气管插管非计划拔管风险评估工具的范围综述

目的 系统综述国内外与气管插管非计划拔管（unplanned endotracheal extubations,UEE）风险评估工具相关的原始文献、指南和专家共识。方法 聚焦UEE风险评估工具,系统检索中、英文数据库和指南网站,检索时限为建库至2021年3月1日。提取的信息包括作者、年份、国家、适用对象、工具类型、研究方法、主要评估内容和高危临界值。结果 最终纳入13篇文献,11篇为基于德尔菲法和专家会议法等定性研究方法的文献,2篇为基于病例对照等定量研究方法的文献,工具类型分为风险评估表、风险评估体系、风险评估图和风险预测模型。结论 患者因素和导管因素为UEE风险评估的重要内容。UEE风险评估工具的种类多样,但其信效度仍有待进一步检验,需要进一步开展多中心、大范围的临床应用研究。     

Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review

Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn‐over and burn‐out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre‐empt incidences of OV during ED episodes of care. A five‐stage methodological framework for scoping reviews was used to identify, summarise and synthesise OV risk factors from five key databases. A validated tool was used to appraise the quality of included studies. Independent evaluation by the reviewers was used throughout. Patient factors were extracted and described from 24 methodologically and geographically diverse papers. Methodological quality for these studies varied from moderate to high. A total of 34 OV risk factors were identified. Although there was variation in, and differences between, staff‐perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage.     

卒中后疲劳评估工具的范围综述

目的 全面、系统地收集国内外用于评估卒中后疲劳的工具,总结并分析其开发过程、特点及应用情况,为临床医护人员选择筛查卒中后疲劳的适宜评估工具提供参考。方法 系统检索7个中英文数据库,检索时限为建库至2022年3月13日。提取卒中后疲劳评估工具相关内容进行系统分析,并采用范围综述的方法对检索结果进行规范化报告。结果纳入48篇符合标准的文献,36篇关于评估工具的开发与验证,12篇关于评估工具的本土化及应用,共涉及20个卒中后疲劳评估工具。结论 建议使用多维度疲劳评估工具评估卒中后疲劳,未来应进一步验证现有卒中后疲劳评估工具的信效度,完善评估工具,并继续引入或研制本土化、全面、有效的卒中后疲劳特异性评估工具。     

骨质疏松风险评估工具的研究进展

骨质疏松症是常见的慢性疾病,在影响患者身心健康的同时可造成沉重的经济负担。风险评估工具的应用可有效预测骨质疏松症的发生,且具有经济、简单、便捷等优势。本文就骨质疏松风险评估工具的应用意义及危险因素进行综述,并比较国内外开发的骨质疏松风险评估工具在我国的应用现状,以期为我国人群骨质疏松症的筛查提供参考。     

People brought to the emergency department under involuntary assessment orders: A scoping review

BackgroundSome people with mental health problems arrive to the Emergency Department (ED) under involuntary assessment orders (IAOs) and can have complex medical and socioeconomic factors, which may impact on the delivery of care in the ED. Therefore, this scoping review aimed to identify, evaluate and summarise the current literature regarding the demographic characteristics, clinical characteristics and outcomes for people brought to the ED under IAOs.MethodA scoping review was undertaken guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines and the Arksey and O’Malley framework.ResultsIn total 21 articles were included in this review. People under IAOs most commonly present to EDs with suicidal ideation/intent, with interagency involvement noted when responding to these people in the pre-hospital setting. Most people arriving to ED under IAOs were reported to experience length of stay longer than four hours.ConclusionThis review highlights the limited information pertaining to people brought to EDs under an IAO. High levels of mental health problems and extended length of stay for people under IAOs suggests the need for interagency collaboration to inform the development and implementation of models of care that incorporates social determinants of health and are tailored to this complex population.     

Falls risk screening tools intended to reduce fall risk among independent community-dwelling older adults: A systematic review

Aims

The aim of this study is to evaluate an evidence-based fall risk screening tool to predict the risk of falls suitable for independent community-dwelling older adults guided by the World Health Organization's International Classification of Functioning, Disability and Health (WHO-ICF) components, and to examine the reliability and validity of the fall risk screening tool to predict fall risks, and to examine the feasibility of tools among independent community-dwelling older adults.

Methods

A systematic literature search guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was performed using the EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar between July and August 2021. Studies from January 2010 to January 2021 were eligible for review. Nine articles were eligible and included in this systematic review. The risk of bias assessment used the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. The WHO-ICF helped to guide the categorization of fall risk factors.

Results

Seven screening tools adequately predicted fall risk among community-dwelling older adults. Six screening tools covered most of the components of the WHO-ICF, and three screening tools omitted the environmental factors. The modified 18-item Stay Independent Brochure demonstrated most of the predictive values in predicting fall risk. All tools are brief and easy to use in community or outpatient settings.

Conclusion

The review explores the literature evaluating fall risk screening tools for nurses and other healthcare providers to assess fall risk among independent community-dwelling older adults. A fall risk screening tool consisting of risk factors alone might be able to predict fall risk. However, further refinements and validations of the tools before use are recommended.     

Hospital fall risk assessment tools: a critique of the literature

There are numerous fall risk assessment tools developed for use by nurses in hospitals; however, few of them have established validity and reliability. This article will examine the current state of knowledge in regard to fall risk assessment tools through review and critique of the literature on the topic. Recommendations for future research on fall risk assessment tools will be made and a conceptual framework detailing the relationship between the variables involved in assessing the accuracy of fall risk assessment tools will be presented.     

经外周静脉输注血管活性药物风险管理范围的综述

目的 探讨经外周静脉输注血管活性药物的风险因素及安全输注方案.方法 系统检索5个指南网站、7个中英文数据库,检索时限为建库至2021年3月7日,定性描述经外周静脉输注血管活性药物并发症的基本特征、风险因素及安全输注方案.结果 纳入14篇文献,其中指南2篇、系统评价4篇、原始研究8篇.经外周静脉输注血管活性药物的安全性受...     

老年性骨质疏松患者骨折风险预测工具的范围综述

目的 综合分析老年性骨质疏松患者骨折风险预测工具,为研究人员开发或引入符合本国国情的预测工具提供参考。方法 采用范围综述方法,检索PubMed、Embase、Web of Science、中国知网、万方数据知识服务平台、维普中文科技期刊数据及中国生物医学文献数据库7个中英文数据库,由2名研究者独立筛选文献和提取数据,并进行偏倚风险及适用性评价。结果最后纳入18篇英文文献,包括12项预测工具开发研究及6项预测工具效能验证研究,共涉及12个老年性骨质疏松患者骨折风险预测工具,工具类型主要为风险预测模型及风险评估表。结论 老年性骨质疏松患者骨折风险预测工具种类繁多,预测性能良好但总体偏倚风险较高。相关研究人员一方面应对现有的预测工具进行验证及校准,另一方面应基于本土数据开发低偏倚风险、高临床适用性的风险预测工具,为老年性骨质疏松患者的精准健康管理提供参考。     

丧亲者悲伤评估工具研究进展

本文对国内外丧亲者悲伤评估工具的发展过程、测量内容、信度、效度,使用方法及应用现状等内容进行综述,旨在为国内学者测评丧亲者悲伤程度选择合适工具和研发符合我国人群特征的丧亲者悲伤测评工具提供参考。     

住院患者出院计划实践工具的范围综述

目的 系统综述国内外住院患者出院计划实践工具相关研究及指南、政府文件。 方法 聚焦出院计划实践工具,系统检索中英文数据库和相关指南、政府网站,各类工具提取的信息包括：作者/发布机构、年份、国家/地区、工具名称、适用对象、工具内容简介和使用时机。 结果 沿患者入院至出院时间轴,将出院计划实践工具分为入院时-评估、住院期间-实施、出院前24 h-核查、出院时-转介和出院后-随访5个类别、共29个促进出院计划顺利实施的工具。 结论 建议卫生保健人员在综合和了解国外出院计划实践工具的基础上,制订和发展适合本国国情和医疗环境的出院计划实践工具,以标准化的工具有效推进出院计划的实施,优化患者结局,提升患者医疗护理服务的延续性。     

Datasets to support workforce planning in nursing: A scoping review

AimThis review sought to identify and describe evidence regarding the value and benefits of datasets to support nursing workforce planning and quality patient care.DesignScoping review.Data sourcesThe following data bases were searched Ovid EMCARE, MEDLINE, EMBASE, Scopus, Informit, and ProQuest Dissertations.Review methodsThe Joanna Briggs Scoping review guidelines informed the structure of this review which entailed a stepped search strategy. 3036 records were screened by title and abstract by two independent reviewers for relevance to the aims of the review, with disputes resolved by a third independent reviewer. Following assessment of 44 full-text documents, 18 were included in the review.ResultsThere is limited evidence on the attributes or efficacy of workforce datasets. This is linked to the multiple variabilities across clinical settings and jurisdictions, such as education and qualifications, the nomenclature of nursing titles, clinical facility/unit classification, and the quantification of patient acuity, among other factors. A comprehensive workforce dataset was not reported in the literature examined here.ConclusionThe absence of evidence regarding standardised workforce datasets and their value is impacting on nurse leaders’ capacity to proactively plan and develop a viable strategy for sustaining the nursing workforce.ImpactThe lack of standardised national workforce datasets and their efficacy results in inadequate, ad hoc or contradictory approaches to workforce planning.     

Cardiovascular disease: application of a composite risk index from the Telehealth System in a district community

Assessing a combination of cardiovascular disease (CVD)-risk factors may be a practical tool for risk assessment and for finding the high-risk group among local community members. This study examines the association between the number of CVD-risk factors, regardless of any specific combination with the CVD ambit, using data from 1,570 residents in Tsing Yi community (Hong Kong) who registered with the Telehealth System. A quantitative composite CVD Risk Index (CVDRI) with scores ranging from 0 to 6 included rankings for high systolic and diastolic blood pressure, presence of diabetes, body mass index (BMI), smoking, and age. Multivariate logistic regression was used to estimate odds ratios for the prevalence of CVD. Those with a CVDRI of 1, 2, or 3 and above were 1.7 [95% confidence interval (CI) = 1.34-3.99], 5.3 (95% CI = 3.60-7.90), and 10 times (95% CI = 6.41-15.50) more likely to have CVD, respectively, than those with a risk index of 0. Among the CVDRI components, high blood pressure had the greatest influence on CVD risk, followed by presence of diabetes and high BMI. In conclusion, a CVDRI based on existing health data from a Telehealth System was developed and used to identify local community members at risk of CVD. Nurse intervention may achieve greater reduction of CVD morbidity and mortality if multiple risk factors for the high-risk group are addressed at the same time.     

老年患者术后谵妄风险预测模型的范围综述

目的 对老年患者术后谵妄风险预测模型进行范围综述,为临床工作及未来研究提供借鉴。方法 聚焦老年患者术后谵妄风险预测模型,检索中英文数据库,获取与老年患者术后谵妄相关的风险预测模型文献。结果 共纳入26项研究,老年患者术后谵妄发生率为4.6%~39.7%。模型构建方法包括Logistic回归及多种机器学习算法,模型呈现形式多样,年龄、痴呆史、术前认知功能水平、麻醉分级、糖尿病史、麻醉时间、查尔森合并症指数、术前血清白蛋白水平是老年患者术后谵妄风险预测模型中重要的预测因子。结论 临床护理人员应关注老年患者术后谵妄的高危因素,重视规范、科学的预测模型构建及验证流程,未来应探索更加科学精准、性能良好、易于推广的老年患者术后谵妄风险预测模型。