Evidence-based literature search on intensive care unit delirium

ICU Delirium

Search of Literature for Evidence

One of the most crucial elements towards conducting a high-quality research is conducting an effective and valid search of literature for evidence. The search of literature for evidence is defined as an organized comprehensive search of existing literature published regarding the research issue. A well-organized search of literature is important when conducting a study since it's the most efficient and effective means for locating sound evidence on the research topic. For this study on intensive care delirium, a literature search is crucial towards identifying existing evidence on the topic and identifying gaps in knowledge. The information or insights obtained from the literature search is used to provide guidelines on the research process and how to fill the gaps in knowledge.

In this regard, the researcher conducted a search on electronic databases in order to identify credible sources of data. The researcher conducted the search on several electronic databases i.e. EBSCOHost, ProQuest, Emerald Insight, JSTOR, and CINAHL since the researcher already has access to these paid databases. Since these databases contain medical journals, they were essential in identifying relevant studies that provide reliable evidence on the research topic. When identifying relevant studies in the databases, the researcher selected studies that have been published within the last 5 years. This restriction was geared towards ensuring that most recent evidence was identified and utilized for the study. The identification of relevant studies in these electronic databases also entailed using some key words and phrases relating to the research (PICOT) question. Some of the key words and phrases that were utilized include ICU delirium, prevention and treatment of ICU delirium, valid delirium assessment instrument, ICU among adults, and ICU delirium multicomponent interventions.

Evaluation Table

Author (Year)

Luetz et al. (2014, November). Delirium, Sedation and Analgesia in the Intensive Care Unit: A Multinational, Two-Part Survey among Intensivists. PLOS One, 9(11), 1-6.

Ista et al. (2014, October 2). Improvement of Care for ICU Patients with Delirium by Early Screening and Treatment: Study Protocol of iDECePTIvE Study. Implementation Science, 9(143), 1-10.

Conceptual Framework

ICU delirium is not sufficiently acknowledged by intensivists and nurses providing care on a daily basis. The use of a validated assessment instrument enhances healthcare professionals' abilities to identify the condition.

ICU delirium management among critically ill patients requires adequate measures including systematic screening.

Design/Method

A patient survey was carried out through the use of a questionnaire, which was administered to ICU patients.

The researchers conducted an iDECePTIve study through a mixed method research design in 6 ICUs in southwest Netherlands.

Findings

While 44% of hospitals and ICUs reported using a validated screening assessment, only 27% of patients had been monitored using the instrument. However, the researchers found that a validated screening instrument enhances the ability of healthcare professionals to identify ICU delirium.

The rates of delirium occurrence increases among ICU patients following the implementation of early screening because of detection of hypoactive screening. However, the ICU delirium prevention and management lessens these incidences. Therefore, screening should be carried out and followed by prevention and management.

Appraisal

The study highlights the significance of using a validated assessment instrument in intensive care units to identify ICU delirium. As shown in the research, the identification of the condition is relatively difficult without the use of such a tool.

This study highlights the significance of a wide approach in addressing ICU delirium beyond screening. It demonstrates that screening is not adequate to deal with the various issues surrounding the management of the condition. In this regard, screening should be followed by prevention and management.

Strategies for Identifying Evidence for the Study

The PICOT question that guided the search of literature for evidence is, "Does the use of a validated delirium assessment instrument (intervention) improve delirium detection (outcome) among adults in the ICU (population) as compared multicomponent interventions (comparison)?" One of the strategies employed by the researcher in identifying evidence for the study is using key words and phrases from the PICOT question. The use of these words and phrases was geared towards maintaining a narrow focus of the literature search and ensuring that the evidence was relevant to the purpose of the research. The use of terms in this PICOT question helped in identifying useful research studies. Since a wide range of information relating to ICU delirium exists, the use of the terms helped in ensuring that the researcher maintained a specific focus, which helped to identify relevant studies. Additionally, the researcher utilized MESH terms such as delirium diagnosis, risk factors, treatment outcomes, intensive care units, and delirium drug therapy. These MESH terms were helpful in finding additional studies and expanded the literature search. The most useful databases for this study were EBSCOHost, ProQuest, and CINAHL while JSTOR and Emerald Insight were not useful. The levels of evidence found in the studies were experimental and quasi-experimental evidence.