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加强老年人重症监护中的护理实践:对老年友好型护理干预措施的系统评价

Enhancing Nursing Practices in Critical Care for Older Adults: A Systematic Review of Age-Friendly Nursing Interventions.

作者信息

Shaban Mostafa, Elsayed Ramadan Osama Mohamed, Zaky Mohammed Elsayed, Mohamed Abdallah Haitham Mokhtar, Mohammed Huda Hamdy, Abdelgawad Mohamed Ezzelregal

机构信息

Community Health Nursing Department, College of Nursing, Jouf University, Sakaka, Saudi Arabia.

College of Nursing, Jouf University, Sakaka, Saudi Arabia.

出版信息

J Am Med Dir Assoc. 2025 Jan;26(1):105323. doi: 10.1016/j.jamda.2024.105323. Epub 2024 Oct 23.

Abstract

OBJECTIVES

To synthesize evidence on the implementation and effectiveness of age-friendly interventions in intensive care units (ICUs) to optimize care for older adults.

DESIGN

Systematic review of studies published up to February 2024, focusing on interventions tailored to meet the needs of older adults in ICU settings.

SETTING AND PARTICIPANTS

Comparative studies conducted in ICUs worldwide, involving older adults receiving critical care, were reviewed.

METHODS

A systematic search of databases including Embase, MEDLINE, and Cochrane was performed. The quality of studies was assessed using the ROSVIS-II tool, and findings were synthesized narratively and thematically.

RESULTS

Out of 1200 articles initially identified, 45 studies met inclusion criteria. Age-friendly interventions (eg, geriatric assessment teams, multimodal care bundles) demonstrated significant benefits, including a 19% reduction in major in-hospital complications and shorter hospital stays by an average of 3 days.

CONCLUSIONS AND IMPLICATIONS

The review supports the effectiveness of age-friendly interventions in improving clinical outcomes for older ICU patients. However, consistent reporting of effect sizes was lacking, and more high-quality comparative effectiveness research is needed. Implications for practice include integrating these interventions into standard ICU protocols to enhance older adult care. Policy implications involve advocating for health care policies that support the dissemination and implementation of effective age-friendly practices. Further research should focus on establishing a robust evidence base to guide implementation and policy decisions.

摘要

目的

综合重症监护病房(ICU)中针对老年人的友好型干预措施的实施情况及效果的证据,以优化对老年人的护理。

设计

对截至2024年2月发表的研究进行系统综述,重点关注为满足ICU环境中老年人需求而量身定制的干预措施。

背景与参与者

对全球ICU中进行的比较研究进行了综述,这些研究涉及接受重症监护的老年人。

方法

对包括Embase、MEDLINE和Cochrane在内的数据库进行系统检索。使用ROSVIS-II工具评估研究质量,并对研究结果进行叙述性和主题性综合分析。

结果

在最初识别的1200篇文章中,45项研究符合纳入标准。针对老年人的友好型干预措施(如老年评估团队、多模式护理包)显示出显著益处,包括主要院内并发症减少19%,平均住院时间缩短3天。

结论与启示

该综述支持针对老年人的友好型干预措施在改善老年ICU患者临床结局方面的有效性。然而,缺乏对效应量的一致报告,需要更多高质量的比较有效性研究。对实践的启示包括将这些干预措施纳入标准ICU方案以加强对老年人的护理。政策启示包括倡导支持有效针对老年人的友好型实践的传播和实施的医疗保健政策。进一步的研究应侧重于建立坚实的证据基础,以指导实施和政策决策。

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