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新生儿病房的循证设计:一项系统综述

Evidence-based design for neonatal units: a systematic review.

作者信息

O'Callaghan N, Dee A, Philip R K

机构信息

Mid-West Department of Public Health, HSE, Limerick, Ireland.

2Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland.

出版信息

Matern Health Neonatol Perinatol. 2019 Apr 30;5:6. doi: 10.1186/s40748-019-0101-0. eCollection 2019.

Abstract

Evidence-based design (EBD) of hospitals could significantly improve patient safety and make patient, staff and family environments healthier. This systematic review aims to determine which neonatal intensive care unit design features lead to improved neonatal, parental and staff outcomes. Medline, CINAHL, Web of Science Citation Index and Cochrane Central Register of Controlled Trials Registry, were searched in January 2017. Using combinations of the relevant key words, review was performed following the recommended guidelines for reporting systematic reviews. English language limitation was applied and term limited to 2006-2016. Included studies were assigned a grade based upon their level of evidence and critically appraised using defined tools. Data were not synthesized for meta-analysis due to nature of literature reviewed and heterogeneity. Three thousand five hundred ninety-two titles were screened with 43 full-texts assessed for eligibility. Twenty nine studies were deemed eligible for inclusion. These included 19 cohort studies, two qualitative studies, seven cross-sectional studies, and one randomised control trial. Grey literature search from guidelines, and repositories yielded an additional 10 guidelines. (SFR) design for neonatal units is recommended. An optimally designed neonatal unit has many possible health implications, including improved breastfeeding, infection and noise control, reduced length of stay, hospitalisation rates and potentially improved neonatal morbidity and mortality. High quality, family centred care (FCC) in neonatology could be assisted through well grounded, future proofed and technology enabled design concepts that have the potential to impact upon early life development.

摘要

医院的循证设计(EBD)可显著提高患者安全性,并使患者、医护人员及家属的环境更健康。本系统综述旨在确定新生儿重症监护病房的哪些设计特征可改善新生儿、父母及医护人员的相关结果。2017年1月检索了医学期刊数据库(Medline)、护理学与健康领域数据库(CINAHL)、科学引文索引(Web of Science Citation Index)和考科蓝对照试验中央注册库。按照报告系统综述的推荐指南,使用相关关键词组合进行综述。设定语言限制为英文,时间范围限制在2006年至2016年。纳入的研究根据其证据水平进行分级,并使用既定工具进行严格评估。由于所审查文献的性质和异质性,未对数据进行综合以进行荟萃分析。共筛选了3592篇标题,评估了43篇全文的 eligibility。29项研究被认为符合纳入标准。其中包括19项队列研究、2项定性研究、7项横断面研究和1项随机对照试验。从指南和知识库进行的灰色文献检索又获得了10项指南。推荐采用(SFR)设计用于新生儿病房。设计优化的新生儿病房对健康有诸多潜在影响,包括改善母乳喂养、控制感染和噪音、缩短住院时间、降低住院率,并可能改善新生儿的发病率和死亡率。基于扎实、面向未来且具备技术支持的设计理念,高质量的以家庭为中心的新生儿护理(FCC)能够得到助力,这些理念有可能对早期生命发育产生影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/226c/6492317/3583124b37c4/40748_2019_101_Fig1_HTML.jpg

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