Understanding Risks in the Care of People With Dementia in Acute Hospital Settings: Definitions, Types and Management Strategies—A Scoping Review

IF 3.6 3区医学 Q1 NURSING

Journal of Clinical Nursing Pub Date : 2026-10-01 Epub Date: 2026-08-08 DOI:10.1111/jocn.70433

Ashitha Bhaskaran, Kate Irving, Eileen Courtney, Bert Gordijn, Marie Cantwell

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引用次数: 0

Abstract

Aims

This scoping review explores how risk is defined, managed and mitigated in the care of people with dementia in acute hospital settings.

Methods

This scoping review followed Arksesy and O'Malley's five-stage framework (2005) and was guided by the Joanna Briggs Institute methodology. A literature search was conducted in October 2023 and updated in December 2024 across Web of Science, MEDLINE, CINAHL, Academic Search Complete and PsycINFO databases. The results were reported as per PRISMA-ScR guidelines.

Results

A total of 3916 articles were screened, 181 full-text articles assessed and 61 studies included in the final review. The literature on the care of people with dementia in acute hospital settings demonstrates an implicit understanding of risk, focusing mainly on physical risks with less emphasis on psychological, social and spiritual aspects. Identified risk management strategies include targeted screening, dementia-specific interventions, environmental modifications, non-pharmacological approaches, person-centred family-inclusive care and workforce competency enhancement. Limited studies address positive risk-taking, and ethical considerations are often overlooked, indicating a need for a more balanced approach to risk in the care of people with dementia in acute settings.

Conclusion

This review highlights critical gaps in the conceptualisation and management of risk in the care of people with dementia in acute settings. A dominant focus on physical safety often overshadows other essential aspects of well-being, and ethical issues are rarely discussed. The findings underscore the urgent need for person-centred, ethically informed approaches that balance safety with autonomy and quality of life.

Patient or Public Contribution

No patient or public involvement was included in this review.

Implications for the Profession

This review addresses significant gaps in understanding and managing risks in the care of people with dementia in acute settings. It serves as a vital resource for healthcare professionals to better understand risks in the care of people with dementia in acute settings and consolidate actionable insights that support the delivery of high-quality, person-centred care for patients with dementia.

Trial Registration

Open Science Framework: https://doi.org/10.17605/OSF.IO/K67S4

查看原文本刊更多论文

了解急性医院环境中痴呆症患者护理的风险：定义、类型和管理策略-范围综述

目的：本综述探讨了如何定义、管理和减轻急性医院环境中痴呆症患者护理中的风险。方法：本综述遵循Arksesy和O'Malley的五阶段框架（2005），并以乔安娜布里格斯研究所的方法为指导。文献检索于2023年10月进行，并于2024年12月在Web of Science、MEDLINE、CINAHL、Academic search Complete和PsycINFO数据库中更新。结果按照PRISMA-ScR指南报告。结果：共筛选了3916篇文章，评估了181篇全文文章，最终纳入了61项研究。关于急性医院环境中痴呆症患者护理的文献表明对风险的隐性理解，主要关注身体风险，较少强调心理，社会和精神方面。已确定的风险管理策略包括有针对性的筛查、针对痴呆症的干预措施、环境改造、非药物方法、以人为本的家庭包容性护理和提高劳动力能力。有限的研究涉及积极的冒险行为，而伦理方面的考虑往往被忽视，这表明需要在急性环境中对痴呆症患者的护理采取更平衡的风险方法。结论：本综述强调了急性痴呆患者护理中概念化和风险管理方面的关键差距。对人身安全的主要关注往往掩盖了福祉的其他基本方面，道德问题很少被讨论。研究结果强调，迫切需要以人为本，道德知情的方法，平衡安全与自主和生活质量。患者或公众参与：本综述不包括患者或公众参与。对专业的影响：本综述解决了在理解和管理急性痴呆患者护理风险方面的重大差距。它是医疗保健专业人员更好地了解急性痴呆症患者护理风险的重要资源，并巩固可操作的见解，支持为痴呆症患者提供高质量、以人为本的护理。试验注册：开放科学框架：https://doi.org/10.17605/OSF.IO/K67S4。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.