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Filiatreault S, Grimshaw JM, Kreindler SA, Chochinov A, Linton J, Doupe MB. A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol. Syst Rev 2022; 11:262. [PMID: 36464728 PMCID: PMC9720973 DOI: 10.1186/s13643-022-02145-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/25/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Up to 35% of older adults present to the emergency department (ED) with delirium or develop the condition during their ED stay. Delirium associated with an ED visit is independently linked to poorer outcomes such as loss of independence, increased length of hospital stay, and mortality. Improving the quality of delirium care for older ED patients is hindered by a lack of knowledge and standards to guide best practice. High-quality clinical practice guidelines (CPGs) have the power to translate the complexity of scientific evidence into recommendations to improve and standardize practice. This study will identify and synthesize recommendations from high-quality delirium CPGs relevant to the care of older ED patients. METHODS We will conduct a multi-phase umbrella review to retrieve relevant CPGs. Quality of the CPGs and their recommendations will be critically appraised using the Appraisal of Guidelines, Research, and Evaluation (AGREE)-II; and Appraisal of Guidelines Research and Evaluation - Recommendations Excellence (AGREE-REX) instruments, respectively. We will also synthesize and conduct a narrative analysis of high-quality CPG recommendations. DISCUSSION This review will be the first known evidence synthesis of delirium CPGs including a critical appraisal and synthesis of recommendations. Recommendations will be categorized according to target population and setting as a means to define the bredth of knowledge in this area. Future research will use consensus building methods to identify which are most relevant to older ED patients. TRIAL REGISTRATION This study has been registered in the Open Science Framework registries: https://doi.org/10.17605/OSF.IO/TG7S6 .
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Affiliation(s)
- Sarah Filiatreault
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada.
| | - Jeremy M Grimshaw
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, K1H8L6, Canada.,Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5, Canada
| | - Sara A Kreindler
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada
| | - Alecs Chochinov
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada.,Department of Emergency Medicine, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada
| | - Janice Linton
- Neil John Maclean Health Sciences Library, University of Manitoba, 727 McDermot Ave, Winnipeg, MB, R3E 3P5, Canada
| | - Malcolm B Doupe
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada.,Department of Emergency Medicine, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB, R3E0W2, Canada
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Dijkers MP, Ward I, Annaswamy T, Dedrick D, Hoffecker L, Millis SR. What Determines the Quality of Rehabilitation Clinical Practice Guidelines?: An Overview Study. Am J Phys Med Rehabil 2021; 100:790-797. [PMID: 33214385 PMCID: PMC8265547 DOI: 10.1097/phm.0000000000001645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of the study was to determine what factors determine the quality of rehabilitation clinical practice guidelines. DESIGN Six databases were searched for articles that had applied the Appraisal of Guidelines for Research & Evaluation II quality assessment tool to rehabilitation clinical practice guidelines. The 573 deduplicated abstracts were independently screened by two authors, resulting in 81 articles, the full texts of which were independently screened by two authors for Appraisal of Guidelines for Research & Evaluation II application to rehabilitation clinical practice guidelines, resulting in a final selection of 40 reviews appraising 504 clinical practice guidelines. Data were extracted from these by one author and checked by a second. Data on each clinical practice guideline included the six Appraisal of Guidelines for Research & Evaluation II domain scores, as well as the two Appraisal of Guidelines for Research & Evaluation II global evaluations. RESULTS All six Appraisal of Guidelines for Research & Evaluation II domain scores were statistically significant predictors of overall clinical practice guideline quality rating; D3 (rigor of development) was the strongest and D1 (scope and purpose) the weakest (overall model P < 0.001, R2 = 0.53). Five of the six domain scores were significant predictors of the clinical practice guideline use recommendation, with D3 the strongest predictor and D5 (applicability) the weakest (overall model P < 0.001, pseudo R2 = 0.53). CONCLUSIONS Quality of rehabilitation clinical practice guidelines may be improved by addressing key domains such as rigor of development.
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Filiatreault S, Hodgins M, McCloskey R, Moore N. Retrospective analysis of administrative data examining the feasibility of quality statements for the management of patients with hip fractures in the emergency department. Int Emerg Nurs 2020; 54:100940. [PMID: 33190087 DOI: 10.1016/j.ienj.2020.100940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/13/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Sarah Filiatreault
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB E3B5A3, Canada; Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB R3E0W2, Canada.
| | - Marilyn Hodgins
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB E3B5A3, Canada
| | - Rose McCloskey
- Department of Nursing and Health Sciences, University of New Brunswick, P.O. Box 5050, Saint John, NB E2L4L5, Canada
| | - Nicole Moore
- Emergency Department, Dr. Everett Chalmers Regional Hospital, 700 Priestman Street, P.O. Box 9000, Fredericton, NB E3B5N, Canada
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Dijkers MP, Ward I, Annaswamy T, Dedrick D, Feldpausch J, Moul A, Hoffecker L. Quality of Rehabilitation Clinical Practice Guidelines: An Overview Study of AGREE II Appraisals. Arch Phys Med Rehabil 2020; 101:1643-1655. [DOI: 10.1016/j.apmr.2020.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/30/2022]
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Boman E, Duvaland E, Gaarde K, Leary A, Fagerström L. Implementation of advanced practice nursing for orthopaedic patients in the emergency care context – A study protocol for outcome studies. J Adv Nurs 2020; 76:1069-1076. [DOI: 10.1111/jan.14299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/15/2019] [Accepted: 12/10/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Erika Boman
- Department of Nursing and Health Sciences University of South‐Eastern Norway Drammen Norway
- Department of Nursing Åland University of Applied Sciences Mariehamn Finland
| | | | - Kim Gaarde
- Drammen Hospital Vestre Viken HF Drammen Norway
| | - Alison Leary
- Department of Nursing and Health Sciences University of South‐Eastern Norway Drammen Norway
- School of Health and Social Care London South Bank University London UK
| | - Lisbeth Fagerström
- Department of Nursing and Health Sciences University of South‐Eastern Norway Drammen Norway
- Faculty of Education and Welfare Studies Åbo Akademi University Vaasa Finland
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