Effect of Delirium Prevention Program on Delirium Occurrence and the Length of Intensive Care Unit (ICU) Stay: A Systematic Review and Meta-Analysis

Abstract

Background: ICU patients typically experience diverse kinds of distress factors, which make them vulnerable to delirium thereby resulting in a higher rate of delirium occurrence. We aimed to review systematically current states of preventive nursing intervention in ICUs, and to analyze delirium occurrence and the length of ICU stay to provide suggestions for the preventive nursing practice in ICU. Methods: Data collection was done with literature search databases including PubMed, Ovid-MEDLINE, EMBASE, CINAHL, KMbase, KoreaMed, Korean Studies Information Service System (KISS), Korea Institute of Science and Technology Information (KiSTi), Research Information Service System (RISS) and with hand searching, from Apr 20 to May 10, 2020. Two researchers independently selected research literature, and three researchers summarized and identified related variables based on data extraction methods. Results: Overall, 236 articles identified, 11 articles met the inclusion criteria for review. The systematic review of the contents of preventive nursing intervention other than drug administration rendered the four types of intervention. The Peto odds ratio (OR) of the rate of delirium occurrence appeared as 0.29 (95% Confidence Interval (CI)=0.20∼0.43) which was statistically significant (Z=6.23, P<.01) in both group. The magnitude of the effect for the length of ICU stay demonstrated insignificant values, Mean difference (MD) –0.23 (95% CI=-0.51∼0.05) (Z=1.60, P=.11). Conclusion: For management of delirium among ICU patients, multi-component intervention packages, suitable for care setting in ICUs, need to be taken into account for the preparation of nursing intervention for prevention of delirium applicable to nursing practices.

Keywords

• Delirium
• Intensive care unit
• Systematic review
• Meta-analysis