중환자실 섬망예방을 위한 근거중심 간호중재 프로토콜 개발
Development of an Evidence-Based Protocol for Preventing Delirium in Intensive Care Unit Patients
1
조회
0
다운로드
14
인용
0
참고문헌
키워드
초록
Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.
Abstract
Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.
참고문헌 (27)
- 박명화, "근거중심간호의 이해와 적용" (2006), 군자출판사
- 박영숙, "일 종합병원 간호사들의 섬망에 대한 인식 및 교육요구에 관한 기초조사", Journal of Korean Academy of Nursing, 36(8), pp.1183~1192 (2006), 한국간호과학회
- 박태남, "시설노인의 비약물적 변비관리를 위한 근거중심 간호실무 가이드라인 개발", 박사, pp.2006
- 장인실, "환경적 간호중재가 개심술 환자의 중환자실섬망증, 환경적 스트레스 및 수면에 미치는 효과", 임상간호연구, 14(2), pp.127~138 (2008), 병원간호사회
- Balas, M. C, "Comprehensive assessment and management of the critically ill", pp.565~593 (2008), Springer Publishing Company
- Bogardus, S. T, "The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults", The American Journal of Medicine, 114(5), pp.383~390 (2003)
- Cole,M.G, "Delirium: Effectiveness of systematic interventions", Dementia and Geriatric Cognitive Disorders, 10(5), pp.406~411 (1999)
- Inouye,S.K, "Delirium in older persons. The new English Journal of Medicine", Medicine, 354(11), pp.1157~1165 (2006)
- Inouye, S. K, "A Multicomponent intervention to prevent delirium in hospitalized older patents", The New England Journal of Medicine, 340(9), pp.669~676 (1999)
- Inouye, S. K, "Risk factors for delirium at discharge: Development and validation of a predictive model", Archives of Internal Medicine, 167(13), pp.1406~1413 (2007)
- Larsson, C, "Confusion assessment method for the intensive care unit (CAM-ICU): Translation, retranslation and validation into Swedish intensive care settings", Acta Anaesthesiologica Scandinavica, 51(7), pp.888~892 (2007)
- Lundstrm, M, "A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients", Journal of the American Geriatrics Society, 53(4), pp.622~628 (2005)
- McNicoll, L, "Detection of delirium in the intensive care unit: Comparison of confusion assessment method for the intensive care unit with confusion assessment method ratings", Journal of the American Geriatrics Society, 53(3), pp.495~500 (2005)
- Mentes, J. C, "Reducing hydration- linked in nursing home residents", Clinical Nursing Research, 12(3), pp.210~225 (2003)
- Michaud, L, "Delirium: Guidelines for general hospitals", Journal of Psychosomatic Research, 62(3), pp.371~383 (2007)
- Milisen, K, "A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients", Journal of American Geriatrics Society, 49(5), pp.523~532 (2001)
- Milisen, K, "Multicomponent intervention strategies for managing delirium in hospitalized older people: Systematic review", Journal of Advanced Nursing, 52(1), pp.79~90 (2005)
- Morandi, A, "Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients", Intensive Care Medicine, 34(10), pp.1907~1915 (2008)
- "elirium: Diagnosis, prevention and management"[URL]
- Rapp,C.G, "Acute confusion", delirium protocol, 2001, pp.27(4), 21~33
- Rizzo, J. A, "Multicomponent targeted intervention to prevent delirium in hospitalized older patients: What is the economic value?", Medical Care, 39(7), pp.740~752 (2001)
- Sendelbach, S, "Acute confusion", delirium(Revised 03, The University of Iowa College of Nursing, pp.2009, ~
- Siddiqi, N, "Interventions for preventing delirium in hospitalised patients", The Cochrane Collaboration, ~, pp.issue 1 (2009)
- "A Guidline developer’s handbook"[URL]
- Soja, S. L, "Implementation, reliability testing, and compliance monitoring of the confusion assessment method for the intensive care unit in trauma patients", Intensive Care Medicine, 34(7), pp.1263~1268 (2008)
- Truman, B, "Monitoring delirium in critically ill patients: Using the confusion assessment methods for the intensive care unit", Critical Care Nurse, 23(2), pp.25~35 (2003)
- Weber, J. B, "Delirium:Current trends in prevention and treatment.Internal Medicine", Internal Medicine Journal, 34(3), pp.115~121 (2004)