title: Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: protocol for a systematic review of quantitative and qualitative research.
abstract: BACKGROUND
  Critically ill patients have an increased risk of developing delirium during their intensive care stay. To date, pharmacological interventions have not been shown to be effective for delirium management but non-pharmacological interventions have shown some promise. The aim of this systematic review is to identify effective non-pharmacological interventions for reducing the incidence or the duration of delirium in critically ill patients.
  
  
  METHODS
  We will search MEDLINE, EMBASE, CINAHL, Web of Science, AMED, psycINFO and the Cochrane Library. We will include studies of critically ill adults and children. We will include randomised trials and controlled trials which measure the effectiveness of one or more non-pharmacological interventions in reducing incidence or duration of delirium in critically ill patients. We will also include qualitative studies that provide an insight into patients and their families' experiences of delirium and non-pharmacological interventions. Two independent reviewers will assess studies for eligibility, extract data and appraise quality. We will conduct meta-analyses if possible or present results narratively. Qualitative studies will also be reviewed by two independent reviewers, and a specially designed quality assessment tool incorporating the CASP framework and the POPAY framework will be used to assess quality.
  
  
  CONCLUSIONS
  Although non-pharmacological interventions have been studied in populations outside of intensive care units and multicomponent interventions have successfully reduced incidence and duration of delirium, no systematic review of non-pharmacological interventions specifically targeting delirium in critically ill patients have been undertaken to date. This systematic review will provide evidence for the development of a multicomponent intervention for delirium management of critically ill patients that can be tested in a subsequent multicentre randomised trial.
  
  
  BACKGROUND
  PROSPERO CRD42015016625.
authors.affiliation: Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland. lbannon01@qub.ac.uk.
authors.forename: Leona
authors.initials: L
authors.lastname: Bannon
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McGaughey
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, Northern Ireland.
authors.forename: Mike
authors.initials: M
authors.lastname: Clarke
authors.affiliation: Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland.
authors.forename: Daniel Francis
authors.initials: DF
authors.lastname: McAuley
authors.affiliation: Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland.
authors.forename: Bronagh
authors.initials: B
authors.lastname: Blackwood
mesh_terms: D016638:Critical Illness / Q000523:psychology / Q000628:therapy*; D003693:Delirium / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D006801:Humans; D007103:Immobilization; D007362:Intensive Care Units; D009622:Noise; D036301:Qualitative Research; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012683:Sensory Deprivation; D012892:Sleep Deprivation / Q000517:prevention & control / Q000628:therapy; D012934:Social Isolation; D000078202:Systematic Reviews as Topic
keywords: Critical illness; Delirium; ICU syndrome; Intensive care unit; Non-pharmacological interventions