Enhancing Nursing Practices in Critical Care for Older Adults: A Systematic Review of Age-Friendly Nursing Interventions

To synthesize evidence on the implementation and effectiveness of age-friendly interventions in intensive care units (ICUs) to optimize care for older adults. Systematic review of studies published up to February 2024, focusing on interventions tailored to meet the needs of older adults in ICU settings. Comparative studies conducted in ICUs worldwide, involving older adults receiving critical care, were reviewed. A systematic search of databases including Embase, MEDLINE, and Cochrane was performed. The quality of studies was assessed using the ROSVIS-II tool, and findings were synthesized narratively and thematically. Out of 1200 articles initially identified, 45 studies met inclusion criteria. Age-friendly interventions (eg, geriatric assessment teams, multimodal care bundles) demonstrated significant benefits, including a 19% reduction in major in-hospital complications and shorter hospital stays by an average of 3 days. The review supports the effectiveness of age-friendly interventions in improving clinical outcomes for older ICU patients. However, consistent reporting of effect sizes was lacking, and more high-quality comparative effectiveness research is needed. Implications for practice include integrating these interventions into standard ICU protocols to enhance older adult care. Policy implications involve advocating for health care policies that support the dissemination and implementation of effective age-friendly practices. Further research should focus on establishing a robust evidence base to guide implementation and policy decisions.