Effects of intermittent pneumatic compression devices interventions to prevent deep vein thrombosis in surgical patients: A systematic review and meta-analysis of randomized controlled trials.

This review aimed to determine the effectiveness of Intermittent Pneumatic Compression (IPC) intervention on Deep Vein Thrombosis (DVT) in surgical patients. An electronic database search was conducted with PubMed, OVID-MEDLINE, EMBASE, and CENTRAL, from September 22 to 28, 2023. Three researchers independently selected the studies, assessed their methodological quality, and extracted relevant data. We conducted a meta-analysis of the effect of IPC versus the control group and summarized the intervention results from the included studies. Of the 2,696 articles identified 16 randomized control trials met the inclusion criteria for review. IPC interventions significantly affected DVT prevention (OR = 0.81, 95% CI: 0.59-1.11). In the subgroup analysis, there was a significant pooled effect (OR = 0.41, 95% CI: 0.26-0.65]), when the comparison group was no prophylaxis group. However, when the comparison groups were the pharmacologic prophylaxis group ([OR = 1.32, 95% CI 0.78-2.21]) and IPC combined with the pharmacologic prophylaxis group (OR = 2.43, 95% CI: 0.99-5.96) did not affect DVT prevention. The pooled effects of Pulmonary Embolism (PE) (OR = 5.81, 95% CI: 1.25-26.91) were significant. IPC intervention showed a significant effect on bleeding prevention (OR = 0.17, 95% CI: 0.08-0.36) when compared to IPC combined with the pharmacologic groups. IPC intervention effectively prevented DVT, PE, and bleeding in surgical patients. Therefore, we propose that IPC intervention be applied to surgical patients to avoid DVT, pulmonary embolism, and bleeding in the surgical nursing field as scientific evidence suggests.

Effect of Delirium Prevention Program on Delirium Occurrence and the Length of Intensive Care Unit (ICU) Stay: A Systematic Review and Meta-Analysis.

Background: ICU patients typically experience diverse kinds of distress factors, which make them vulnerable to delirium thereby resulting in a higher rate of delirium occurrence. We aimed to review systematically current states of preventive nursing intervention in ICUs, and to analyze delirium occurrence and the length of ICU stay to provide suggestions for the preventive nursing practice in ICU. Methods: Data collection was done with literature search databases including PubMed, Ovid-MEDLINE, EMBASE, CINAHL, KMbase, KoreaMed, Korean Studies Information Service System (KISS), Korea Institute of Science and Technology Information (KiSTi), Research Information Service System (RISS) and with hand searching, from Apr 20 to May 10, 2020. Two researchers independently selected research literature, and three researchers summarized and identified related variables based on data extraction methods. Results: Overall, 236 articles identified, 11 articles met the inclusion criteria for review. The systematic review of the contents of preventive nursing intervention other than drug administration rendered the four types of intervention. The Peto odds ratio (OR) of the rate of delirium occurrence appeared as 0.29 (95% Confidence Interval (CI)=0.20∼0.43) which was statistically significant (Z=6.23, P<.01) in both group. The magnitude of the effect for the length of ICU stay demonstrated insignificant values, Mean difference (MD) -0.23 (95% CI=-0.51∼0.05) (Z=1.60, P=.11). Conclusion: For management of delirium among ICU patients, multi-component intervention packages, suitable for care setting in ICUs, need to be taken into account for the preparation of nursing intervention for prevention of delirium applicable to nursing practices.

Effects of non-pharmacological interventions for preventing delirium in general ward inpatients: A systematic review & meta-analysis of randomized controlled trials.

The purpose of this study was to identify the types and contents of non-pharmacological delirium prevention interventions applied to inpatients in general wards, and to verified the effectiveness of the interventions on the incidence of delirium. We performed an extensive search of bibliographic databases and registries (CENTRAL, MEDLINE, EMBASE, CINAHL, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform, PubMed and Google Scholar, and Korean DB such as RISS, DBpia, KISS, NDSL and KCI) using terms to identify delirium, prevention, and non-pharmacological. We searched all databases from their inception to January 2021 and imposed restriction on language of publication in English and Korean. We included studies if they were conducted as all types of randomized controlled trials (RCT), involving adult patients aged 19 years or more who were admitted to a general ward. We included trials comparing non-pharmacological intervention versus usual care. The entire process of data selection and extraction, assessment of risk of bias with ROB2.O was independently performed by three researchers. The estimated effect size was an odds ratio (OR) and 95% confidence interval. The fixed effects model and general inverse variance estimation method were adopted. The type of non-pharmacological delirium prevention interventions for inpatients in general ward was mainly multi-component intervention to correct delirium risk factors. The content and intensity of non-pharmacological interventions varied greatly depending on the characteristics of the patient and the clinical situation. As a result of the meta-analysis, non-pharmacological multi-component intervention was effective in reducing the incidence of delirium, and it was confirmed that it was effective in reducing the incidence of delirium in both the internal and surgical wards. It was confirmed by quantitative evidence that non-pharmacological interventions, especially multi-component interventions, were effective in preventing delirium in general ward inpatients.

The Effects of Cognitive-Based Interventions in Older Adults: A Systematic Review and Meta-Analysis.

BACKGROUND: Cognitive-based intervention is divided into three types: Cognitive Stimulation (CS), Cognitive Training (CT), and Cognitive Rehabilitation (CR). This study was conducted to identify systematically the effects of cognitive-based interventions in randomized controlled trials (RCTs) applied to older adults in the following three groups: cognitively healthy, mild cognitive impairment (MCI), and dementia. METHODS: This search was carried out using the Ovid-MEDLINE, EMBASE, Cochrane library, CINAHL, ProQuest, and Korea databases. The effectiveness of the intervention was verified using the CMA 2.0 program. RESULTS: A total of 54 RCTs were included in systematic reviews and 38 studies were analyzed by meta-analysis. Meta-analysis showed that cognitive-based interventions were effective in improving the cognitive function (SMD=0.39, 95% CI=0.32-0.44) of older adults. The subgroup analysis of cognitive function revealed that CT was the most effective in the cognitively healthy (SMD=0.40, 95% CI=0.33-0.46) and the MCI (SMD=0.45, 95% CI=0.27-0.63) groups, and CS was the most effective in the dementia group (SMD=0.57, 95% CI=0.43-0.70). CONCLUSION: In order to improve the cognitive function of older adults in each group, the most effective intervention type needs to be considered first. Evidence on the appropriate type of Cognitive-based intervention will be helpful in nursing practice.

Effect of structured pre-simulation preparation and briefing on student's self-confidence, clinical judgment, and clinical decision-making in simulation.

Background: The importance of preparation and briefing before simulation has been overlooked. A 'think-before-action' strategy is needed in simulation.Purpose: To determine the effect of structured preparation and briefing prior to simulation on nursing students' learning outcomes.Method: In the experimental group, structured pre-simulation preparation and briefing lasted for a total of 35 minutes before simulation. The control group were performed in a conventional manner. Subjects were 80 senior students in one university in Korea (40 students in each group). Data were analyzed using independent t-test.Results: Scores for self-confidence for problem solving (F = 17.414, p < 0.001), clinical judgment (F = 123.781, p < 0.001), and clinical decision-making (F = 45.593, p < 0.001) in the experimental group were significantly higher than those in the control group.Conclusions: Structured preparation and briefing prior to simulation can effectively improve nursing-students' self-confidence for problem solving, clinical judgment, and clinical decision-making.

[Effects of Breastfeeding Interventions on Breastfeeding Rates at 1, 3 and 6 Months Postpartum: A Systematic Review and Meta-Analysis].

PURPOSE: This study was a systematic review and meta-analysis designed to evaluate the effects of breastfeeding intervention on breastfeeding rates. METHODS: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a systematic search was conducted using eight core electronic databases and other sources including gray literature from January 9 to 19, 2017. Two reviewers independently select the studies and assessed methodological risk of bias of studies using the Cochrane criteria. The topics of breastfeeding interventions were analyzed using descriptive analysis and the effects of intervention were meta-analyzed using the Review Manager 5.2 software. RESULTS: A total of 16 studies were included in the review and 15 were included for meta-analysis. The most frequently used intervention topics were the importance of good latch-on and frequency of feeding and determining adequate intake followed. The pooled total effect of breastfeeding intervention was 1.08 (95% CI 1.03~1.13). In the subgroup analysis, neither pre-nor post-childbirth intervention was effective on the breastfeeding rates at 1, 3, and 6 months, and neither group nor individual interventions had an effect. Only the 1 month breastfeeding rate was found to be affected by the individual intervention with the persistent strategies 1.21 (95% CI 1.04~1.40). CONCLUSION: Effective breastfeeding interventions are needed to help the mother to start breastfeeding after childbirth and continue for at least six months. It should be programmed such that individuals can acquire information and specific breastfeeding skills. After returning home, there should be continuous support strategies for breastfeeding as well as managing various difficulties related to childcare.

[Comparison of nursing activities reflected in nursing notes and in-depth interviews of nurses in an acute hospital].

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.