Construction and application of nursing scheme for perioperative delirium in elderly patients with orthopedic trauma
10.3760/cma.j.cn115682-20210224-00826
- VernacularTitle:老年骨科创伤患者围手术期谵妄护理方案的构建及应用
- Author:
Lili SONG
1
;
Xing WANG
;
Jianfang CHEN
Author Information
1. 海军军医大学第一附属长海医院创伤骨科，上海 200433
- Keywords:
Aged;
Perioperative care;
Delirium;
Trauma;
Omaha system
- From:
Chinese Journal of Modern Nursing
2022;28(3):319-324
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a prevention and control system for perioperative delirium in elderly patients with orthopedic trauma and evaluate its clinical application value.Methods:By referring to the Omaha system management framework and connotation, reviewing relevant literature and combining with demographic information, disease characteristics and clinical treatment of patients, the risk points of delirium occurrence were defined. A perioperative delirium prevention and control plan for elderly orthopedic trauma patients and a delirium prevention and control transfer order that met the actual use requirements were developed. The convenient sampling method was used to select 120 elderly patients with orthopedic trauma who were admitted to the First Affiliated Changhai Hospital of Naval Military Medical University from October 2019 to October 2020 who underwent surgical treatment and perioperative delirium care prevention and control as the experimental group. A total of 111 elderly patients with orthopedic trauma who received surgical treatment and routine care from May 2018 to May 2019 were selected as the control group. The incidence of delirium in patients before and after the implementation of the perioperative delirium prevention and control scheme was compared.Results:The delirium risk score of the patients in the experimental group after the intervention of delirium prevention and control to 1 day before surgery was lower than that at admission, and the difference was statistically significant ( P<0.05) . Although the risk of delirium increased within 3 days after operation, the delirium risk score after intervention for prevention and control of delirium to 7 days after operation was lower than that at 3 days after operation, and the difference was statistically significant ( P<0.05) . During the hospitalization period, the rate of delirium in the experimental group was 14.2% (17/120) , lower than 24.3% (27/111) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The prevention and control scheme for perioperative delirium based on the Omaha system theory can reduce the risk of delirium in elderly patients with orthopedic trauma.
