Your browser doesn't support javascript.
loading
A nurse-led intervention to reduce the incidence and duration of delirium among adults admitted to intensive care: A stepped-wedge cluster randomised trial.
Brennan, Kathleen; Sanchez, David; Hedges, Sonja; Lynch, Joan; Hou, Yu Chin; Al Sayfe, Masar; Shunker, Sharon-Ann; Bogdanoski, Tony; Hunt, Leanne; Alexandrou, Evan; He, Steven; Mai, Ha; Rolls, Kaye; Frost, Steven A.
Afiliación
  • Brennan K; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Bankstown-Lidcombe Hospital, Australia; South Western Sydney Clinical School, University of New South Wales, Australia. Electronic address: Kathleen.Brennan@Health.nsw.gov.au.
  • Sanchez D; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Campbelltown Hospital, Australia. Electronic address: David.Sanchez@Health.nsw.gov.au.
  • Hedges S; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Bankstown-Lidcombe Hospital, Australia. Electronic address: Sonja.Hedges@Health.nsw.gov.au.
  • Lynch J; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Liverpool Hospital, Australia; Western Sydney University, Australia. Electronic address: Joan.Lynch@westernsydney.edu.au.
  • Hou YC; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Liverpool Hospital, Australia; Western Sydney University, Australia. Electronic address: Yu.Hou@Health.nsw.gov.au.
  • Al Sayfe M; Department of Intensive Care, Fairfield Hospital, Australia. Electronic address: masar.alsayfe@philips.com.
  • Shunker SA; Department of Intensive Care, Liverpool Hospital, Australia. Electronic address: SharonAnn.Shunker@Health.nsw.gov.au.
  • Bogdanoski T; Department of Intensive Care, Liverpool Hospital, Australia. Electronic address: Tony.Bogdanoski@Health.nsw.gov.au.
  • Hunt L; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Liverpool Hospital, Australia; Western Sydney University, Australia. Electronic address: L.Hunt@westernsydney.edu.au.
  • Alexandrou E; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Liverpool Hospital, Australia; Western Sydney University, Australia; South Western Sydney Clinical School, University of New South Wales, Australia. Electronic address: Evan.Alexandrou@Health.n
  • He S; South Western Sydney Nursing and Midwifery Research Alliance, Ingham Institute of Applied Medical Research, Liverpool Hospital, Australia. Electronic address: steven.he@westernsydney.edu.au.
  • Mai H; South Western Sydney Nursing and Midwifery Research Alliance, Ingham Institute of Applied Medical Research, Liverpool Hospital, Australia. Electronic address: h.mai@westernsydney.edu.au.
  • Rolls K; University of Wollongong, Australia. Electronic address: kaye.rolls@uow.edu.au.
  • Frost SA; Critical Care Research in Collaboration and Evidence Translation, Australia; Department of Intensive Care, Liverpool Hospital, Australia; Western Sydney University, Australia; South Western Sydney Clinical School, University of New South Wales, Australia; South Western Sydney Nursing and Midwifery R
Aust Crit Care ; 36(4): 441-448, 2023 Jul.
Article en En | MEDLINE | ID: mdl-36182540
ABSTRACT

BACKGROUND:

Delirium is an acute change in behaviour, characterised by a fluctuating course, inattention, and disorganised thinking. For critically ill adults in the intensive care, the incidence of delirium has been reported to be at least 30% and is associated with both short-term and long-term complications, longer hospital stay, increased risk of mortality, and long-term cognitive problems.

AIM:

The objective of this study was to determine the effectiveness of a nurse-led delirium-prevention protocol in reducing the incidence and duration of delirium among adults admitted to intensive care.

METHODS:

A hybrid stepped-wedge cluster randomised controlled trial was conducted to assess the effectiveness of the implementation and dissemination of the nurse-led intervention to reduce the incidence and duration of delirium among adults admitted to the four adults intensive care units in the southwest of Sydney, Australia.

RESULTS:

Between May 2019 and February 2020, over a 10-month period, 2618 admissions, among 2566 patients, were included in the study. After an initial 3-month baseline period, each month there was a random crossover to the nurse-led intervention in one of the four intensive care units, and by the 7th month of the trial, all units were exposed to the intervention for at least 3 months. The incidence of acute delirium was observed to be 10.7% (95% confidence interval [CI] = 9.1-12.4%), compared to 14.1% (95% CI = 12.2-16.2%) during the preintervention (baseline) period (adjusted rate ratio [adjRR] = 0.78, 95% CI = 0.57-1.08, p = 0.134). The average delirium-free-days for these preintervention and postintervention periods were 4.1 days (95% CI = 3.9-4.3) and 4.4 days (95% CI = 4.2-4.5), respectively (adjusted difference = 0.24 days [95% CI = -0.12 to 0.60], p = 0.199).

CONCLUSION:

Following the introduction of a nurse-led, nonpharmacological intervention to reduce the burden of delirium, among adults admitted to intensive care, we observed no statistically significant decrease in the incidence of delirium or the duration of delirium.
Asunto(s)
Palabras clave
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Rol de la Enfermera / Hospitalización Tipo de estudio: Clinical_trials / Incidence_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Aust Crit Care Asunto de la revista: ENFERMAGEM / TERAPIA INTENSIVA Año: 2023 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Rol de la Enfermera / Hospitalización Tipo de estudio: Clinical_trials / Incidence_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Aust Crit Care Asunto de la revista: ENFERMAGEM / TERAPIA INTENSIVA Año: 2023 Tipo del documento: Article