The Design and validation of a Nursing Plan for Elderly Patients with Postoperative Delirium

Abstract

Delirium is the sudden alteration of the state of consciousness and perception, fluctuating over hours or days. It predominates in older adults and is associated with the aging process. The incidence of delirium increases between 10% and 15% in surgical interventions. The objective of this study was the design and validation of a nursing care plan for elderly patients with postoperative delirium. This study was based on the Delphi method and applied to nursing professionals at the Hospital Universitario del Caribe, Cartagena. The sample consisted of 36 nurses with knowledge of the taxonomy of nursing diagnoses. The care plan was applied in two rounds. For the analysis, measures of central tendency and dispersion were used, as well as frequency and percentages. The participants were women (90.9%) from the hospitalization service (51.5%), with training in Nursing Diagnosis (NANDA), Nursing interventions classification (NIC) and Nursing Outcome Classifications (NOC) (78.8%). The validated care plan has eight diagnostic features. Highlights include “Risk for Ineffective Cerebral Tissue Perfusion” and “Disturbed Sleep Pattern” (in 98.1%; 11 results), with the highest score in the first round being “Vital Signs” (with 100%) and “Sleep” (100%) and “Mobility” (100%) in the second round. Forty-four interventions and 18 suggested activities were identified. This care plan offers the nursing professionals reliable and pertinent tools in clinical practice for the management of patients with postoperative delirium.

Managing delirium in acute inpatient units: A cross‐sectional study of nursing teams' knowledge and perceived limitations

“…Therefore, holding joint training sessions and working together to develop a protocol for managing delirium could lead to improvements. There is a clear need for additional training in managing delirium in nursing, which could be addressed independently by developing standardized care plans for delirium prevention and management, as reported in other publications (Melguizo‐Herrera et al, 2019; Solà‐Miravete et al, 2018). However, several studies suggest that joint interdisciplinary educational interventions are more effective (Albert, 2018; Hshieh et al, 2015; Siddiqi et al, 2016; Toye et al, 2017).…”

“…In Fick et al (2018) et al, 2019;Solà-Miravete et al, 2018). However, several studies suggest that joint interdisciplinary educational interventions are more effective (Albert, 2018;Hshieh et al, 2015;Siddiqi et al, 2016;Toye et al, 2017).…”

Delirium risk screening and assessment among older patients in general wards and the emergency department: a best practice implementation project

“…The text of the interventions was written using NANDA terminology, 17 similarly to other acute confusional syndrome intervention projects. 18 All these…”

Nurses' management of older patients with post-anesthesia delirium: A Q methodology approach

“…Although studies have been conducted on the usefulness of the tools for early detection of delirium, delirium diagnosis is mainly clinical, requiring frequent observation and high awareness. Managing emergence delirium in a PACU is very dynamic, and practical knowledge must be put into action over a short period of time [11]. The indications of delirium among patients in the PACU should be considered an abnormal process during their recovery period.…”