Table 1 Nursing care plan for 2 groups patients
Control group intervention methods | Experimental group intervention methods | ||
|---|---|---|---|
Regular nursing intervention | Stratified nursing protocol for intervention | ||
1.Nursing evaluation | 1. Nursing evaluation | ||
1.1 Delirium judgment | The technique of identifying symptoms was used to monitor delirium. When a patient exhibits behavioral abnormalities (aggression towards others, indifference, impatience, etc.), hallucinations, and disorientation, and the diagnostic criteria for delirium are the same as those in the intervention group; delirium may be present. Assessment by the responsible nurse once a day | 1.1 Delirium judgment | The responsible nurse would use the Nu-DESC scale to assess, with a total score of ≥ 1 indicating the possibility of delirium. The diagnosis of delirium: Consult a psychiatrist, and confirm the diagnosis of delirium according to the relevant content in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The high-risk group and those with delirium were assessed once per shift, and the low-risk group was assessed once per day |
1.2 Delirium risk stratification | Using a risk prediction scoring model to differentiate high-risk groups and low-risk groups for non-delirious patients | ||
1.3 Delirium risk factors assessment | Risk factors are assessed using the Delirium Risk Factor Assessment Form and the Delirium High Risk Medication Assessment Form. Low-risk groups are assessed once at admission and at any change in condition; high-risk groups and delirium patients are assessed daily | ||
2. Nursing measures | 2. Nursing measures | ||
2.1 Regular nursing | â‘ changes in blood pressure, heart rate, blood oxygen saturation, and 24-h intake and output; â‘¡ postoperatively routine analgesia, phlegm and anti-inflammatory treatment, the indicators monitoring lab, exception handling in a timely manner; â‘¢responsible nurses assisted and oversaw limb function exercise; â‘£ provide a quiet and comfortable ward environment to encourage sleep | 2.1 Stratified care management | â‘ the low-risk group was given routine care, and targeted interventions were implemented if any risk factors were present â‘¡The high-risk group and those with delirium were given routine care in addition to the early mobility, pain, sleep, cognitive function, physiological needs, and complication management outlined in this protocol, and the variable factors were adjusted based on the results of daily assessments |
2.2 Patient care for delirium | The degree of delirium was noted, and consequences stemming from the condition were noted. Medication and physical constraint were administered to patients experiencing acute delirium | 2.2 Management of delirium patients | Non-severe delirium patients were managed in the same way as above. Severe delirium patients were given routine care in addition to following the doctor’s orders for nighttime sedation; the use of psychiatric restraints was implemented using assessment and discontinuation forms to assess the patient’s restraint needs; and nursing safety management was carried out |
2.3 Health education | Responsible nurses conducted propaganda and education on the ward environment, visiting system, postoperative pipeline, rehabilitation exercise, food management, anticoagulation management, and other relevant topics. When a delirium occurs, the nurse educates families about the delirium, introduces successful cases, and encourages families to accompany | 2.3 Family support | In addition to routine education, the group members would provide video, pamphlets, and classroom instruction to family members on delirium-related knowledge on days 1, 3, and 5 after the patient’s admission, to help them understand the risk factors of delirium, recognize symptoms and signs of an attack, and care methods |