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Clinical checklists of multicomponent non-pharmacological interventions for delirium management in adult patients in non-ICU inpatient healthcare settings: a rapid review
Shirley Harvey Bush, Monisha Kabir, Véronique French-Merkley, Lindsey Sikora, Meera Ruth Agar, Annmarie Hosie, Imogen Featherstone, Sarina R. Isenberg et al.. BMJ Open, 2026-06-01
Topic: Risk, prevention and care in population studies
From the database searches, 4796 records were identified. After the removal of duplicates, 3513 records underwent title and abstract screening, with 344 records undergoing full-text screening. A final 32 records were included. From the grey literature search, 6593 records were reviewed for relevance, from which 62 records were included in full-text screening. No grey literature records were of high enough quality to be included. All studies were published in English, with most studies conducted in the USA, n=12/32 (37.5%). The 32 studies were quasi-experimental (n=18), randomised controlled trials (n=8), qualitative (n=4), expert opinion (n=1) and policy/consensus guidelines (n=1). Clinical checklists included structured protocols, algorithms and order sets, which were paper-based or part of electronic delirium order sets. People with dementia participated as key stakeholders for a guidance document during the COVID-19 pandemic, but the target population was not included in the development phase of other checklists. Target users of clinical checklists were usually healthcare staff and trained volunteers and rarely family carers and study intervention nurses. Four of the 32 studies included all 10 National Institute for Health and Care Excellence clinical factors/preventive strategies for non-pharmacological interventions. For the remaining 28 studies, missing domains varied and included: therapeutic/cognitive activity, hydration, nutrition, constipation, urinary catheterisation, hypoxia, infection, pain and medication review. Only two studies involved family carers as active partners in patient care. Reported formal economic analysis was limited. Codesign of future clinical checklists should involve patients and family carers. Further research is needed on the feasibility of using clinical checklists by all members of the interprofessional team and family carers, the factors needed to ensure high levels of adherence and sustainability of multicomponent non-pharmacological interventions for delirium management, in addition to economic evaluations. PROSPERO REGISTRATION: CRD42022342328.
Key findings
- From the database searches, 4796 records were identified.
- After the removal of duplicates, 3513 records underwent title and abstract screening, with 344 records undergoing full-text screening.
- From the grey literature search, 6593 records were reviewed for relevance, from which 62 records were included in full-text screening.
- No grey literature records were of high enough quality to be included.
- All studies were published in English, with most studies conducted in the USA, n=12/32 (37.5%).
Why it matters
This rapid review examined clinical checklists of multicomponent non-pharmacological interventions for delirium management in non-ICU inpatient settings, finding that only four of 32 studies included all recommended preventive strategies. It describes the content and gaps of existing checklists and does not test any treatment, cure or prevention for Alzheimer's disease.
Study details
- Participants12
- Effect size37.5%
- Evidence strengthHigh
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMJ Open) |
| Journal's citation record | 2 / 4 | BMJ Open: journal h-index 240 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 12 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 5.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Peter Gerard Lawlor: h-index 36 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Ottawa: institution h-index 908 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42366006) |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Bush, S. H., Kabir, M., French-Merkley, V., Sikora, L., Agar, M. R., Hosie, A., et al. (2026). Clinical checklists of multicomponent non-pharmacological interventions for delirium management in adult patients in non-ICU inpatient healthcare settings: a rapid review. BMJ Open. https://doi.org/10.1136/bmjopen-2025-105740
Vancouver
Bush SH, Kabir M, French-Merkley V, Sikora L, Agar MR, Hosie A, et al. Clinical checklists of multicomponent non-pharmacological interventions for delirium management in adult patients in non-ICU inpatient healthcare settings: a rapid review. BMJ Open. 2026. doi:10.1136/bmjopen-2025-105740. PMID: 42366006.
BibTeX
@article{bush2026-42366006,
author = {Bush, Shirley Harvey and Kabir, Monisha and French-Merkley, Véronique and Sikora, Lindsey and Agar, Meera Ruth and Hosie, Annmarie and Featherstone, Imogen and Isenberg, Sarina R. and others},
title = {{Clinical checklists of multicomponent non-pharmacological interventions for delirium management in adult patients in non-ICU inpatient healthcare settings: a rapid review}},
journal = {BMJ Open},
year = {2026},
doi = {10.1136/bmjopen-2025-105740},
pmid = {42366006},
url = {https://doi.org/10.1136/bmjopen-2025-105740}
}
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