A systematic review of interventions to improve acute hospital care for people with dementia
People with dementia are confronted with negative consequences due to hospital stays. When developing new interventions to improve the care of people with dementia in acute care hospitals, it is crucial to have a comprehensive overview of the previous interventions tested in this field and to know the investigated outcomes and effects. Methods We conducted a systematic review of interventional studies to provide an overview of interventions targeting the care situation of patients with dementia
... in acute care hospitals. We included trials with interventional study designs and systematic reviews of interventional studies with no restrictions regarding the outcomes. We searched five electronic databases, conducted a hand search of journals and performed forward and backward citation tracking of the included studies. For risk of bias assessment, we used the Cochrane Collaboration's tool for assessing risk of bias in randomised trials, ROBANS (for non-randomised controlled trials) and AMSTAR (for systematic reviews). We provide tabular and narrative summaries of the findings. Results Nineteen studies met the inclusion criteria. he findings indicated a broad range of interventions and outcomes. We categorised the interventions into nine intervention types: educational programmes, family-/person-centred programmes, use of specially trained nurses, volunteer programmes, delirium management programmes, special care units and inpatient rehabilitation interventions. Staff outcomes were primarily investigated, followed by patient outcomes. Outcomes for relatives were only reported in three of the included studies. Educational programmes were the most commonly reported intervention type and showed improvements in staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were able to improve patient-related outcomes, e.g. delirium severity, functional performance and rehospitalisation rates. Rehabilitation interventions after hip fractures and special care units for people with dementia showed hardly significant effects.