The effectiveness of postoperative delirium prevention, diagnosis, and intervention protocol in patients monitored in the intensive care unit after cardiac surgery: a quasi-experimental study.

IF 3.1 2区 医学 Q1 NURSING
Gönül Kara Söylemez, Hülya Bulut
{"title":"The effectiveness of postoperative delirium prevention, diagnosis, and intervention protocol in patients monitored in the intensive care unit after cardiac surgery: a quasi-experimental study.","authors":"Gönül Kara Söylemez, Hülya Bulut","doi":"10.1186/s12912-024-02547-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The incidence of delirium is high in the intensive care unit (ICU) after cardiac surgery. The development of evidence-based care protocols for delirium management and training of nurses in this regard can ensure effective management of delirium. This quasi-experimental study aimed to assess the effectiveness of a postoperative delirium prevention, diagnosis, and intervention protocol in patients undergoing monitoring in the ICU after cardiac surgery.</p><p><strong>Methods: </strong>This study included 64 patients who underwent cardiac surgery and met the inclusion criteria, along with 14 nurses working in the ICU. Patients were divided into control (n = 32) and intervention (n = 32) groups. The study comprised three phases: determining the incidence of delirium in the control group and the delirium diagnosis status of the nurses; providing training to nurses on postoperative delirium prevention, diagnosis and intervention protocol; implementing a preliminary study of the protocol; and finally, implementing the protocol in the intervention group. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>While there was no significant agreement in delirium diagnosis between researcher and nurses in the control group (kappa: 0.207) (p > 0.05), significant agreement was observed in the intervention group (kappa: 1.00) (p < 0.001). The delirium diagnosis rate of the nurses was 14.3% in the control group and 100% in the intervention group, which was a significant difference. The incidence of delirium was 21.9% in the control group and 9.4% in the intervention group, although the difference was not significant.</p><p><strong>Conclusion: </strong>Postoperative delirium prevention, diagnosis, and intervention protocol effectively enhance delirium diagnosis compliance among researchers and nurses and improve the accuracy of delirium diagnosis among postcardiac surgery ICU patients. The implementation of this protocol is recommended for delirium management in such patients.</p><p><strong>Trial registration: </strong>This study was retrospectively registered at Clinicaltrials.gov on 19.02.2024 (Clinical Trials ID: NCT06268119).</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"904"},"PeriodicalIF":3.1000,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658154/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12912-024-02547-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The incidence of delirium is high in the intensive care unit (ICU) after cardiac surgery. The development of evidence-based care protocols for delirium management and training of nurses in this regard can ensure effective management of delirium. This quasi-experimental study aimed to assess the effectiveness of a postoperative delirium prevention, diagnosis, and intervention protocol in patients undergoing monitoring in the ICU after cardiac surgery.

Methods: This study included 64 patients who underwent cardiac surgery and met the inclusion criteria, along with 14 nurses working in the ICU. Patients were divided into control (n = 32) and intervention (n = 32) groups. The study comprised three phases: determining the incidence of delirium in the control group and the delirium diagnosis status of the nurses; providing training to nurses on postoperative delirium prevention, diagnosis and intervention protocol; implementing a preliminary study of the protocol; and finally, implementing the protocol in the intervention group. Statistical significance was set at p < 0.05.

Results: While there was no significant agreement in delirium diagnosis between researcher and nurses in the control group (kappa: 0.207) (p > 0.05), significant agreement was observed in the intervention group (kappa: 1.00) (p < 0.001). The delirium diagnosis rate of the nurses was 14.3% in the control group and 100% in the intervention group, which was a significant difference. The incidence of delirium was 21.9% in the control group and 9.4% in the intervention group, although the difference was not significant.

Conclusion: Postoperative delirium prevention, diagnosis, and intervention protocol effectively enhance delirium diagnosis compliance among researchers and nurses and improve the accuracy of delirium diagnosis among postcardiac surgery ICU patients. The implementation of this protocol is recommended for delirium management in such patients.

Trial registration: This study was retrospectively registered at Clinicaltrials.gov on 19.02.2024 (Clinical Trials ID: NCT06268119).

心脏手术后重症监护病房监测患者术后谵妄预防、诊断和干预方案的有效性:一项准实验研究。
背景:心脏手术后重症监护病房(ICU)谵妄的发生率较高。谵妄管理的循证护理方案的发展和护士培训在这方面可以确保谵妄的有效管理。本准实验研究旨在评估心脏手术后ICU监护患者术后谵妄预防、诊断和干预方案的有效性。方法:本研究纳入64例符合纳入标准的心脏手术患者,以及14名在ICU工作的护士。患者分为对照组(n = 32)和干预组(n = 32)。研究分为三个阶段:测定对照组患者谵妄发生率及护理人员谵妄诊断情况;对护士进行术后谵妄预防、诊断和干预方案培训;对议定书进行初步研究;最后,在干预组实施该方案。结果:对照组研究者与护士在谵妄诊断上差异无统计学意义(kappa: 0.207) (p < 0.05),干预组研究者与护士在谵妄诊断上差异有统计学意义(kappa: 1.00) (p < 0.05)。术后谵妄预防、诊断及干预方案有效地提高了科研人员和护士对谵妄诊断的依从性,提高了心脏术后ICU患者谵妄诊断的准确性。本方案推荐用于此类患者的谵妄管理。试验注册:本研究于2024年2月19日在Clinicaltrials.gov上回顾性注册(临床试验ID: NCT06268119)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BMC Nursing
BMC Nursing Nursing-General Nursing
CiteScore
3.90
自引率
6.20%
发文量
317
审稿时长
30 weeks
期刊介绍: BMC Nursing is an open access, peer-reviewed journal that considers articles on all aspects of nursing research, training, education and practice.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信