Luisa Sist1, Nikita Valentina Ugenti2, Gloria Donati3, Silvia Cedioli3, Irene Mansutti4, Ermellina Zanetti5, Maria Macchiarulo6, Rossella Messina7, Paola Rucci7, Alvisa Palese4. 1. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Via Ugo Foscolo 7, 40138, Bologna, Italy. luisa.sist@unibo.it. 2. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 3. Alma Mater, Studiorum University of Bologna, Bologna, Italy. 4. Department of Medical Science, University of Udine, Udine, Italy. 5. Fondazione Brescia Solidale, APRIRE Network, Brescia, Italy. 6. Acute Geriatrics, Orthogeriatrics and Cognitive Disorders and Dementia Center - Department of Continuity and Integration, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 7. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Via Ugo Foscolo 7, 40138, Bologna, Italy.
Abstract
BACKGROUND: Delirium is a common condition during hospitalisation that should be prevented and treated. Several recommendations have been established to date, whereas few studies have investigated their applicability in daily practice for medical and post-acute settings. AIM: The aim of this research exercise was to emerge the applicability of the interventions recommended by studies in the daily care of patients at risk or with delirium cared in medical and post-acute settings. METHODS: The study was organised in three phases. A systematic literature review according to Centre for Reviews and Dissemination was conducted (January-February 2021). Cochrane Library, Pubmed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Psychological Information Database, and the Joanna Briggs Institute databases were searched. Primary and secondary studies were evaluated in their methodological quality with the Standard Quality Assessment Criteria, the Critical Appraisal Skills Programme, and the Appraisal of Guidelines for Research & Evaluation. Then, the interventions identified were assessed in their applicability using the Nominal Group Technique who ranked their judgement on a four-point Likert scale from 1 (totally inapplicable) to 4 (totally applicable). Qualitative feedbacks were also considered, and a validation of the final list was performed by the Nominal Group. RESULTS: A total of 12 studies were included producing a list of 96 interventions categorised into four macro-areas (prevention, non-pharmacological, communication and pharmacological management). The Nominal Group identified 51 interventions (average score > 3.5) as applicable in medical and post-acute settings. Then, through a process of re-reading, and revising according to the comments provided by the Nominal Group, a list of 35 interventions out of the initial 96 were judged as applicable. CONCLUSION: Applicability should be assessed with experts in the field to understand the involved factors. One-third of interventions have been judged as applicable in the Italian context; the nurses' expertise, the work environment features, and the time required for each intervention in a high workload setting may prevent the full applicability of the interventions recommended by the literature.
BACKGROUND: Delirium is a common condition during hospitalisation that should be prevented and treated. Several recommendations have been established to date, whereas few studies have investigated their applicability in daily practice for medical and post-acute settings. AIM: The aim of this research exercise was to emerge the applicability of the interventions recommended by studies in the daily care of patients at risk or with delirium cared in medical and post-acute settings. METHODS: The study was organised in three phases. A systematic literature review according to Centre for Reviews and Dissemination was conducted (January-February 2021). Cochrane Library, Pubmed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Psychological Information Database, and the Joanna Briggs Institute databases were searched. Primary and secondary studies were evaluated in their methodological quality with the Standard Quality Assessment Criteria, the Critical Appraisal Skills Programme, and the Appraisal of Guidelines for Research & Evaluation. Then, the interventions identified were assessed in their applicability using the Nominal Group Technique who ranked their judgement on a four-point Likert scale from 1 (totally inapplicable) to 4 (totally applicable). Qualitative feedbacks were also considered, and a validation of the final list was performed by the Nominal Group. RESULTS: A total of 12 studies were included producing a list of 96 interventions categorised into four macro-areas (prevention, non-pharmacological, communication and pharmacological management). The Nominal Group identified 51 interventions (average score > 3.5) as applicable in medical and post-acute settings. Then, through a process of re-reading, and revising according to the comments provided by the Nominal Group, a list of 35 interventions out of the initial 96 were judged as applicable. CONCLUSION: Applicability should be assessed with experts in the field to understand the involved factors. One-third of interventions have been judged as applicable in the Italian context; the nurses' expertise, the work environment features, and the time required for each intervention in a high workload setting may prevent the full applicability of the interventions recommended by the literature.
Authors: Niamh A O'Regan; James Fitzgerald; Dimitrios Adamis; David William Molloy; David Meagher; Suzanne Timmons Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472
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Authors: Terry E Goldberg; Chen Chen; Yuanjia Wang; Eunice Jung; Antoinette Swanson; Caleb Ing; Paul S Garcia; Robert A Whittington; Vivek Moitra Journal: JAMA Neurol Date: 2020-11-01 Impact factor: 18.302
Authors: Giuseppe Bellelli; Alessandro Morandi; Simona G Di Santo; Andrea Mazzone; Antonio Cherubini; Enrico Mossello; Mario Bo; Angelo Bianchetti; Renzo Rozzini; Ermellina Zanetti; Massimo Musicco; Alberto Ferrari; Nicola Ferrara; Marco Trabucchi Journal: BMC Med Date: 2016-07-18 Impact factor: 8.775