Implementation and evaluation of perioperative delirium prevention scheme for elderly patients with hip fracture / 中华护理杂志

ABSTRACT

Objective To summarize common nursing problems of postoperative delirium in elderly patients with hip fracture,to formulate perioperative management scheme,and to implement proactive nursing intervention.Methods Multidisciplinary cooperative team was established,2014 clinical practice guidelines for preventing postoperative delirium in elderly patients from American Geriatrics Society was referenced.Through oxygen therapy and respiratory function training preoperatively,perfusion balance and temperature control and restricted blood transfusion intraoperatively,multimodal analgesia and comprehensive management of sleep postoperatively,professional,systematic perioperative delirium coping strategies were implemented to reduce the incidence of postoperative delirium in elderly patients with hip fracture.Results The incidence of postoperative delirium was 16.36％(9/55) and 30.91％ (17/55) for the experimental group and the control group,the duration of delirium was (3.37±1.21) d and (4.53± 1.87) d,the incidence of postoperative hypoxemia was 9.09％(5/55) and 14.55％(8/55),and the daily total sleep time was(5.18±0.53)h and(3.56±0.69)h.Conclusion Perioperative delirium management scheme involved various nursing coping strategies and quality continuous improvement projects,shortened the first time of ambulation and average days of hospitalization,and reduced the incidence of postoperative delirium.