The effectiveness of clinical pathway software in inpatient settings: a systematic review

Background: The evidence indicates that the optimal observation period following renal biopsy ranges between 6 and 8 h. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Methods: We searched the MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 1985 to February 2020. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. The primary and secondary outcomes were risks of bleeding and major events (including mortality) following the procedure, respectively. Subgroup analysis was conducted according to the original study design (i.e., prospective or retrospective). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effect meta-analysis. Heterogeneity was assessed using the I2 test. Results: Data from all 10 eligible studies, which included a total of 1801 patients and 203 bleeding events, were included for analysis. Renal biopsies in outpatient settings were not associated with a higher bleeding risk than those in inpatient settings (OR = 0.81; 95% CI, 0.59–1.11; I2 = 0%). The risk of major events was also comparable across both groups (OR = 0.45; 95% CI, 0.16–1.29; I2 = 4%). Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed.

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Developing delirium best practice: a systematic review of education interventions for healthcare professionals working in inpatient settings

European Geriatric Medicine ◽

10.1007/s41999-019-00278-x ◽

2020 ◽

Vol 11 (1) ◽

pp. 1-32 ◽

Cited By ~ 2

Author(s):

Song Yuin Lee ◽

James Fisher ◽

Anne P. F. Wand ◽

Koen Milisen ◽

Elke Detroyer ◽

...

Keyword(s):

Systematic Review ◽

Best Practice ◽

Healthcare Professionals ◽

Inpatient Settings ◽

Education Interventions

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A Systematic Review of the Safety and Effectiveness of Restraint and Seclusion as Interventions for the Short-Term Management of Violence in Adult Psychiatric Inpatient Settings and Emergency Departments

Worldviews on Evidence-Based Nursing ◽

10.1111/j.1741-6787.2006.00041.x ◽

2006 ◽

Vol 3 (1) ◽

pp. 8-18 ◽

Cited By ~ 71

Author(s):

Louise Nelstrop ◽

Jackie Chandler-Oatts ◽

William Bingley ◽

Tony Bleetman ◽

Frank Corr ◽

...

Keyword(s):

Systematic Review ◽

Emergency Departments ◽

Psychiatric Inpatient ◽

Short Term ◽

Inpatient Settings ◽

Term Management

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Inclusion, characteristics and outcomes of people requiring palliative care in studies of non-pharmacological interventions for delirium: A systematic review

Palliative Medicine ◽

10.1177/0269216319853487 ◽

2019 ◽

Vol 33 (8) ◽

pp. 878-899 ◽

Cited By ~ 3

Author(s):

Annmarie Hosie ◽

Najma Siddiqi ◽

Imogen Featherstone ◽

Miriam Johnson ◽

Peter G Lawlor ◽

...

Keyword(s):

Systematic Review ◽

Palliative Care ◽

Subjective Experience ◽

Intervention Studies ◽

Search Terms ◽

Study Heterogeneity ◽

Inpatient Settings ◽

Almost All ◽

Multicomponent Interventions

Background: Delirium is common, distressing, serious and under-researched in specialist palliative care settings. Objectives: To examine whether people requiring palliative care were included in non-pharmacological delirium intervention studies in inpatient settings, how they were characterised and what their outcomes were. Design: Systematic review (PROSPERO 2017 CRD42017062178). Data sources: Systematic search in March 2017 for non-pharmacological delirium intervention studies in adult inpatients. Database search terms were ‘delirium’, ‘hospitalisation’, ‘inpatient’, ‘palliative care’, ‘hospice’, ‘critical care’ and ‘geriatrics’. Scottish Intercollegiate Guidelines Network methodological checklists guided risk of bias assessment. Results: The 29 included studies were conducted between 1994 and 2015 in diverse settings in 15 countries (9136 participants, mean age = 76.5 years ( SD = 8.1), 56% women). Most studies tested multicomponent interventions ( n = 26) to prevent delirium ( n = 19). Three-quarters of the 29 included studies ( n = 22) excluded various groups of people requiring palliative care; however, inclusion criteria, participant diagnoses, illness severity and mortality indicated their presence in almost all studies ( n = 26). Of these, 21 studies did not characterise participants requiring palliative care or report their specific outcomes (72%), four reported outcomes for older people with frailty, dementia, cancer and comorbidities, and one was explicitly focused on people receiving palliative care. Study heterogeneity and limitations precluded definitive determination of intervention effectiveness and only allowed interpretations of feasibility for people requiring palliative care. Acceptability outcomes (intervention adverse events and patients’ subjective experience) were rarely reported overall. Conclusion: Non-pharmacological delirium interventions have frequently excluded and under-characterised people requiring palliative care and infrequently reported their outcomes.

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What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review

BMC Medicine ◽

10.1186/s12916-016-0580-z ◽

2016 ◽

Vol 14 (1) ◽

Cited By ~ 54

Author(s):

Adegboyega K. Lawal ◽

Thomas Rotter ◽

Leigh Kinsman ◽

Andreas Machotta ◽

Ulrich Ronellenfitsch ◽

...

Keyword(s):

Systematic Review ◽

Clinical Pathway ◽

Operational Definition ◽

Cochrane Systematic Review

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Nonpharmacological Interventions to Prevent Delirium: An Evidence-Based Systematic Review

Critical Care Nurse ◽

10.4037/ccn2015423 ◽

2015 ◽

Vol 35 (1) ◽

pp. 39-49 ◽

Cited By ~ 32

Author(s):

Ryan M. Rivosecchi ◽

Pamela L. Smithburger ◽

Susan Svec ◽

Shauna Campbell ◽

Sandra L. Kane-Gill

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Critical Care ◽

Length Of Stay ◽

Adverse Effects ◽

Hospital Costs ◽

Evidence Based ◽

Inpatient Settings ◽

Stay Hospital ◽

Critical Care Patients

Development of delirium in critical care patients is associated with increased length of stay, hospital costs, and mortality. Delirium occurs across all inpatient settings, although critically ill patients who require mechanical ventilation are at the highest risk. Overall, evidence to support the use of antipsychotics to either prevent or treat delirium is lacking, and these medications can have adverse effects. The pain, agitation, and delirium guidelines of the American College of Critical Care Medicine provide the strongest level of recommendation for the use of nonpharmacological approaches to prevent delirium, but questions remain about which nonpharmacological interventions are beneficial.

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The Impact of Chronic Obstructive Lung Clinical Pathway Implementation on Readmission: A Systematic Review

Strengthening Hospital Competitiveness to Improve Patient Satisfaction and Better Health Outcomes ◽

10.26911/the6thicph.05.03 ◽

2019 ◽

Author(s):

Joan Puspita Tanumihardja ◽

◽

Atik Nurwahyuni ◽

Keyword(s):

Systematic Review ◽

Clinical Pathway ◽

Chronic Obstructive ◽

The Impact

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Baclofen Use in Alcohol Withdrawal Patients in Inpatient Settings: A Systematic Review

10.28971/532020pm95 ◽

2020 ◽

Author(s):

Mona Petal

Keyword(s):

Systematic Review ◽

Alcohol Withdrawal ◽

Meta Analysis ◽

Statistical Significance ◽

Signs And Symptoms ◽

Withdrawal Symptoms ◽

Significant Difference ◽

Health Decision ◽

Inpatient Settings ◽

Ebsco Host

Aim: To carry out a systematic review of the available evidence from health decision makers, patients, and therapists regarding the ability of Baclofen use in decreasing alcohol withdrawal symptoms to patients in inpatient settings. acute care setting. Methodology: Systematic searches were carried out on the following databases: Academic Search Premier, CINAHL, Cochrane and PsycINFO via EBSCO Host, Embase, MEDLINE via PubMed, and Web of Science. The last search date was May 28, 2019. The search was limited to the last 10 years, i.e., from January 1st, 2010. Findings: Four studies were included in the final review. The total population was 258 patients. The studies did not report any statistically significant difference between Baclofen to placebo during the end of the treatment when it comes to decreasing alcohol withdrawal symptoms and reduction of alcohol intake. There was also not a considerable difference between baclofen and standard care dropout, adverse events, and anxiety. Baclofen also increased the frequency of vertigo, dry mouth, and sleepiness. Conclusions: It was uncertain whether Baclofen improves withdrawal signs and symptoms and reduces side effects in comparison to placebo or other medicines as the studies reviewed did not point to any statistical significance. It is recommended that future reviews assume the meta-analysis approach that can help in measuring the level of heterogeneity in such studies to effectively examine the extent to which baclofen can be effective.

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Use of Mobile Devices to Help Cancer Patients Meet Their Information Needs in Non-Inpatient Settings: Systematic Review

JMIR mhealth and uhealth ◽

10.2196/10026 ◽

2018 ◽

Vol 6 (12) ◽

pp. e10026 ◽

Cited By ~ 13

Author(s):

Rebecca Richards ◽

Paul Kinnersley ◽

Kate Brain ◽

Grace McCutchan ◽

John Staffurth ◽

...

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Mobile Devices ◽

Information Needs ◽

Inpatient Settings

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How Leading Hospitals Operationalize Evidence-Based Readmission Reduction Strategies: A Mixed-Methods Comparative Study Using Systematic Review and Survey Design

American Journal of Medical Quality ◽

10.1177/1062860618824410 ◽

2019 ◽

Vol 34 (6) ◽

pp. 529-537

Author(s):

Bita A. Kash ◽

Juha Baek ◽

Ohbet Cheon ◽

Joanna-Grace Mayo Manzano ◽

Stephen L. Jones ◽

...

Keyword(s):

Systematic Review ◽

Discharge Planning ◽

Survey Design ◽

Hospital Readmissions ◽

Cancer Center ◽

Evidence Based ◽

Post Discharge ◽

Effective Interventions ◽

Inpatient Settings ◽

Md Anderson

Although various interventions targeted at reducing hospital readmissions have been identified in the literature, little is known about actual operationalization of such evidence-based interventions. This study conducted a systematic review and a survey of key informants in 2 leading hospitals, Houston Methodist (HM) and MD Anderson Cancer Center (MDACC), to compare and contrast the most cited evidence-based interventions in the current literature with interventions reported by those hospitals. The authors found that both hospitals followed evidence-based practices reported as successful in the literature. Both hospitals have implemented interventions for inpatient settings, and the timing of interventions was very similar. Major implementation differences observed for post-discharge interventions focused on collaboration. It also was found that HM was more likely than MDACC to use medication reconciliation in outpatient ( P = .018) and discharge planning for community/home patients ( P = .032). Results will provide hospital professionals with insights for implementing the most effective interventions to reduce readmissions.

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