Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.
Health Care Research Group (GRECS), [Lleida Institute for Biomedical Research Dr. Pifarré Foundation], IRBLleida, 25198, Lleida, Spain.
BMC Geriatr. 2022 Jul 1;22(1):552. doi: 10.1186/s12877-022-03218-w.
Infection is more frequent, and serious in people aged > 65 as they experience non-specific signs and symptoms delaying diagnosis and prompt treatment. Monitoring signs and symptoms using decision support tools (DST) is one approach that could help improve early detection ensuring timely treatment and effective care.
To identify and analyse decision support tools available to support detection of infection in older people (> 65 years).
A scoping review of the literature 2010-2021 following Arksey and O'Malley (2005) framework and PRISMA-ScR guidelines. A search of MEDLINE, Cochrane, EMBASE, PubMed, CINAHL, Scopus and PsycINFO using terms to identify decision support tools for detection of infection in people > 65 years was conducted, supplemented with manual searches.
Seventeen papers, reporting varying stages of development of different DSTs were analysed. DSTs largely focussed on specific types of infection i.e. urine, respiratory, sepsis and were frequently hospital based (n = 9) for use by physicians. Four DSTs had been developed in nursing homes and one a care home, two of which explored detection of non- specific infection.
DSTs provide an opportunity to ensure a consistent approach to early detection of infection supporting prompt action and treatment, thus avoiding emergency hospital admissions. A lack of consideration regarding their implementation in practice means that any attempt to create an optimal validated and tested DST for infection detection will be impeded. This absence may ultimately affect the ability of the workforce to provide more effective and timely care, particularly during the current covid-19 pandemic.
老年人（>65 岁）感染更为频繁且更为严重，因为他们会出现非特异性体征和症状，从而导致诊断和及时治疗的延误。使用决策支持工具（DST）监测体征和症状是一种有助于提高早期检测率、确保及时治疗和有效护理的方法。
确定并分析可用于帮助检测老年人（>65 岁）感染的决策支持工具。
根据 Arksey 和 O'Malley（2005 年）框架和 PRISMA-ScR 指南，对 2010 年至 2021 年的文献进行了范围综述。使用识别老年人感染检测决策支持工具的术语对 MEDLINE、Cochrane、EMBASE、PubMed、CINAHL、Scopus 和 PsycINFO 进行了检索，并辅以手动检索。
分析了 17 篇报告不同发展阶段的不同 DST 论文。DST 主要集中在特定类型的感染上，即尿液、呼吸道和败血症，且多数（n=9）是针对医生在医院使用而开发的。有 4 个 DST 是在疗养院开发的，1 个是在护理院开发的，其中有 2 个探索了非特异性感染的检测。
DST 为早期检测感染提供了机会，支持及时采取行动和治疗，从而避免紧急住院。在实践中考虑到它们的实施不足意味着，任何创建一个用于感染检测的最佳优化验证和测试 DST 的尝试都将受到阻碍。这种缺乏可能最终会影响工作人员提供更有效和及时护理的能力，特别是在当前 COVID-19 大流行期间。
