Abstract
BackgroundDespite the growing international interest in patient safety as a discipline, there has been a lack of exploration of its application to mental health. It cannot be assumed that findings based upon physical health in acute care hospitals can be applied to mental health patients, disorders and settings. To the authors’ knowledge, there has only been one review of the literature that focuses on patient safety research in mental health settings, conducted in Canada in 2008. We have identified a need to update this review and develop the methodology in order to strengthen the findings and disseminate internationally for advancement in the field. This systematic review will explore the existing research base on patient safety in mental health within the inpatient setting.MethodsTo conduct this systematic review, a thorough search across multiple databases will be undertaken, based upon four search facets (“mental health”, “patient safety”, “research” and “inpatient setting”). The search strategy has been developed based upon the Canadian review accompanied with input from the National Reporting and Learning System (NRLS) taxonomy of patient safety incidents and the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). The screening process will involve perspectives from at least two researchers at all stages with a third researcher invited to review when discrepancies require resolution. Initial inclusion and exclusion criteria have been developed and will be refined iteratively throughout the process. Quality assessment and data extraction of included articles will be conducted by at least two researchers. A data extraction form will be developed, piloted and iterated as necessary in accordance with the research question. Extracted information will be analysed thematically.DiscussionWe believe that this systematic review will make a significant contribution to the advancement of patient safety in mental health inpatient settings. The findings will enable the development and implementation of interventions to improve the quality of care experienced by patients and support the identification of future research priorities.Systematic review registrationPROSPERO CRD42016034057 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0365-7) contains supplementary material, which is available to authorized users.
Highlights
Despite the growing international interest in patient safety as a discipline, there has been a lack of exploration of its application to mental health
The vast majority of this body of research to date has focused on physical healthcare; it cannot be assumed that findings based upon physical health patients can be applied to mental health patients, disorders and settings
Strengths and limitations of the review The main strength of this systematic review is that it will be purposely broad in terms of patient safety issues and is expected to cover a wide range of literature
Summary
The checklist included as an Additional file 1 has been used to guide the information included in this protocol. The reference lists of the eligible articles identified after full-text screening by the main search strategy will be reviewed by the research team to ensure that no key articles have been missed. Hawker’s checklist evaluates nine domains: (1) abstract/ title, (2) introduction and aims, (3) method and data, (4) sampling, (5) data analysis, (6) ethics and bias, (7) results, (8) transferability and generalisability and (9) implications and usefulness The quality of these nine domains will be assessed according to four descriptors: very poor, poor, fair and good. The quality assessment tool will be applied to all included articles by two reviewers, and results will be compared and discussed with input from the broader research team. Excel spreadsheets are being used to apply screening criteria systematically, record the reasoning behind decision-making and extract data from high-relevance articles in line with the research question. Data synthesis Data synthesis is likely to be thematic in nature and influenced by the core research question (i.e. identifying key findings from the existing research base that can help set a future research agenda)
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