{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:49:34Z","timestamp":1785829774049,"version":"3.56.0"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To quantify the effect of nurse\u2010led or nurse\u2010coordinated multicomponent non\u2010pharmacological interventions on delirium incidence in hospitalised older adults and to examine secondary outcomes, intervention components and moderators of effect.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Systematic review and meta\u2010analysis.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n Nine electronic databases (PubMed\/MEDLINE, EMBASE, CINAHL, CENTRAL, Web of Science, Scopus, PsycINFO, LILACS and ICTRP) were searched from January 1999 to March 2026.<\/jats:p>\n <\/jats:sec>\n \n Review Methods<\/jats:title>\n Randomised controlled trials and quasi\u2010experimental studies evaluating nurse\u2010led multicomponent interventions targeting \u2265\u20092 delirium risk factors in adults aged \u2265\u200960\u2009years were included. Risk of bias was assessed using RoB 2 and ROBINS\u2010I. Random\u2010effects meta\u2010analysis generated pooled risk ratios (RR) and mean differences (MD). Subgroup analyses, meta\u2010regression and GRADE assessment were conducted. The review followed PRISMA 2020 and was registered in PROSPERO.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty\u2010one studies (\n n<\/jats:italic>\n \u2009=\u20096354) were included. Nurse\u2010led multicomponent interventions significantly reduced delirium incidence (RR 0.64, 95% CI 0.58\u20130.70;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%). HELP\u2010based protocols demonstrated the largest subgroup effect (RR 0.58). Interventions also reduced delirium duration (MD\u22120.91\u2009days), falls (RR 0.63) and length of stay (MD \u22121.23\u2009days). Subgroup and meta\u2010regression analyses did not identify statistically significant effect moderators. Evidence certainty was moderate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Nurse\u2010led multicomponent interventions significantly reduce delirium incidence and related adverse outcomes in hospitalised older adults (moderate certainty of evidence). Structured programmes such as HELP represent evidence\u2010informed best practice and should be strongly considered for implementation within acute care systems.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n These findings provide moderate\u2010certainty evidence supporting nurse\u2010led delirium prevention as a high\u2010value, scalable strategy to improve patient outcomes and reduce healthcare burden. The results inform clinical practice, workforce planning and policy by emphasising the central role of nursing in delivering effective multicomponent care.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n Not applicable.<\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n This review was prospectively registered in PROSPERO (CRD420261338135).<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70706","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:36:16Z","timestamp":1785828976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse\u2010Led Multicomponent Interventions for Delirium Prevention in Hospitalised Older Adults: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7822-1653","authenticated-orcid":false,"given":"Mostafa","family":"Shaban","sequence":"first","affiliation":[{"name":"Gerontological Nursing Department, Faculty of Nursing Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda Hamdy","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6726-5770","authenticated-orcid":false,"given":"Yasmine","family":"M. Osman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nursing, Faculty of Nursing Zagazig University Zagazig Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-8796","authenticated-orcid":false,"given":"Marwa Mamdouh","family":"Shaban","sequence":"additional","affiliation":[{"name":"Community Health Nursing Department, Faculty of Nursing Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2016.09.002"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425787","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2022"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20106576.2010.02232.x"},{"key":"e_1_2_12_5_1","article-title":"Non\u2010Pharmacological Interventions for Preventing Delirium in Hospitalised Non\u2010ICU Patients","volume":"7","author":"Burton J. 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