心外重症监护室患者谵妄管理的循证证据总结

Summary of Evidence for Delirium Management in Extracardiac Intensive Care Unit

目的整合心外重症监护室患者谵妄管理的最佳证据,为心外科谵妄患者管理提供循证依据。方法系统检索中国知网、万方数据库、中国生物医学文献数据库、维普、BMJ最佳临床实践、循证卫生保健中心图书馆、UpToDate、PubMed、CINAHL、Cochrane Library、加拿大安大略注册护士协会指南网、英国国家医疗保健优化研究所指南网、国际指南协作网、美国国家指南库、苏格兰学院间指南网络等数据库关于心外重症监护室患者谵妄管理的相关证据,包括指南、证据总结、系统评价、随机对照试验。检索时限为2011年1月1日至2021年12月31日。由2名以上完成循证护理培训的研究员对纳入文献独立质量评价,并对最终纳入的文献进行证据提取、整合。结果共纳入7篇文献,包括指南4篇、系统评价3篇,从中进行证据汇总,最终整合为风险因素、筛查与监测、防治策略3个维度37条心外重症监护室患者谵妄管理的最佳证据。结论基于总结的最佳证据可形成心外重症监护室患者谵妄管理方案,以期减少谵妄的发生及其产生的不良影响,确保患者安全。

Objectives Synthesizing the best evidence for delirium management in extracardiac intensive care units to provide evidence-based basis for delirium patient management in cardiac surgery.Methods We systematically searched CNKI,Wanfang Database,CBM,VIP,BMJ Best Practice,JBI,UpToDate,Pubmed,CINAHL,Cochrane,Registered Nurse Association of Ontario(RNAO),National Institute for Health and Care Excellence(NICE),Guidelines International Network(GIN),National Guideline Clearinghouse(NGC),and Scottish Intercollegiate Guidelines Network(SIGN)to collect guidelines,evidence summaries,systematic evaluations,and randomized controlled trial related to the delirium management in cardiac surgery intensive care unit.The search period is from January 1,2011 to December 31,2021.Two or more researchers who have completed evidence-based nursing training independently evaluate the quality of the selected literature,and extract and integrate evidence.Results A total of 7 literatures were selected in this study,including 4 guidelines and 3 systematic reviews,from which evidences were summarized and ultimately integrated into 37 pieces in three aspects,including risk factors,screening and monitoring,prevention and treatment strategies.Conclusions Based on the best summarized evidences,we can form a delirium management plan for patients in extracardiac intensive care unit,in order to reduce the occurrence of delirium and its adverse effects,and ensure the safety of patient.