McPhail 1990.

Methods	Randomised cross‐over trial
Participants	21 nurses working on the unit: 10 nurses doing primary nursing, 11 nurses doing team nursing; 108 patients: 53 receiving primary nursing, 55 receiving team nursing; 16 clinicians
Interventions	Intervention: primary nursing Control: team nursing
Outcomes	Work environment scale; patient satisfaction, nurse absenteeism
Country/Setting	Canada: 35‐bed medical/surgical unit in a tertiary care teaching hospital
Notes	No source of funding reported. No conflict of interest reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Nurses were stratified for their days of the week and previous years' absenteeism and randomly assigned to Group A or B. Sequence generation not discussed.
Allocation concealment (selection bias)	High risk	Not discussed, probably not done.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Blinding not possible and bias likely from lack of blinding.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not clear how nurse absenteeism data was obtained; patient data was self‐reported; nurses' work environment scale data was self‐reported.
Incomplete outcome data (attrition bias) All outcomes	High risk	9/20 nurses refused to complete questionnaire; only 40% of patients completed satisfaction questionnaire.
Selective reporting (reporting bias)	Low risk	All outcomes reported.
Baseline characteristics similar for intervention group and control?	Unclear risk	Not discussed, but cross‐over trial.
Other bias	High risk	Small sample; possible issues of contamination/cross‐over ‐ i.e. not clear what was the washout effect of crossing over, and whether there was any evaluation of the integrity of the primary nursing and team nursing models after crossing over.