The effectiveness of non-pharmacological multi-component interventions for the prevention of delirium in non-intensive care unit older adult hospitalized patients: a systematic review

Abstract

Review question/objective In older adult hospitalized non-intensive care unit (ICU) patients, are targeted non-pharmacological, multi-component interventions effective for preventing and shortening the duration of delirium when compared to usual care? Inclusion criteria Types of participants This review will consider studies that include hospitalized patients aged 60 years and over, who are identified to be at risk for delirium or experiencing delirium using one of the standard published delirium screening, recognition and diagnostic tools: Diagnostic and Statistical Manual of Mental Disorders (DSM IV), 34 Mental Status Questionnaires, 35 Mini Mental State Examination (MMSE), 36 Confusion Assessment Method (CAM), 21 and International Classification of Diseases (ICD10). 37 Types of intervention(s)/phenomena of interest This review will consider studies that evaluate non-pharmacological, multi-component interventions for the prevention of delirium compared to usual care. Typical multi-component interventions will include use of specialized clinical staff/volunteers, geriatric/psychiatric consultation, staff education, patient orientation, addressing visual and hearing needs, sleep enhancement, medication review, hydration and nutrition, early mobilization, pain management, addressing bowel and bladder functions, prevention and treatment of medical complications etc. Types of outcomes This review will consider studies that include the following outcome measures: Incidence of delirium, which is the number of new cases occurring during hospitalization, and length of delirium time defined as the onset of delirium symptoms to resolution of delirium symptoms.