Conectar
Tibial plateau fractures present a complex orthopaedic challenge and usually require surgical intervention to restore joint alignment and stability as well as to prevent complications. In practice, determining the most appropriate surgical approach, implant selection and positioning remains a challenge and depends on the surgeon’s experience and patient-specific factors. Therefore, this scoping review aims to map the current evidence on surgical fixation methods for proximal tibia fractures in adults. In particular, we seek to first assess study types and their distribution across levels of evidence and second to identify knowledge gaps to support evidence-based surgical planning.
The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews and will be reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Information for this study will be gathered from Medline, Cochrane and Embase. Data analysis will involve categorising the studies by their level of evidence and extracting predefined parameters, including fracture characteristics, surgical approach, implant type and key findings relevant to the review question. The study focuses on surgically stabilised intra-articular proximal tibia fractures in adults. Only English- and German-language studies that are available in full text and published after 1995 will be included.
No ethical approval is required. The findings of the proposed review will be disseminated through publications in peer-reviewed journals.
Open Science Framework, osf.io/g9zfu.
To systematically review and synthesise qualitative research on nurses' experiences of speaking up in various contexts and to identify factors facilitating or impeding such a behaviour.
This review was conducted as a qualitative metasynthesis, utilising the qualitative meta-ethnography approach.
A total of 6250 articles were screened. Two reviewers screened titles, abstracts and full texts. A total of 15 studies were included in this review. Researchers conducted a quality appraisal using the JBI critical appraisal checklist for qualitative research. An a priori protocol was created and registered on the Open Science Framework.
Literature searches were conducted in five international bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global) and five Korean databases (RISS, KISS, DBpia, KCI and NDSL).
Three main themes were identified from the 15 studies used in the metasynthesis: (1) decisional complexity of speaking up, (2) motivators for speaking up and (3) barriers to speaking up. Nurses experienced challenges in speaking up. They were, and continue to be, concerned about negative responses. Hierarchy structure and poor work environment were identified as barriers to speaking up; professional responsibility and a supportive atmosphere were identified as facilitators for speaking up.
This review synthesised nurses' experiences of speaking up and influencing factors. Speaking up is crucial for nurses to improve patient safety, as frontline nurses are ideally positioned to observe early indicators of unsafe conditions in healthcare delivery.
Identified motivators and barriers of nurses' speaking-up behaviour offer considerations and opportunities for healthcare leaders and managers. This could lead to improvement in patient safety through the establishment of a safety culture that facilitates nurses' speaking-up behaviour.
The review adhered to the ENTREQ guideline.
No patient or public contribution has been made in this review.
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