OBJECTIVE: The objective of this review is to examine the effectiveness, implementation, and costs of multifaceted care approaches, including care bundles, for the prevention and mitigation of @entity933 in @entity1 hospitalized in intensive care units (ICUs). DATA SOURCES: A systematic search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted utilizing PubMed, EMBASE, and CINAHL. Searches were limited to studies published in English from January 1, 1988, to March 31, 2014. Randomized controlled trials and comparative studies of multifaceted care approaches with the @entity933 in ICU @entity1 as an outcome and evaluations of the implementation or cost-effectiveness of these interventions were included. DATA EXTRACTION: Data on study methods including design, cohort size, interventions, and outcomes were abstracted, reviewed, and summarized. Given the variability in study design, populations, and interventions, a qualitative review of findings was conducted. DATA SYNTHESIS: In all, 14 studies met our inclusion criteria: 6 examined outcomes, 5 examined implementation, 2 examined outcomes and implementation, and 1 examined cost-effectiveness. The majority of studies indicated that multifaceted care approaches were associated with improved @entity1 outcomes including reduced incidence and duration of @entity933 . Additionally, improvements in functional status and reductions in @entity772 and ventilator days, hospital length of stay, and/or mortality rates were observed. Implementation strategies included structured quality improvement approaches with ongoing audit and feedback, multidisciplinary care teams, intensive training, electronic reporting systems, and local support teams. The cost-effectiveness analysis indicated an average reduction of  1000 in hospital costs for @entity1 treated with a multifaceted care approach. CONCLUSION: Although multifaceted care approaches may reduce @entity933 and improve @entity1 outcomes, greater improvements may be achieved by deploying a comprehensive bundle of care practices including awakening and breathing trials, @entity933 monitoring and treatment, and early mobility. Further research to address this knowledge gap is essential to providing best care for ICU @entity1 .

A Review of Multifaceted Care Approaches for the Prevention and Mitigation of XXXX in Intensive Care Units.

@entity933 :: ('MESH:D003693', 'Disease') :: ['reduction of delirium', 'delirium'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity772 :: ('MESH:D003128', 'Disease') :: ['coma']
@entity933 :: (MESH:D003693,Disease) :: ['Delirium']
