Effect Of Care Bundle Nursing Intervention On Delirium After Hip Replacement In Elderly Patients

Objective:l.To examine incidence of delirium,the duration of delirium on elderly hip replacement patients with care bundle nursing intervention based on HELP model.2.To observe 40-item quality of recovery score,pain scale,number of pressing pain pump,hospital stay and cost and satisfaction of elderly patients receiving hip replacement.Methods:This was a prospective randomized comparison study.80 elderly patients with hip replacement after hip fracture enrolled for surgical treatment since March 2017 to July 2017 in Three levels of first-class hospital in Shandong province.The patients were divided into two groups randomly,control group(group C)and intervention group(group I).In group C,patients administrated with conventional nursing intervention and in group I patients received care bundle nursing intervention based on conventional nursing.The observed index included incidence of delirium,duration time of delirium,40-item quality of recovery score,pain scale,number of pressing pain pump,hospital stay,hospital cost,and satisfaction in hospital.Results:The incidence of delirium in group I(5/39,12.8%)was lower than that of in group C(12/37,32.4%),the difference was statistically significant(P=0.040,P<0.05);The duration of delirium in group I(1.20±0.45)day was lower than that of group C(1.50±0.67)day,but the difference was with no significance(P>0.05).1.40-item quality of recovery score in group I at next day after operation(171.2±11.77)was higher than that in group C(165.19±13.81),and the difference was statistically significant(P=0.032,P<0.05);40-item quality of recovery score in group I at fifth day after operation(178.10±8.28)was higher than that in the group C(172.24±11.87),and the difference was statistically significant(P=0.016,P<0.05);The satisfaction score of in group I(43.29±2.41)was higher than that in group C(41.84±3.07),and the difference was statistically significant(P=0.022,P?0.O5).2.24 hours visual analogue pain score in group I(1.31±0.89)was lower than that of group C(1.89±1.21),and the difference was statistically significant(P=0.025,P?0.05);48 hours visual analogue pain score in group I(1.15±0.59)was lower than that of group C(1.32±0.58),and the difference was with no significance(P>0.05).The number of pressing pain pump in group I(0.44±0.85)was lower than that of group C(1.08±1.62),and the difference was statistically significant(P=0.036,P<0.05).3.The hospital stay in group I(14.26±2.21)was lower than that in group C(15.65 ±2.48),the difference was statistically significant P=0.012,P?0.05);The hospital cost in group I(4.91±0.85)was lower than that in group C(5.05±0.99),the difference was with no significance(P>0.05).Conclusion1.The care bundle nursing intervention could effectively reduce the incidence of delirium in elderly patients with hip replacement.2.The care bundle nursing intervention could improve 40-item quality of recovery,decrease pain scale and number of pressing pain pump,decline total hospital stays,and improve satisfaction of elderly patients receiving hip replacement.