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中国江苏省三级医院髋部骨折手术后老年患者术后谵妄风险评估与筛查护士应用情况的横断面调查

A Cross-Sectional Survey on Nurses' Utilization of Risk Assessment and Screening for Postoperative Delirium in Older Patients Following Hip Fracture Surgery in Tertiary Hospitals in Jiangsu Province, China.

作者信息

Yang Jing, Liu Mei, Yang Lei, Fang Shujing, Wang Guangling, Gu Zejuan

机构信息

Nursing Department, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.

Orthopedics Department, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2024 Oct 19;17:2457-2464. doi: 10.2147/RMHP.S481087. eCollection 2024.

DOI:10.2147/RMHP.S481087
PMID:39450282
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11499614/
Abstract

OBJECTIVE

To analyze the current utilisation of delirium risk assessment and screening for older patients after hip fracture surgery in tertiary hospitals in Jiangsu Province, China.

METHODS

This cross-sectional study was conducted from April 1 to April 30, 2023 among nurses working in orthopedics from Level III hospitals in Jiangsu Province, China. Data were collected using a self-designed questionnaire that focused on the utilisation of delirium risk assessment and prevention measures for older patients after hip fracture surgery. The questionnaire was administered through the online platform Questionnaire Star. Differences between data were analyzed using chi-square and rank-sum tests.

RESULTS

A total of 616 nurses from 48 hospitals in Jiangsu province responded to the survey. Among them, 50.17% reported having no training in delirium management, 66.88% did not assess patients for delirium risk, and 73.21% did not screen patients for delirium in their clinical practice. It was observed that nurses with longer tenure, nurses specialising in orthopaedics, and nurses with ICU experience were more attentive to delirium risk assessment and delirium screening of patients (P<0.001).

CONCLUSION

Medical institutions must focus on strengthening nurses' training in delirium management for older patients after hip fracture surgery, improve their ability to undertake risk assessment and risk screening, unify delirium management norms, and ultimately improve nurses' delirium management ability.

摘要

目的

分析中国江苏省三级医院髋部骨折手术后老年患者谵妄风险评估与筛查的当前应用情况。

方法

本横断面研究于2023年4月1日至4月30日在中国江苏省三级医院的骨科护士中进行。使用自行设计的问卷收集数据,该问卷聚焦于髋部骨折手术后老年患者的谵妄风险评估及预防措施的应用情况。问卷通过在线平台问卷星发放。采用卡方检验和秩和检验分析数据差异。

结果

江苏省48家医院的616名护士参与了调查。其中,50.17%的护士报告未接受过谵妄管理培训,66.88%的护士未对患者进行谵妄风险评估,73.21%的护士在临床实践中未对患者进行谵妄筛查。观察发现,任职时间较长的护士、骨科专科护士以及有重症监护病房(ICU)工作经验的护士对患者的谵妄风险评估和谵妄筛查更为关注(P<0.001)。

结论

医疗机构必须重视加强髋部骨折手术后老年患者谵妄管理方面护士的培训,提高其进行风险评估和风险筛查的能力,统一谵妄管理规范,最终提升护士的谵妄管理能力。

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本文引用的文献

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Association between postoperative delirium and adverse outcomes in older surgical patients: A systematic review and meta-analysis.术后谵妄与老年手术患者不良结局的关系:系统评价和荟萃分析。
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Risk factors for postoperative delirium after colorectal surgery: a systematic review and meta-analysis.结直肠手术后术后谵妄的危险因素:一项系统评价和荟萃分析。
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