Nursing interventions for prevention of postoperative delirium

Uvod: Pooperativni delirij predstavlja akutno disfunkcijo možganov v pooperativnem obdobju. Pooperativni delirij je zelo pogost, pojavlja se pri 10‒60 % pacientov, odvisno od vrste operacije. Namen zaključnega dela je bil izpostaviti najpogostejše intervencije medicinskih sester za preprečevanje pooperativnega delirija. Raziskovalne metode: Izvedli smo integrativni pregled znanstvene literature. Literaturo smo glede na vključitvene in izključitvene kriterije, ki smo jih oblikovali iz raziskovalnega vprašanja, iskali v podatkovnih bazah MEDLINE, CINAHL, SAGE in Wiley Online Library. Potek iskanja je prikazan s pomočjo PRISMA diagrama, izvedli smo vsebinsko analizo. Rezultati: V končni pregled smo vključili deset člankov. V sintezi dokazov smo rezultate razdelili v dve podkategoriji: predoperativne in pooperativne intervencije. Najpogostejše intervencije so zgodnja mobilizacija, izobraževanje pacientov, obvladovanje bolečine, zagotavljanje varnega okolja, izboljšanje kvalitete spanja, izogibanje senzoričnih motenj, dodatno izobraževanje medicinskih sester, pomoč in svetovanje pri prehranjevanju, normaliziranje elektrolitov in vnosa tekočin, preprečevanje obstipacije in nepotrebne katetrizacije. Razprava in sklep: Intervencije medicinskih sester za preprečevanje pooperativnega delirija so učinkovite pri zmanjševanju pojavnosti delirija. Zapleti povezani s pooperativnim delirijem predstavljajo finančni problem in višje tveganje za umrljivost, zato je pomembno, da se za preprečevanje pooperativnega delirija dodatno izobrazi medinske sestre o simptomih, dejavnikih tveganja, uporabi ocenjevalnih lestvic ter intervencijah medicinskih sester, ki se s pooperativnim delirijem srečujejo vsak dan.Introduction: Postoperative delirium represents acute brain dysfunction in the postoperative period. Postoperative delirium is very common, occurring in 10-60% of patients, depending on the type of surgery. The purpose of the final work was to highlight the most common nursing interventions to prevent postoperative delirium. Methods: We performed an integrative review of the scientific literature. We searched literature in the databases MEDLINE, CINAHL, SAGE, Wiley Online Library according to the inclusion and exclusion criteria, which was formed from the research question. The search process is shown using the PRISMA diagram, according to the method of content analysis. Results: 10 articles were included in final review. In the evidence synthesis, the results were divided into two subcategories: preoperative and postoperative interventions. The most common interventions are early mobilization, patient education, pain management, ensuring a safe environment, improving sleep quality, avoiding sensory disturbances, further educating nurses, assisting and advising on nutrition, normalizing electrolytes and fluid intake, preventing constipation and unnecessary catheterization. Discussion and Conclusion: Nursing interventions to prevent postoperative delirium are effective in reducing incidence of delirium. Complications associated with postoperative delirium pose a financial problem and higher risk of mortality. Therefore, to prevent postoperative delirium, it is important to further educate nurses who experience postoperative delirium on a daily basis on symptoms, risk factors, use of screening tools and nursing interventions