Page 534 - Encyclopedia of Nursing Research

SySTemATIC ReVIeW n 501

A quantitative systematic review uses to approach the question differently, or a
statistical methods to combine the results new question must be considered.
of two or more studies, where appropriate. 2. Formulation of a pICO-based research S
The review may or may not be a meta-anal- question.
ysis. A meta-analysis involves the pooling of 3. Development of a review protocol that
results from comparable randomized con- includes specific aims and objectives,
trolled trials. The focus of a meta-analysis clear inclusion and exclusion criteria,
is on therapy and interventions. Its purpose and an explicit search strategy developed
is to provide a single estimate of effect of an with the assistance of a medical librarian.
intervention or treatment from the combined Consideration needs to be given to the
results of included studies. When the results importance of the problem addressed. The
of qualitative studies are synthesized, the databases and other sources of evidence to
review may be called a qualitative systematic be searched need is a prestudy decision.
review, or meta-synthesis. economic system- 4. Criteria for considering studies for
atic reviews compare both the costs and the review must include a description of the
consequences of different courses of action. types of participants, types of interven-
By quantitatively combining the results of tions (if applicable), types of outcome
several studies, meta-analyses create more measures, and types of studies (study
and convincing conclusions, meta-synthesis designs).
illuminates and expands the understanding
of processes and meaning, and economic The stages associated with conducting
systematic review quantifies attributable cost the review are as follows:
and cost effectiveness. examples of these are
recent reviews highlighting nursing inter- 5. Identification of research studies and
shift reports in acute care hospitals (poletick other evidence for possible inclusion in
& holly, 2010), outcomes of magnet designa- the review.
tion (Salmond, Begley, Brennan, & Saimbert, 6. Assessment of methodological quality
2009), an examination of factors that contrib- using a standardized critical appraisal
ute to nursing leadership, the effectiveness of instrument and conducted by at least
educational interventions in developing lead- two reviewers working independently.
ership behaviors among nurses (Cummings 7. Determination of studies for inclusion
et al., 2008), and an economic analysis of based on the quality assessment.
hospital-acquired infections (Stone, Braccia, 8. Data extraction involved.
& larsen, 2005).
A systematic review involves several The stages associated with interpreting
discrete steps. Decisions at each step of the the review are:
process are accomplished through the use of
at least two reviewers. The steps associated 9. Data synthesis, which involves rea-
with planning, conducting, and interpreting soning from the general to the partic-
findings follow. ular whereby a new interpretation is
The stages associated with planning the presented. If heterogeneity is found,
review are as follows: approaches to finding the reason need to
be specified.
1. Identification of the need for a review. 10. Recommendations for best practice.
This can be accomplished through “scop- 11. Recommendations for further research.
ing,” searching the literature to see if a
review has been done already. If a review While systematic reviews are regarded
has been done, a determination is needed as the strongest form of evidence, a review