriptive, exploratory, multicenter study was included. Disguised direct observation was performed in four studies to assess medication administration, a method in which the observed team is not aware of the study to avoid change, or unusual behaviors. 

What were the consistent and important across-study’s conclusions?

Credibility

Was the topic clearly defined?  Yes   No   Not clear

Was the search for studies and other 
evidence comprehensive and unbiased?  Yes   No   Not clear

Was the screening of citations for 
inclusion based on explicit criteria?  Yes   No   Not clear

*Were the included studies assessed 
for quality?  Yes   No   Not clear

Were the design characteristics and 
findings of the included studies displayed 
or discussed in sufficient detail?  Yes   No   Not clear

*Was there a true integration (i.e., synthesis) of the findings—not
merely reporting of findings from 
each study individually?  Yes   No   Not clear

*Did the reviewers explore why differences 
in findings might have occurred?  Yes   No   Not clear

Did the reviewers distinguish between
conclusions based on consistent findings 
from several good studies and those 
based on inferior evidence (number or quality)?  Yes   No   Not clear

Which conclusions were supported by 
consistent findings from two or more 
good or high-quality studies? List

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Are the conclusions 
credible?  Yes All   Yes Some   No

Clinical Significance

*Across studies, is the size of the
treatment or the strength of the
association found or the
meaningfulness of qualitative findings
strong enough to make a difference
in patient outcomes or experiences of care?  Yes   No   Not clear

Are the conclusions relevant to the
care the nurse gives?  Yes   No   Not clear

Are the conclusions 
clinically significant?  Yes All   Yes Some   No

Applicability

Does the SR address a problem,
situation, or decision we are addressing in our setting?  Yes   No   Not clear

Are the patients in the studies or a
subgroup of patients in the studies 
similar to those we, see?  Yes   No   Not clear

What changes, additions, training, or
purchases would be needed to implement
and sustain a clinical protocol based
on these conclusions? Specify and list

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Is what we will have to do to implement
the new protocol realistically achievable 
by us (resources, capability, commitment)?  Yes   No   Not clear

How will we know if our patients are 
benefiting from our new protocol? Specify

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Are these conclusions
applicable to our setting?  Yes All   Yes Some   No

Should we proceed to design
a protocol incorporating 
these conclusions?  Yes All   Yes Some   No

* = Important criteria

Comments

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