Nursing Interventions to Manage Postoperative Delirium

Background Delirium is a highly prevalent clinical condition in postoperative patients. It has various adverse effects on patients and healthcare organizations, including increased health care costs, long-term cognitive impairments, and in-hospital mortality. Although nurses have a distinctive role in identifying and managing delirium, there are currently very few studies that have examined the effect of nursing interventions on postoperative delirium. Objective The objective of this integrative literature review was to explore and evaluate the effect of nursing interventions in preventing and managing postoperative delirium. Methods Six databases (Academic Search Premier, CINAHL, Medline, APA Psycarticles, Psychological and Behavioral Sciences Collection, and APA PsycInfo) were searched from September 2020 to November 2020. Articles published from January 15 to November 2020 were searched using the following keywords: delirium, post operative, post-operative, postoperative, post surgery, nursing, nurse, nurses, nursing care, and nursing practices. Eight articles were included in the final review. The evidence level and quality of the studies were evaluated using the Johns Hopkins evidence appraisal tool. All eight studies but one (87.5%) were rated with high level evidence in terms of evidence strength and quality. Results Nursing interventions were categorized into physical, environmental, and social and emotional components. Common nursing interventions provided in the studies included reduction of environmental stimuli, early mobilization, frequent reorientation, and inclusion of the family members in the care plan. The majority of the studies (87.5%) found statistical significance in the reduction of delirium incidence rate. Multiple studies observed decreased delirium severity, delirium duration, length of hospital stay, and mortality with the nursing interventions although several studies reported no statistical significance. Conclusion The findings of this integrative literature review indicate nursing interventions have positive implications on preventing and managing postoperative delirium. With further research and promotion of appropriate nursing interventions, there is a high prospect for improving patient outcomes