Griffiths Peter, Bridges Jackie, Sheldon Helen, Thompson Rachel
Faculty of Health Sciences, University of Southampton, Southampton and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), UK.
J Clin Nurs. 2015 May;24(9-10):1394-405. doi: 10.1111/jocn.12717. Epub 2014 Dec 3.
To identify the potential benefits of dementia specialist nursing and to inform the implementation of roles to support people with dementia during hospital admission.
Extended stays and adverse events mean that hospital admissions are costly for people with dementia, and patient experiences and outcomes can be poor. Specialist nurses have been identified as having potential to enhance care quality, reduce excess stays and reduce costs, but the evidence base for dementia specialist nurse roles has not previously been synthesised.
Scoping review.
Cochrane Library, Campbell Collaboration, Clinical Evidence, Evidence-Based Medicine, York Centre for Reviews and Dissemination, PubMed, Medline, CINAHL and PsycInfo databases and internet searches and personal libraries/expert consultation to identify grey literature.
Initial scoping searches were used to inform more focused systematic searches. Studies directly evaluating dementia nurse specialist roles or giving evidence of effectiveness of interventions/services that could be delivered by them to improve core outcomes were identified by one reviewer and verified by a second reviewer.
While direct evidence for the effectiveness of these roles is lacking, a number of areas were identified in which a nurse specialist role could make a contribution, including preventing adverse events and improving patient experiences and outcomes. There is a considerable body of evidence for the effectiveness of these interventions although the volume of evidence for specific interventions is not always significant.
The evidence indicates that a skilled dementia specialist nurse, undertaking a clearly defined role, and working directly with people with dementia and their carers for a significant proportion of the time, could benefit people with dementia in hospitals and their family carers.
Clear guidance for the development and implementation of dementia specialist nurse roles in acute hospital settings.
确定痴呆症专科护理的潜在益处，并为在医院住院期间支持痴呆症患者的角色实施提供信息。
长时间住院和不良事件意味着痴呆症患者的住院费用高昂，而且患者的体验和结局可能较差。专科护士已被确定有潜力提高护理质量、减少超长住院时间并降低成本，但此前尚未对痴呆症专科护士角色的证据基础进行综合分析。
范围综述。
考克兰图书馆、坎贝尔协作组织、临床证据、循证医学、约克综述与传播中心、PubMed、Medline、CINAHL和PsycInfo数据库，以及互联网搜索和个人藏书/专家咨询以识别灰色文献。
最初的范围搜索用于为更有针对性的系统搜索提供信息。由一名评审员识别直接评估痴呆症护士专科角色或提供其可实施的干预措施/服务有效性证据以改善核心结局的研究，并由另一名评审员进行核实。
虽然缺乏这些角色有效性的直接证据，但确定了一些护士专科角色可做出贡献的领域，包括预防不良事件以及改善患者体验和结局。尽管特定干预措施的证据量并不总是很大，但有大量证据证明这些干预措施有效。
证据表明，一名熟练的痴呆症专科护士，承担明确界定的角色，并在相当长的时间内直接与痴呆症患者及其护理人员合作，可为住院的痴呆症患者及其家庭护理人员带来益处。
为急性医院环境中痴呆症专科护士角色的发展和实施提供明确指导。
