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Supplementary File 4: Quality assessment tool and scoring guide

Criteria Poor/High risk of bias Average/Medium risk of bias Good/Low risk of bias Unknown/N.A
Representativeness Self-selected sample from one site Self-selected sample, from more More than one site, high
(and one ward), with a low proportion than one ward, with a medium proportion of eligible participants
of eligible participants taking part proportion of eligible participants taking part
taking part
Randomisation Self-selected participants Recruitment sent to all/random Recruitment sent to all/random
sample of eligible participants, but sample of eligible participants,
<50% participated but >50% participated
Blinding No blinding or incomplete blinding, Attempted blinding, but likely not Outcome not likely influenced by
which is likely to influence the carried out effectively lack of/broken blinding.
outcome Or, effective blinding.
Measure of patient safety/quality Measure developed for this study, Measure developed for this study, Validated, well known measure
with no mention of validity, reliability with attempts to display validation OR new measure with validity
or piloting (e.g. concurrent validity) and reliability displayed (e.g.
more than one type of validity)
Measure of wellbeing/burnout Measure developed for this study, Measure developed for this study, Validated, well known measure
with no mention of validity, reliability with attempts to display validation OR new measure with validity
or piloting (e.g. concurrent validity) and reliability displayed (e.g.
more than one type of validity)
Participants lost to follow Participants lost, but no mention of Analysis to check for differences
up/Incomplete outcome data differences between completers or between completers and non-
non-completers. completers, with significant
differences controlled for in main
No intention to treat analysis on analysis.
missing data.
Intention to treat analysis for
missing data
Confounding variables No evidence of attempting to account Accounted for basic potential Accounted for basic confounding
for possible confounding variables in confounding variables at either variables and additional
analysis (or recruitment) recruitment or analysis (e.g. Age, potential confounding variables,
Gender) at either recruitment or analysis
(e.g. Years in practice)
Power and effect size Power analysis reported, with below Power analysis reported, with small - Power analysis reported, with
small effect size medium effect size medium – large/large effect size

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