{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:15:48Z","timestamp":1792818948105,"version":"4.5.0"},"reference-count":63,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP19K24234"],"award-info":[{"award-number":["JP19K24234"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Delirium is a common complication among patients in the intensive care unit (ICU). It is important to prevent the occurrence of delirium in critically ill patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This review aimed to evaluate the efficacy of non\u2010pharmacological interventions and determine what combination of these is effective in preventing delirium among Intensive Care Unit patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A systematic review and meta\u2010analysis. This review follows the guidelines of the Preferred Reporting Items for Systematic reviews and Meta Analysis statements for Network Meta\u2010Analysis (PRISMA\u2010NMA). Data sources included the Cumulative Index to Nursing &amp; Allied Health Literature., MEDLINE, and Cochrane library databases. The integrated data were investigated with odds ratio (OR) and 95% confidence interval (95% CI), using the random\u2010effects Mantel\u2013Haenszel model. Data were considered significant when <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05. Furthermore, to reveal what combination of care is effective, we performed a network meta\u2010analysis estimated OR, 95% CI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified three randomized controlled trials and eight controlled before\u2010after trials (11 in total, with 2549 participants). The pooled data from 11 trials of multicomponent intervention had a significant effect on delirium prevention (OR 0.58, 95% CI 0.44\u20130.76, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). As a result of network meta\u2010analysis, two bundles were effective compared to the control group in reducing the incidence of delirium: a) the combination of sleep promotion (SP), cognitive stimulation (CS), early mobilization (EM), pain control (PC), and assessment (AS) (OR 0.47, 95% CI 0.35\u20130.64, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.002), and b) the combination of SP and CS (OR 0.46, 95% CI 0.28\u20130.75, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed that non\u2010pharmacological interventions, particularly multicomponent interventions, helped to prevent delirium in critically ill patients. In the network meta\u2010analysis, the most effective care combination for reducing incidence of delirium was found to be multicomponent intervention, which comprises SP\u2010CS\u2010EM\u2010PC\u2010AS, and SP\u2010CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>These findings reveal an efficient combination of multicomponent interventions for preventing delirium, which may be a very important prerequisite in planning care programs in the future.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nicc.12780","type":"journal-article","created":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T04:44:01Z","timestamp":1653713041000},"page":"727-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Effects of non\u2010pharmacologic prevention on delirium in critically ill patients: A network meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6217-9531","authenticated-orcid":false,"given":"Yutaka","family":"Matsuura","sequence":"first","affiliation":[{"name":"Division of Nursing Mie University Graduate School of Medicine  Tsu Japan"},{"name":"Division of Health Science Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Ohno","sequence":"additional","affiliation":[{"name":"Division of Health Science Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Toyoshima","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Ueno","sequence":"additional","affiliation":[{"name":"Division of Health Science Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.016"},{"key":"e_1_2_12_6_1","volume-title":"Delirium: Diagnosis, Prevention and Management","author":"National Clinical Guideline, 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