Effectiveness of nonpharmacological interventions to prevent adverse events in the intensive care unit : A review of systematic reviews
Suclupe Obregón, Stefanie (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Efrain Pantoja Bustillos, Percy (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Pérez Bracchiglione, Javier Andrés (Institut d'Investigació Biomèdica Sant Pau)
Requeijo, Carolina (Institut d'Investigació Biomèdica Sant Pau)
Salas-Gama, Karla (Hospital Universitari Vall d'Hebron)
Solà, Ivan (Institut d'Investigació Biomèdica Sant Pau)
Merchán Galvis, Ángela María (Universidad del Cauca)
Uya Muntaña, Jaume (Hospital Universitari de Bellvitge)
Robleda, Gemma (Universitat de Barcelona)
Martinez-Zapata, Maria Jose (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Different types of interventions have been assessed for the prevention of adverse events. However, determining which patient-safety practice is most effective can be challenging when there is no systematised evidence synthesis. An overview following the best methodological standards can provide the best reliable integrative evidence. Objectives: The objective of this study was to provide an overview of effectiveness nonpharmacological interventions aimed at preventing adverse events in the intensive care unit. A review of systematic reviews (SRs) was conducted according to the Cochrane Handbook and PRISMA recommendations. PubMed, CINAHL, and Cochrane Library were searched for SRs published until March 2022. Two reviewers independently assessed the study's quality, using AMSTAR-2, and extracted data on intervention characteristics and effect on prevention of adverse events. Thirty-seven SRs were included, and 27 nonpharmacological interventions were identified to prevent 11 adverse events. Most of the reviews had critically low methodological quality. Among all the identified interventions, subglottic secretion drainage, semirecumbent position, and kinetic bed therapy were effective in preventing ventilator-associated pneumonia; the use of earplugs, early mobilisation, family participation, and music in reducing delirium; physical rehabilitation in improving muscle strength; use of respiratory support in preventing reintubation; the use of a computerised physician order entry system in reducing risk of medication errors; and the use of heated water humidifier was effective in reducing artificial airway occlusion. Some nonpharmacological interventions reduced adverse events in the intensive care setting. These findings should be interpreted carefully due to the low methodological quality. SRs on preventing adverse events in the intensive care unit should adhere to quality assessment tools so that best evidence can be used in decision-making.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Adverse event ; Evidence-based practice ; Intensive care unit ; Nonpharmacological ; Patient safety ; Prevention ; Quality of health care ; Review of systematic reviews
Publicat a:	Australian Critical Care, Vol. 36 Núm. 5 (september 2023) , p. 902-914, ISSN 1036-7314

DOI: 10.1016/j.aucc.2022.11.003
PMID: 36572576

13 p, 1.3 MB

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