重症监护室谵妄患者睡眠管理最佳证据总结

Summary of best evidence for sleep management in delirium patients in the intensive care unit

目的对重症监护室谵妄患者睡眠管理干预的相关证据进行遴选,总结最佳证据。方法使用计算机检索BMJ Best Practice、UpToDate、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、加拿大安大略注册护士协会循证护理指南网、苏格兰学院间指南协作网、英国国家卫生与临床优化研究所网站、Cochrane Library、PubMed、CINAHL(EBSCO)、Springer Link、Elsevier Science Direct、Embase(OVID)、Web of Science、中国知网、医脉通、中国生物医学文献数据库、万方数据库、维普数据库中重症监护室患者睡眠管理相关证据,其中包括指南、推荐实践、系统评价、专家共识及相关证据总结。由2名研究者根据澳大利亚乔安娜布里格斯研究所循证卫生保健中心证据预分级系统(2014版)进行证据分级对纳入文献进行独立质量评价,对符合质量评价标准的文献进行资料提取,并结合专业人员的判断,对文献进行证据汇总。结果共纳入文献12篇,包括系统评价5篇、专家共识2篇、证据总结2篇、指南3篇,从护理管理、自我管理、环境管理、药物管理、非药物管理5个方面最终总结了20条最佳证据。结论该研究总结了重症监护室谵妄患者睡眠管理的最佳证据,可为重症医护人员提供循证证据。医护人员应结合临床情境,审慎地选择并应用证据以科学的方法管理谵妄患者的睡眠,提高患者的睡眠质量,减少谵妄持续时间。

Objective To select the evidence for sleep management intervention in patients with delirium in the ICU and summarize the best evidence.Methods To select relevant evidence for sleep management interventions in delirium patients in the intensive care unit and summarize the best evidence.Methods We used a computer to search for evidence related to sleep management in ICU patients in the BMJ Best Practice,UpToDate,Australian Joanna Briggs Institute Evidence Based Health Care Center Database,Registered Nurses'Association of Ontario evidence-based nursing guide network,Scottish Intercollegiate Guidelines Network,National institute for Health and Care Excellence Network,Cochrane Library,PubMed,CINAHL(EBSCO),Springer Link,Elsevier Science Direct,Embase(OVID),Web of Science,China National Knowledge Infrastructure,Yimaitong,China Biomedical Literature Service Database,Wanfang Database,and VIP Database,including guidelines,recommended practices,systematic evaluations,expert consensus,and summary of relevant evidence.Two researchers conducted an independent quality evaluation of the included literature based on the evidence pre grading system of the Australian Joanna Briggs Institute Evidence Based Health Care Center(2014 version),extracted data from literature that met the quality evaluation criteria,and combined with professional judgment,summarized the evidence of the literature.Results A total of 12 articles were included,including 5 systematic evaluations,2 expert consensus papers,2 evidence summaries,and 3 guidelines.20 best evidence were ultimately summarized from 5 aspects of nursing management,self-management,environmental management,drug management,and non drug management.Conclusion This study summarized the best evidence for sleep management in delirium patients in the intensive care unit,and can provide evidence-based evidence for critically ill healthcare professionals.Medical staff should carefully select and apply evidence to scientifically manage the sleep of delirium patients based on clinical situations,improve their sleep quality,and reduce the duration of delirium.