Abstract：
OBJECTIVE: To determine the effects of nurse-coordinated interventions in improving readmissions, cumulative hospital stay, mortality, functional ability and quality of life for frail older adults discharged from hospital.
METHODS: Systematic review with meta-analysis.
METHODS: A systematic search using key search terms of \'frailty\', \'geriatric\', \'hospital\' and \'nurse\'. Covidence was used to screen individual studies. Studies were included that addressed frail older adults, incorporated a significant nursing role in the intervention and were implemented during hospital admission with a focus on transition from hospital to home.
METHODS: This review searched MEDLINE (Ovid), CINAHL (EBSCO), PubMed (EBSCO), Scopus, Embase (Ovid) and Cochrane library for studies published between 2000 and September 2023.
RESULTS: Of 7945 abstracts screened, a total 16 randomised controlled trials were identified. The 16 randomised controlled trials had a total of 8795 participants, included in analysis. Due to the heterogeneity of the outcome measures used meta-analysis could only be completed on readmission (n = 13) and mortality (n = 9). All other remaining outcome measures were reported through narrative synthesis. A total of 59 different outcome measure assessments and tools were used between studies. Meta-analysis found statistically significant intervention effect at 1-month readmission only. No other statistically significant effects were found on any other time point or outcome.
CONCLUSIONS: Nurse-coordinated interventions have a significant effect on 1-month readmissions for frail older adults discharged from hospital. The positive effect of interventions on other health outcomes within studies were mixed and indistinct, this is attributed to the large heterogeneity between studies and outcome measures.
CONCLUSIONS: This review should inform policy around transitional care recommendations at local, national and international levels. Nurses, who constitute half of the global health workforce, are ideally situated to provide transitional care interventions. Nurse-coordinated models of care, which identify patient needs and facilitate the continuation of care into the community improve patient outcomes.
UNASSIGNED: Review findings will be useful for key stakeholders, clinicians and researchers to learn more about the essential elements of nurse-coordinated transitional care interventions that are best targeted to meet the needs of frail older adults.
CONCLUSIONS: When frail older adults experience transitions in care, for example discharging from hospital to home, there is an increased risk of adverse events, such as institutionalisation, hospitalisation, disability and death. Nurse-coordinated transitional care models have shown to be a potential solution to support adults with specific chronic diseases, but there is more to be known about the effectiveness of interventions in frail older adults. This review demonstrated the positive impact of nurse-coordinated interventions in improving readmissions for up to 1 month post-discharge, helping to inform future transitional care interventions to better support the needs of frail older adults.
UNASSIGNED: This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
UNASSIGNED: No Patient or Public Contribution.
METHODS: Systematic review with meta-analysis.
METHODS: A systematic search using key search terms of \'frailty\', \'geriatric\', \'hospital\' and \'nurse\'. Covidence was used to screen individual studies. Studies were included that addressed frail older adults, incorporated a significant nursing role in the intervention and were implemented during hospital admission with a focus on transition from hospital to home.
METHODS: This review searched MEDLINE (Ovid), CINAHL (EBSCO), PubMed (EBSCO), Scopus, Embase (Ovid) and Cochrane library for studies published between 2000 and September 2023.
RESULTS: Of 7945 abstracts screened, a total 16 randomised controlled trials were identified. The 16 randomised controlled trials had a total of 8795 participants, included in analysis. Due to the heterogeneity of the outcome measures used meta-analysis could only be completed on readmission (n = 13) and mortality (n = 9). All other remaining outcome measures were reported through narrative synthesis. A total of 59 different outcome measure assessments and tools were used between studies. Meta-analysis found statistically significant intervention effect at 1-month readmission only. No other statistically significant effects were found on any other time point or outcome.
CONCLUSIONS: Nurse-coordinated interventions have a significant effect on 1-month readmissions for frail older adults discharged from hospital. The positive effect of interventions on other health outcomes within studies were mixed and indistinct, this is attributed to the large heterogeneity between studies and outcome measures.
CONCLUSIONS: This review should inform policy around transitional care recommendations at local, national and international levels. Nurses, who constitute half of the global health workforce, are ideally situated to provide transitional care interventions. Nurse-coordinated models of care, which identify patient needs and facilitate the continuation of care into the community improve patient outcomes.
UNASSIGNED: Review findings will be useful for key stakeholders, clinicians and researchers to learn more about the essential elements of nurse-coordinated transitional care interventions that are best targeted to meet the needs of frail older adults.
CONCLUSIONS: When frail older adults experience transitions in care, for example discharging from hospital to home, there is an increased risk of adverse events, such as institutionalisation, hospitalisation, disability and death. Nurse-coordinated transitional care models have shown to be a potential solution to support adults with specific chronic diseases, but there is more to be known about the effectiveness of interventions in frail older adults. This review demonstrated the positive impact of nurse-coordinated interventions in improving readmissions for up to 1 month post-discharge, helping to inform future transitional care interventions to better support the needs of frail older adults.
UNASSIGNED: This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
UNASSIGNED: No Patient or Public Contribution.
摘要：
目的：确定护士协调干预措施在改善再入院方面的效果，累计住院时间,死亡率,体弱的老年人出院的功能能力和生活质量。
方法：系统评价与荟萃分析。
方法：使用关键搜索词“脆弱”进行系统搜索，\'老年病\',\'医院\'和\'护士\'。Covidence被用来筛选个别研究。包括针对虚弱的老年人的研究，在干预中纳入了重要的护理作用，并在住院期间实施，重点是从医院过渡到家庭。
方法：这篇综述搜索了MEDLINE(Ovid)，CINAHL(EBSCO)，PubMed(EBSCO)，Scopus,Embase（Ovid）和Cochrane图书馆在2000年至2023年9月之间发表的研究。
结果：在筛选的7945篇摘要中，共确定了16项随机对照试验.16项随机对照试验共有8795名参与者，包括在分析中。由于结果测量的异质性，使用荟萃分析只能完成再入院（n=13）和死亡率（n=9）。所有其他其余结果指标均通过叙述性综合报告。在研究之间总共使用了59种不同的结果测量评估和工具。荟萃分析发现，仅在再入院1个月时具有统计学意义的干预效果。对任何其他时间点或结果没有发现其他统计学上显著的影响。
结论：护士协调干预对体弱的老年人出院1个月再入院有显著影响。在研究中，干预措施对其他健康结果的积极影响是混合和模糊的，这归因于研究和结局指标之间的巨大异质性.
结论：这项审查应告知当地有关过渡性护理建议的政策，国家和国际层面。护士,他们占全球卫生劳动力的一半，处于理想的位置，可以提供过渡性护理干预措施。护士协调的护理模式，确定患者需求并促进社区护理的延续，从而改善患者的预后。
■审查结果将对关键利益相关者有用，临床医生和研究人员了解更多关于护士协调过渡护理干预措施的基本要素，这些干预措施最适合满足体弱老年人的需求。
结论：当虚弱的老年人经历护理过渡时，例如从医院出院回家，不良事件的风险增加，比如制度化，住院治疗,残疾和死亡。护士协调的过渡护理模式已被证明是支持患有特定慢性疾病的成年人的潜在解决方案，但对体弱的老年人干预措施的有效性还有更多的了解。这篇综述显示了护士协调干预对改善出院后1个月再入院的积极影响。有助于为未来的过渡护理干预措施提供信息，以更好地支持虚弱的老年人的需求。
■本系统评价是根据系统评价和荟萃分析（PRISMA）指南的参考报告项目报告的。
■没有患者或公共捐款。
方法：系统评价与荟萃分析。
方法：使用关键搜索词“脆弱”进行系统搜索，\'老年病\',\'医院\'和\'护士\'。Covidence被用来筛选个别研究。包括针对虚弱的老年人的研究，在干预中纳入了重要的护理作用，并在住院期间实施，重点是从医院过渡到家庭。
方法：这篇综述搜索了MEDLINE(Ovid)，CINAHL(EBSCO)，PubMed(EBSCO)，Scopus,Embase（Ovid）和Cochrane图书馆在2000年至2023年9月之间发表的研究。
结果：在筛选的7945篇摘要中，共确定了16项随机对照试验.16项随机对照试验共有8795名参与者，包括在分析中。由于结果测量的异质性，使用荟萃分析只能完成再入院（n=13）和死亡率（n=9）。所有其他其余结果指标均通过叙述性综合报告。在研究之间总共使用了59种不同的结果测量评估和工具。荟萃分析发现，仅在再入院1个月时具有统计学意义的干预效果。对任何其他时间点或结果没有发现其他统计学上显著的影响。
结论：护士协调干预对体弱的老年人出院1个月再入院有显著影响。在研究中，干预措施对其他健康结果的积极影响是混合和模糊的，这归因于研究和结局指标之间的巨大异质性.
结论：这项审查应告知当地有关过渡性护理建议的政策，国家和国际层面。护士,他们占全球卫生劳动力的一半，处于理想的位置，可以提供过渡性护理干预措施。护士协调的护理模式，确定患者需求并促进社区护理的延续，从而改善患者的预后。
■审查结果将对关键利益相关者有用，临床医生和研究人员了解更多关于护士协调过渡护理干预措施的基本要素，这些干预措施最适合满足体弱老年人的需求。
结论：当虚弱的老年人经历护理过渡时，例如从医院出院回家，不良事件的风险增加，比如制度化，住院治疗,残疾和死亡。护士协调的过渡护理模式已被证明是支持患有特定慢性疾病的成年人的潜在解决方案，但对体弱的老年人干预措施的有效性还有更多的了解。这篇综述显示了护士协调干预对改善出院后1个月再入院的积极影响。有助于为未来的过渡护理干预措施提供信息，以更好地支持虚弱的老年人的需求。
■本系统评价是根据系统评价和荟萃分析（PRISMA）指南的参考报告项目报告的。
■没有患者或公共捐款。
