Table 1

Five stages of integrative reviews

StageDescriptionSteps completed
Stage 1: problem identificationClearly identify the topic of interest, a well-specified review purpose, questions to be answered and inclusion and exclusion criteria for the search methodThe underreporting of medical errors in the USA remains a threat to patient safety. One method for addressing this issue is by implementing a ‘just culture’. The aim of this integrative review was to identify existing literature relating to the requirements for implementing a ‘just culture’ within healthcare organisations.
Stage 2: literature searchCreate a comprehensive search strategy to identify all relevant publications on the identified topic and gather information using select keywordsThe authors identified databases to search (PubMed, PsychInfo, Cumulative Index of Nursing and Allied Health Literature, ScienceDirect, Scopus, the Cochrane Library and ProQuest Dissertations and Theses). Search terms included ‘just culture’, ‘healthcare system’, ‘healthcare organization’, ‘health care’, ‘healthcare’, ‘implementation’, ‘implementation requirements’. This generated 60 potentially relevant sources that were screened for eligibility, yielding a final sample of 16 reports.
Stage 3: data evaluationAssess the quality of the information retrievedThe authors used the Critical Appraisal Skills Programme appraisal tool because it accommodates multiple research designs and has well-defined review criteria.
Stage 4: data analysisInterpret the information collected according to findings, themes, concepts and so on.Two authors (JSM and JC) developed a template for extracting information about the evidence (e.g., author/year, country, aim, method/study design, setting/sample, level of evidence, theme(s) identified) relevant to the aim of the review. Following extraction of the data by the first, author, the coauthors assessed extracted information for accuracy and completeness.
Stage 5: presentationDevelop tables, figures, graphs to display findings for publishing and presentingFollowing a description of the 16 sources of evidence included in the review, the authors identified for recurring themes based on their analysis (leadership commitment, education and training, accountability and open communication). Results were summarised in tables and discussed in the text.