Author, year (design) | Implementation | Process outcomes | Clinical outcomes | ||||||
---|---|---|---|---|---|---|---|---|---|
Number of strategies used | Implemented care components | Implementation model | Screening adherence | Delirium incidence | Use of antipsychotic drugs | Delirium knowledge | Mortality change | ICU length of stay, days | |
Balas, 2014 [16] (B/Aa study, n = 296) | 12 | ABCDEb | CFIRc | +50% (0 to 50%)d | −13% (62 to 49%), P = 0.02 | +12 mg (6 to 18 mg)e, P = 0.24 | - | −8.6% (19.9 to 11.3%), P = 0.04 | −1f (5 to 4), P = 0.21 |
Van den Boogaard, 2009 [17] (B/A study, n = 1742) | 12 | Delirium screening | Model of Grol and Wensing | +14% (77 to 92%), P <0.0001 | +13% (10 to 23%), P <0.05g | −12 mg (18 to 6 mg)e , P = 0.01 | +1.2 (6.2 to 7.4), P <0.001 | - | −0.3 (1.3 to 1)f P < 0.05 |
Riekerk, 2009 [18] (B/A study, n = NA) | 10 | Delirium screening | Structural implementation pathway | +57% (38 to 95%)d | - | - | +1d,h (3–4) | - | - |
Hager, 2013 [19] (B/A study, n = 202) | 10 | PADw | 4Es frameworki | 0 (90 to 90%) | +18%j (20 to 38%), P = 0.01 | - | - | - | - |
Skrobik, 2010 [20] (B/A study, n = 1133) | 9 | PAD | - | +3k (89 to 92%), P = 0.055 | −0.5% (34.7 to 34.2%), P = 0.9 | +0.3% (39.4 to 39.7%), P = 0.7 | - | −6.5% (29.4 to 22.9%), P = 0.009 | −0.97l (6.32 to 5.35), P = 0.009 |
Bowen, 2012 [21] (pilot study, n = 34 nurses) | 8 | Delirium screening | Diffusion of Innovations theory | +75% (10% to 85%) | - | - | - | - | - |
Soja, 2008 [22] (Prospective study, n = 347) | 10 | Delirium screening | - | +84% (0 to 84)d | - | - | - | - | - |
Gesin, 2012 [23] (B/A study, n = 20 nurses) | 7 | Delirium screening | - | - | - | - | +2.1 (6.1 to 8.2), P = 0.001 | - | - |
Mansouri, 2013 [24] (RCT, n = 201) | 7 | PAD | - | +100%m (0 to 100%) | - | −2.5 mgn (3.2 to 0.7 mg), P = 0.12 | - | −12% (24 to 13%), P = 0.046 | −3.1 (7.1 to 4.0)f , P <0.001 |
Pun, 2005 [25] (Prospective study, n = 711) | 6 | PAD | - | +90% (0 to 90)d +84% (0 to 84)d | - | - | - | - | - |
Radtke, 2012 [26] (B/Ae study, n = 131) | 7 | PAD | Modified extended training | +1.6 (0 to 1.6), P <0.01 | - | - | - | −4.8%o (9.9 to 5.1%), P = 0.16 | −4 (18 to 14)p, P = 0.40 |
−4 (8 to 4)p , P <0.01 | |||||||||
Eastwood, 2012 [27] (B/A study, n = 288 patients/2368 shifts) | 4 | Delirium screening | - | - | - | +8.5%q (5.8 to 14.3%), P <0.0001r | - | +3.2% (5 to 8.2)s,t P = 0.31 | 0 (2 to 2), P = 0.34 |
Kamdar, 2013 [28] (B/A study, n = 285) | 6 | Multifaceted sleep promotion program | Structured QI model | - | odds ratio 0.46a , P = 0.02 | - | - | −6% (25 to 19%), P = 0.88s | −1.1u (5.4 to 4.3), P = 0.60 |
Scott, 2012 [29] (B/A study, n = 119) | 4 | Delirium screening | - | +78% (0 to 78%)d | - | - | +14%v (71 to 85%), P <0.001 | - | - |
Dale, 2014 [30] (B/A study, n = 1483) | 5 | PAD | - | +1.14x (0.35 to 1.49), P <0.01 | odds ratio 0.67, p = 0.01 | −1.7 (2.7 to 1.0)y , P <0.01 | - | 0 (14 to 14%), P = 1.0 | −12.4%j , P = 0.04 |
Kastrup, 2011 [31] (B/A study, n = 205) | 7 | Visual feedback system | - | +37.5% (0.5 to 38%), P <0.01 | +4% (25 to 29%), P = 1.0za | - | - | - | - |
Robinson, 2008 [32] (B/A study, n = 119) | 5 | PAD | - | - | - | +14% (31 to 45%), P = 0.25 | - | −2.9% (17.6 to 14.7), P = 0.64 | −1.8 (5.9 to 4.1), P = 0.21 |
Devlin, 2008 [33] (B/A study, n = 601) | 6 | Delirium screening | SCTzb | +70% (12 to 82%), P <0.0005 | - | - | - | - | - |
Page, 2009 [34] (Retrospective study, n = 60) | 4 | Delirium screening | - | +92% (0 to 92%)d | - | - | - | - | - |
Reade, 2011 [35] (B/A study, n = 288) | 4 | Delirium screening | - | - | −16% (37 to 21%), P = 0.004 | - | - | +3.2% (5 to 8.2)zc, P = 0.31 | 0 (2 to 2), P = 0.34 |
Bryczkowski, 2014 [36] (B/A study, n = 123) | 3 | Delirium prevention program | - | - | +11% (58 to 47%), P = 0.26 | −1% (7 to 6%), P = 0.83 | - | −4% (7 to 3%), P = 0.31 | −3 (9 to 6), P = 0.04 |