Effectiveness of nonpharmacological interventions to prevent adverse events in the intensive care unit: A review of systematic reviews.

Autor: Suclupe S; Universitat Autònoma de Barcelona, Spain; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain. Electronic address: stefanie.suclupe@autonoma.cat., Efrain Pantoja Bustillos P; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain., Bracchiglione J; Universitat Autònoma de Barcelona, Spain; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain; Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Chile., Requeijo C; Epidemiology and Public Health Department, Hospital de La Santa Creu I Sant Pau, Institut de Recerca IIB Sant Pau, Barcelona, Spain., Salas-Gama K; Universitat Autònoma de Barcelona, Spain; Vall D'Hebron University Hospital, Barcelona, Spain., Solà I; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain; Epidemiology and Public Health Department, Hospital de La Santa Creu I Sant Pau, Institut de Recerca IIB Sant Pau, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain., Merchán-Galvis A; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain; Department of Social Medicine and Family Health, Universidad Del Cauca, Colombia., Uya Muntaña J; Hospital Universitario de Bellvitge, Instituto Català de Salut, Nursing Research Group, Bellvitge Institute for Biomedical Research, Spain., Robleda G; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain; Nursing School of Barcelona, Campus Docent Sant Joan de Déu-Private Foundation, University of Barcelona, Spain., Martinez-Zapata MJ; Universitat Autònoma de Barcelona, Spain; Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain.
Jazyk: angličtina
Zdroj: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses [Aust Crit Care] 2023 Sep; Vol. 36 (5), pp. 902-914. Date of Electronic Publication: 2022 Dec 24.
DOI: 10.1016/j.aucc.2022.11.003
Abstrakt: Background: Different types of interventions have been assessed for the prevention of adverse events. However, determining which patient-safety practice is most effective can be challenging when there is no systematised evidence synthesis. An overview following the best methodological standards can provide the best reliable integrative evidence.
Objectives: The objective of this study was to provide an overview of effectiveness nonpharmacological interventions aimed at preventing adverse events in the intensive care unit.
Methods: A review of systematic reviews (SRs) was conducted according to the Cochrane Handbook and PRISMA recommendations. PubMed, CINAHL, and Cochrane Library were searched for SRs published until March 2022. Two reviewers independently assessed the study's quality, using AMSTAR-2, and extracted data on intervention characteristics and effect on prevention of adverse events.
Results: Thirty-seven SRs were included, and 27 nonpharmacological interventions were identified to prevent 11 adverse events. Most of the reviews had critically low methodological quality. Among all the identified interventions, subglottic secretion drainage, semirecumbent position, and kinetic bed therapy were effective in preventing ventilator-associated pneumonia; the use of earplugs, early mobilisation, family participation, and music in reducing delirium; physical rehabilitation in improving muscle strength; use of respiratory support in preventing reintubation; the use of a computerised physician order entry system in reducing risk of medication errors; and the use of heated water humidifier was effective in reducing artificial airway occlusion.
Conclusions: Some nonpharmacological interventions reduced adverse events in the intensive care setting. These findings should be interpreted carefully due to the low methodological quality. SRs on preventing adverse events in the intensive care unit should adhere to quality assessment tools so that best evidence can be used in decision-making.
(Copyright © 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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