急性护理环境中老年患者医院获得性疾病发生的相关因素：一项范围综述
Factors involved in the development of hospital-acquired conditions in older patients in acute care settings: a scoping review.
作者信息
Verdon Mélanie, Agoritsas Thomas, Jaques Cécile, Pouzols Sophie, Mabire Cédric
机构信息
Care Directorate, Geneva University Hospitals, Geneva, Switzerland.
Institute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.
出版信息
BMC Health Serv Res. 2025 Jan 29;25(1):174. doi: 10.1186/s12913-025-12318-3.
BACKGROUND
Older patients hospitalized in acute care settings are at significant risk of presenting hospital-acquired conditions. Healthcare professionals should consider many factors involved in the development of such conditions, including factors related to the patients, as well as those related to the processes of care and the structure of hospitals. The aim of this study was to describe and identify the factors involved in the development of hospital-acquired conditions in older patients in acute care settings.
METHODS
A scoping review was performed based on a structured search in eight databases in September 2022. Data were extracted with an extraction tool and classified into categories. Mapping and a narrative summary were used to synthetize data.
RESULTS
A total of 237 articles were included in the scoping review. Functional decline and delirium were the most frequent hospital-acquired conditions studied. Among all categories, factors related to the patients provided most of the data, whereas factors related to the processes of care and the structure of hospitals were less frequently explored. In most articles, one or two categories of factors were retrieved; fewer articles examined factors among three categories. Personal factors, medications, and the human and work environment were the most frequent subcategories of factors retrieved, whereas social factors, hydration and nutrition, and organizational factors were less common.
CONCLUSIONS
The development of hospital-acquired conditions in older patients in acute care settings involves many factors related to the patients, as well as to the processes of care and the structure of hospitals. Prevention of hospital-acquired conditions must involve to consider the complexities of older patients and of acute care hospitals. Not considering all categories of factors might affect the implementation of new practices of care and interventions.
背景
在急性护理环境中住院的老年患者面临出现医院获得性疾病的重大风险。医疗保健专业人员应考虑与此类疾病发生相关的许多因素，包括与患者相关的因素，以及与护理过程和医院结构相关的因素。本研究的目的是描述和确定急性护理环境中老年患者发生医院获得性疾病所涉及的因素。
方法
2022年9月，基于对八个数据库的结构化搜索进行了一项范围综述。使用提取工具提取数据并分类。采用映射和叙述性总结来综合数据。
结果
范围综述共纳入237篇文章。功能衰退和谵妄是研究最频繁的医院获得性疾病。在所有类别中，与患者相关的因素提供了大部分数据，而与护理过程和医院结构相关的因素研究较少。在大多数文章中，检索到一两类因素；较少文章考察三类因素中的因素。个人因素、药物以及人力和工作环境是检索到的最常见的因素子类别，而社会因素、水合作用和营养以及组织因素则不太常见。
结论
急性护理环境中老年患者医院获得性疾病的发生涉及许多与患者相关的因素，以及与护理过程和医院结构相关的因素。预防医院获得性疾病必须考虑老年患者和急性护理医院的复杂性。不考虑所有类别的因素可能会影响新护理实践和干预措施的实施。
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