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Table 2 Summary of implementation strategies

From: A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes

Implementation strategy

Studies reporting both clinical outcomes and process outcomes before versus after implementation

Studies reporting process outcomes, without clinical outcomes, before versus after implementation*

Percent using strategy

  

Author

Mansouri

Skrobik

Balas

Radtke

Robinson

Kamdar

Reade

Dale

Bryckz.

Eastwood

Devlin

Scott

Gesin

Riekerk

Kastrup

Boogaard

Pun

Hager

Soja

Page

Bowen

 

PO

1

Distribution**

1

1

1

1

1

1

0

1

0

0

0

1

1

1

1

1

1

1

1

1

1

81

2

Educational Meetings

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

100

3

Local consensus

1

1

1

0

1

1

0

1

1

0

0

0

1

1

1

1

0

1

0

0

1

62

4

Outreach

0

0

1

1

0

0

1

1

0

1

1

1

1

1

0

1

1

0

1

1

1

67

5

Opinion leaders

0

1

1

1

1

0

1

0

0

0

1

0

0

1

0

1

0

1

1

0

1

52

6

Patient-mediated

1

1

1

1

1

1

1

1

0

1

1

1

1

1

1

1

0

1

1

1

0

86

7

Audit/feedback

1

1

1

0

0

0

0

0

0

1

1

0

1

1

1

1

1

1

1

0

1

62

8

Reminders

0

0

1

1

0

1

0

0

0

0

0

0

0

0

1

1

0

1

1

0

1

38

9

Tailoring (barriers)

0

1

1

0

0

0

0

0

0

0

0

0

0

1

0

1

0

1

1

0

1

33

10

Mass media

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

O

11

Provider-oriented

1

0

1

0

0

1

0

0

0

0

1

0

0

1

0

1

1

1

1

0

0

43

12

Patient-oriented

0

1

0

0

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

10

13

Structural

0

1

1

1

0

0

0

0

0

0

0

0

1

1

1

1

1

1

1

0

0

48

F

14

Provider

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

0

10

R

15

Medical liability

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

16

Patient complaints

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

17

peer review/licensure

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

5

Total number IS used

7

9

12

7

5

6

4

5

3

4

6

4

7

10

7

12

6

10

10

4

8

 

Post-implementation***

Mortality

=

-

-

-

-

-

-

-

-

-

-

-

 

ICU length of stay

=

=

-

-

-

-

-

-

-

-

-

-

 

Screening adherence

-

-

-

-

-

-

=

 

Incidence

-

-

-

-

-

-

-

-

-

-

-

-

 

Antypsychotic drug use

-

-

-

-

-

-

-

-

-

-

-

-

-

 

Delirium knowledge

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

 
  1. *Study by Eastwood concerns the same study population as the study by Reade and was therefore not used for analysis of clinical outcomes. **For explanation of individual strategies, see Table 1.
  2. ***Only statistically significant changes are in bold text. PO, professional-oriented; O, organizational; F, financial; R, regulatory; IS, implementation strategies.