Systematic Review Delirium in the ICU

Systematic review Delirium in the ICU
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Course
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Date

Ahmed, S., Leurent, B., & Sampson, E. L. (2014). Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis. Age and ageing, 43(3), 326-333.
THE PROBLEM
The authors stated the research problem focusing on understanding the risk factors for incidences of delirium, Data synthesis through systematic reviews and Meta analysis were relied upon to identify the risk factors among older patents. The topic of delirium in the ICU and acute care settings is important to nurses since it goes under-recognized. Even though, screening is an important tool which helps to improve healthcare outcome, nurses do not always perform screening for delirium. Ahmed et al (2014), identified all the risk factors that could cause delirium after conducting a review of previous studies, as they adapted the range of risk factors depending on whether risk factors had been considered by previous studies. The approach was adequate as the researchers were able to pool information on the various delirium risk factors, synthesizing the broad range of data available to highlight on the most prevalent risk factors mentioned. According to Reade and Finfer (2014), patients in the ICU typically experience pain and distress resulting from interventions like endotracheal intubation and mechanical ventilation. Even when under sedation, patients may not always be closely monitored all the time, meaning there is a high risk of delirium, and the management of pain determines the functional long-term health outcomes (Luetz et al., 2014)SEARCH STRATEGY
Ahmed et al (2014) mainly utilized the PubMed database relying on confusion and causality as the Medical Subject headings MeSH terms. Confusion was in turn related to delirium while causality represented the risk factors. This search strategy merely gave broad results, a further break down of the search strategy showed that narrowing down the search for the key words, delirium and risk factors (Ahmed et al., 2014). The same search strategy was employed in other databases in order to identify the most relevant publications (Ahmed et al., 2014). The authors did not rely on a flow chart, but narrowed down the articles by sing the exclusion criteria and identified 11 articles. In a previous study by (Hosie et al, 2012), the diagnostic criteria of delirium is essential to understating the suitability of a research in a systematic review.
THE SAMPLE
It is noteworthy that the researchers only included publications from 1987 to August 2013, and this represented the time when delirium assessment tools were still being utilized (Ahmed et al., 2014). To further ensure that the studies identified were appropriate for the study, a specialist systematic reviewer helped to ensure that the studies included were appropriate. Furthermore, the inclusion data included, studies published in English, where study subjects were 55 years and over having been admitted in medical settings and acute medical settings (Ahmed et al., 2014). There were also two reviewers’ who checked the suitability of various studies. Even though, the study did not focus on intensive care units, the infor...