In-Facility Delirium Prevention Programs as a Patient Safety Strategy A Systematic Review
In-Facility Delirium Prevention Programs as a Patient Safety Strategy A Systematic Review
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DOI：
10.7326/0003-4819-158-5-201303051-00003
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发表时间：
2013-03-05
影响因子：
39.2
通讯作者：
Schoelles, Karen M.
中科院分区：
文献类型：
--
作者：
Reston, James T.;Schoelles, Karen M.
谵妄是一种注意力和认知能力的急性下降，在住院患者中发生率估计为14%至56%，并增加了发病率和死亡率的风险。本系统性综述的目的是评价机构内多组分谵妄预防计划的有效性和安全性。对6个数据库（包括MEDLINE、EMBASE和CINAHL）进行了检索，直至2012年9月。随机对照试验;对照临床试验;间断时间序列有前瞻性干预后部分的对照前后研究符合纳入条件。来自19项符合纳入标准的研究的证据表明，大多数多组分干预措施可有效预防医院环境中高危患者的谵妄发作。证据不足以确定这些方案在其他护理环境中的益处。未来的比较有效性研究与标准化的协议是必要的，以确定哪些组成部分的多组分干预措施是最有效的谵妄预防。Ann Intern Med.2013;158：375-380. www.annals.org
Delirium, an acute decline in attention and cognition, occurs among hospitalized patients at rates estimated to range from 14% to 56% and increases the risk for morbidity and mortality. The purpose of this systematic review was to evaluate the effectiveness and safety of in-facility multicomponent delirium prevention programs. A search of 6 databases (including MEDLINE, EMBASE, and CINAHL) was conducted through September 2012. Randomized, controlled trials; controlled clinical trials; interrupted time series; and controlled before-after studies with a prospective postintervention portion were eligible for inclusion. The evidence from 19 studies that met the inclusion criteria suggests that most multicomponent interventions are effective in preventing onset of delirium in at-risk patients in a hospital setting. Evidence was insufficient to determine the benefit of such programs in other care settings. Future comparative effectiveness studies with standardized protocols are needed to identify which components in multicomponent interventions are most effective for delirium prevention. Ann Intern Med. 2013;158:375-380. www.annals.org