多学科协作背景下老年患者术后谵妄预防及护理管理策略的构建

Construction of prevention and nursing management strategies for postoperative delirium in elderly patients under the background of multidisciplinary cooperation

目的构建多学科协作背景下老年患者术后谵妄的预防及护理管理策略。方法采用文献检索、质量评价、临床调研与专家小组讨论等方法,结合标准化护理语言-奥马哈系统及结果-过程-结果三维质量评价理论,初拟老年患者术后谵妄的预防及护理管理策略。采用德尔菲专家咨询法,经过两轮专家咨询,构建老年患者术后谵妄预防及护理管理体系。结果建立了包括3项一级指标,14项二级指标及45项三级指标的老年患者术后谵妄预防及护理管理体系。其中涉及管理者的指标5项,以护士为主导22项,医护协作16项。结论本研究明确了老年患者术后谵妄预防及管理的核心与关键,强调护士在多学科老年患者术后谵妄预防与管理中的定位,为后期实现同质化管理奠定了基础。

Objective To construct the prevention and nursing management strategy of postoperative delirium in elderly patients under the background of multidisciplinary collaboration. Methods Using literature retrieval, quality evaluation, clinical research, expert group discussion and other methods, combined with standardized nursing language-Omaha system and results-process-results three-dimensional quality evaluation theory, the prevention and nursing management strategy of postoperative delirium in elderly patients was first proposed. Using Delphi method, after two rounds of expert consultation, the management system of postoperative delirium prevention and nursing management for elderly patients was constructed. Results A management system for postoperative delirium prevention and care management for elderly patients with 3 level 1 indicators, 14 secondary indicatorsand45 level III indicators was established. Among them, 5 indicators involving managers, 22 led by nurses and 16 health care collaborations. Conclusion This study clarifies the core and key of postoperative delirium prevention and management in elderly patients, emphasizes the positioning of nurses in postoperative delirium prevention and management in multidisciplinary elderly patients, and lays a foundation for the later realization of homogenization management.