Foster Jan, Kelly Miranda
College of Nursing, Texas Woman's University, Houston, TX 77030, USA.
Clin Nurse Spec. 2013 Sep-Oct;27(5):231-8. doi: 10.1097/NUR.0b013e3182a0b9f9.
PURPOSE/OBJECTIVES: The aims of this study were to determine the feasibility of and test a multicomponent, nonpharmacologic, nurse-driven intervention for prevention of delirium.
This was a prospective, cohort pilot study.
This study was carried out in a 12-bed medical intensive care unit in a Magnet-designated community hospital in a major metropolitan city in the Southwest United States.
A convenience sample of consented patients meeting inclusion criteria was included in this study.
A multicomponent prevention protocol consisting of sedation cessation, sleep-wake cycles, sensory stimulation, mobility, and music was tested.
Capturing data for the interventions was problematic. Insufficient documentation systems and inadequate multidisciplinary participation in carrying out the protocol, especially mobility, were barriers.
There was little difference in the proportion of delirium before and after intervention. Success in the identification and prevention of delirium requires a multidisciplinary approach.
Further research is needed using a larger sample size. Refinement of a mobility program is needed.
目的/目标：本研究的目的是确定一种多组分、非药物、由护士主导的谵妄预防干预措施的可行性并进行测试。
这是一项前瞻性队列试点研究。
本研究在美国西南部一个大城市的一家获得磁铁认证的社区医院的一个拥有12张床位的医疗重症监护病房进行。
本研究纳入了符合纳入标准且同意参与的便利样本患者。
测试了一种由镇静中断、睡眠-觉醒周期、感觉刺激、活动能力和音乐组成的多组分预防方案。
收集干预措施的数据存在问题。记录系统不足以及多学科在执行方案（尤其是活动能力方面）的参与不足是障碍。
干预前后谵妄比例差异不大。识别和预防谵妄的成功需要多学科方法。
需要使用更大样本量进行进一步研究。需要完善活动能力计划。
