Identificación de las cualidades deseables respecto a su personal

A systematic review protocol was developed according to best practice, mapped to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines on developing systematic review protocols.

(75)

Following peer review within the doctoral

supervisory team, the protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). (76) The review aimed to capture both quantitative and qualitative studies. Studies on incidence and nature of errors will have employed quantitative designs while studies of causes or contributory factors may have employed quantitative, qualitative or mixed methods designs.

3.3.1 Inclusion criteria Population

The review considered original primary research involving health

professionals (specifically doctors, nurses or pharmacists) that reported the incidence/prevalence/rate/frequency, nature, severity, factors or causes of medication errors amongst hospitalised patients in any of the 16 Middle Eastern countries. Studies of hospital practitioners (or other key stakeholders such as risk managers) were also included.

Types of interventions, comparators

There were no interventions or comparators as would be the case in reviews of effectiveness or cost-effectiveness.

Outcome(s)

Quantitative outcomes were related to each of the review questions as follows: incidence/prevalence/rate/frequency of medication errors, the nature (e.g. classification, severity, patient outcomes) of errors; and causes and contributory factors leading to errors. Qualitative outcomes were around the causes and contributory factors.

3.3.2 Exclusion criteria

Studies of adverse drug reactions which were not classified as medication errors were excluded, as were review articles, letters, opinion papers, editorials and conference abstracts (due to lack of sufficient study details to allow critical appraisal and data extraction), Studies which employed a pre-, post-intervention design were also excluded due to the difficulty in quantifying incidence as part of data extraction and synthesis.

3.3.3

Study design All study designs were included:

1. Quantitative designs - randomised controlled trials which may have captured data on incidence, nature and causes, non-randomised comparative studies, observational studies, cohort studies and before and after studies, surveys.

2. Qualitative designs - narrative, phenomenology, grounded theory, ethnography, case studies, action research.

3. Mixed methods design.

Language

Due to the difficulty in translation from other languages to English, only papers in English were included.

Capture dates

All papers published from 2000 until the end of March 2018 were included in the review.

3.3.4 Search terms Search terms were:

• medic* OR prescrib* OR dispens* OR administ*

AND

• Error* OR incident* OR mistake*

AND

• Middle East OR Saudi Arabia OR Qatar OR United Arab Emirates OR Kuwait OR Bahrain OR Oman OR Palestine OR Israel OR Iran OR Iraq OR Syria OR Lebanon OR Egypt OR Jordan OR Turkey OR Yemen

Search terms were generated from a number of sources: the previous systematic reviews published around medication errors described in Chapter 1; the title and keywords from key papers in the field; and from Google Scholar scoping search and from the references of published literatures. These search strings were also used to search Medical Subject Headings (MeSH®).

3.3.5 Databases

To ensure adequate performances in search, the review included MEDLINE (including Epub ahead of print), PubMed, Embase, CINAHL (for nursing and allied health sciences), Science Direct and Google Scholar were used.

The narrative review reported in Chapter one identified that almost all of the systematic reviews in the medication errors field had used at least three of these databases.

Table 3.1 describes the different databases included in the review.

Table 3-1: Description of all databases searched

Database Description Year

started Scope

Medline

Medical Literature Analysis and Retrieval System Online (a subset of PubMed), or MEDLARS Online is a bibliographic database of life

sciences and biomedical information. It includes bibliographic information of articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, and health care.

1964 Contains over 26 million records from more than 5,600 selected journals in

40 plus languages.

PubMed PubMed is an online version of Index Medicus produced by the US National Library of Medicine. It covers back to 1966 and selectively to

1809. 1996 Has more than 27 million references

including Medline.

Science Direct

Science Direct is operated by Elsevier. It covers articles from 1823 that include information on topics from Physical Sciences and Engineering Life Sciences Health Sciences Social Sciences and

Humanities.

1997 Has more than 12 million references from 3,500 academic journals and

34,000 e-books.

Embase

A biomedical and pharmacological database that covers literature related to Pharmacology and Pharmaceutical Science;

Pharmacoeconomics; Toxicology; Evidence-Based Medicine;

Environmental Health Research and Policy Management. 1947 Covers 32 million records over 8,500 journals.

CINAHL

The Cumulative Index to Nursing and Allied Health Literature (CINAHL) is one of the most comprehensive databases used by nursing and allied healthcare professionals. It covers articles from

1981 on topics over 50 nursing specialties, speech and language pathology, nutrition, general health and medicine and more.

1961 Covers more than 5.8 million records from 5,500 journals.

CDSR

The Cochrane Database of Systematic Reviews (CDSR) is leading resource for systematic reviews and protocols in healthcare. It covers

systematic reviews related to primary research in human health care

and health policy. 2005 Contains over 10000 records.

Google Scholar and reference lists of all included studies were searched for potentially relevant studies

3.3.6 Screening and selection

Independent, duplicate screening of titles, abstracts and full papers in relation to the review aim (detailed description of the search is given PRISMA flowchart describing systematic review), questions and inclusion criteria was independently performed by two reviewers. Disagreements were resolved by consensus and referred to a third reviewer whenever required.

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