Department of General Medicine, Sutherland Hospital and Community Services, Sydney, Australia.
Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK.
Eur Geriatr Med. 2020 Feb;11(1):1-32. doi: 10.1007/s41999-019-00278-x. Epub 2020 Jan 14.
Understanding the quality of evidence of delirium education studies will assist in designing future education interventions that seek to improve the well-known deficits in delirium prevention, detection and care. The aim of this study is to systematically review the methodological strengths and limitations, as well as the impact of delirium educational interventions for healthcare professionals working in inpatient settings.
MEDLINE, EMBASE, The Cochrane Library, PsychINFO and CINAHL databases were searched according to PRISMA guidelines for delirium educational interventions in hospital inpatient settings from 2007 to 2017. Identified studies were rated using a standardised quality assessment criteria checklist (Kmet). Reported outcomes were organised by level on the Kirkpatrick model for educational outcomes. The search was repeated in March 2018.
1354 papers were screened, of which 42 studies met the inclusion criteria. Interventions delivered included face-to-face education (n = 34), e-learning (n = 8) and interprofessional education (n = 8). Quality of studies varied in Kmet score (14-96%). There were 17 high-quality studies (Kmet > 80%) and 4 very high-quality studies (Kmet over > 90%). Thirty-eight studies (90%) reported improved outcomes post-intervention. In terms of Kirkpatrick level of educational outcomes, 6 studies were rated at level 1; 13 studies at level 2; 15 studies at level 3; and 8 studies at level 4. Thirteen studies measured intervention sustainability with variable impacts.
Healthcare professional education has benefits for inpatient delirium care, as shown by the high number of good-quality studies and the majority demonstrating improved outcomes post-intervention. The sustainability of educational interventions warrants further exploration.
了解谵妄教育研究的证据质量将有助于设计旨在改善谵妄预防、检测和护理方面众所周知缺陷的未来教育干预措施。本研究的目的是系统地回顾在住院环境中工作的医疗保健专业人员的谵妄教育干预措施的方法学优势和局限性，以及其影响。
根据 PRISMA 指南，对 2007 年至 2017 年期间住院患者谵妄教育干预措施进行了 MEDLINE、EMBASE、The Cochrane Library、PsychINFO 和 CINAHL 数据库检索。使用标准化的质量评估标准检查表（Kmet）对确定的研究进行评分。报告的结果按教育结果的 Kirkpatrick 模型的水平进行组织。2018 年 3 月再次进行了检索。
筛选了 1354 篇论文，其中 42 项研究符合纳入标准。干预措施包括面对面教育（n=34）、电子学习（n=8）和跨专业教育（n=8）。Kmet 评分的研究质量差异很大（14-96%）。有 17 项高质量研究（Kmet>80%）和 4 项极高质量研究（Kmet 超过>90%）。38 项研究（90%）报告干预后结果有所改善。在教育结果的 Kirkpatrick 水平方面，6 项研究评为 1 级；13 项研究为 2 级；15 项研究为 3 级；8 项研究为 4 级。13 项研究测量了干预的可持续性，其影响各不相同。
医疗保健专业人员教育对住院患者的谵妄护理有益，高质量研究数量众多，大多数研究表明干预后结果有所改善。教育干预措施的可持续性值得进一步探讨。
