Enhancing Nursing Practices in Critical Care for Older Adults: A Systematic Review of Age-Friendly Nursing Interventions.

IF 4.2 2区 医学 Q2 GERIATRICS & GERONTOLOGY Journal of the American Medical Directors Association Pub Date : 2024-10-22 DOI:10.1016/j.jamda.2024.105323
Mostafa Shaban, Osama Mohamed Elsayed Ramadan, Mohammed Elsayed Zaky, Haitham Mokhtar Mohamed Abdallah, Huda Hamdy Mohammed, Mohamed Ezzelregal Abdelgawad
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Abstract

Objectives: To synthesize evidence on the implementation and effectiveness of age-friendly interventions in intensive care units (ICUs) to optimize care for older adults.

Design: Systematic review of studies published up to February 2024, focusing on interventions tailored to meet the needs of older adults in ICU settings.

Setting and participants: Comparative studies conducted in ICUs worldwide, involving older adults receiving critical care, were reviewed.

Methods: A systematic search of databases including Embase, MEDLINE, and Cochrane was performed. The quality of studies was assessed using the ROSVIS-II tool, and findings were synthesized narratively and thematically.

Results: Out of 1200 articles initially identified, 45 studies met inclusion criteria. Age-friendly interventions (eg, geriatric assessment teams, multimodal care bundles) demonstrated significant benefits, including a 19% reduction in major in-hospital complications and shorter hospital stays by an average of 3 days.

Conclusions and implications: The review supports the effectiveness of age-friendly interventions in improving clinical outcomes for older ICU patients. However, consistent reporting of effect sizes was lacking, and more high-quality comparative effectiveness research is needed. Implications for practice include integrating these interventions into standard ICU protocols to enhance older adult care. Policy implications involve advocating for health care policies that support the dissemination and implementation of effective age-friendly practices. Further research should focus on establishing a robust evidence base to guide implementation and policy decisions.

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加强老年人重症监护中的护理实践:老年友好护理干预的系统回顾》。
目的综合重症监护病房(ICU)中实施年龄友好型干预措施并提高其有效性的证据,以优化对老年人的护理:设计:对截至 2024 年 2 月发表的研究进行系统综述,重点关注在重症监护室环境中为满足老年人需求而量身定制的干预措施:方法:系统性检索数据库(web.org.cn)中的所有研究:方法:对 Embase、MEDLINE 和 Cochrane 等数据库进行了系统检索。采用 ROSVIS-II 工具对研究质量进行评估,并对研究结果进行叙事性和主题性综合:在最初确定的 1200 篇文章中,有 45 项研究符合纳入标准。对老年人友好的干预措施(如老年病评估小组、多模式护理捆绑包)显示出显著的益处,包括主要院内并发症减少了 19%,平均住院时间缩短了 3 天:综述支持年龄友好型干预措施在改善老年重症监护病房患者临床疗效方面的有效性。然而,缺乏对效果大小的一致报告,因此需要更多高质量的比较效果研究。对实践的启示包括将这些干预措施纳入标准重症监护病房方案,以加强对老年人的护理。对政策的影响包括倡导医疗保健政策,支持传播和实施有效的老年友好实践。进一步的研究应侧重于建立一个强大的证据库,以指导实施和政策决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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