Study On Construction Of Evidence-based Prevention Strategies Of Delirium In The Elderly

Objective:The purpose of this study is to find standardized measures to prevent delirium in the elderly through evidence-based methods,and to construct a set of scientific,objective and comprehensive prevention strategies for delirium in the elderly,which is suitable for the actual medical treatment in China,so as to reduce the incidence of delirium in the elderly,alleviate the suffering of patients,save medical costs,shorten hospital stays,and provide reference for quality evaluation and process monitoring of geriatric nursing.Methods:In this study,we searched the databases of Cochrane,Pubmed,CINAHL,Elsevier,EBSCO,CBM,Wanfang Data and CNKI in the last five years,and evaluated the quality of the included documents by Johns Hopkins evidentiary grade and quality evaluation method.The expert group discussion was used to draw up a suitable database for China's national conditions.Preventive strategies for delirium in the elderly include management,education and training,assessment,intervention and other dimensions.Delphi method was used to evaluate the importance and operability of prevention strategies by 25 experts according to the 5-level Likert scale method.Finally,the prevention strategies of delirium in the elderly were obtained.The reliability and representativeness of expert consultation are tested by using the index of expert's positive coefficient,authority coefficient,coefficient of variation and coordination coefficient.Results:Based on evidence,a set of prevention strategies for delirium in the elderly was constructed,which included 72 items in four dimensions:management,education and training,evaluation and intervention.The intervention measures included improving cognitive function and orientation,improving hearing and visual impairment,body fluid balance and nutrition management,excretion management,correcting hypoxia,preventing infection.Static analgesia management,sleep management,activity program,drug management,traditional Chinese medicine nursing.Delphi consultation method was used.The positive coefficients of the two rounds of expert consultation were 92.00%and 95.65%(>60%),the authoritative coefficients of experts were 0.845 and 0.840(>0.7),the variation coefficients of the importance of each item were 0-20.82%and the operational variation coefficients were 0-33.80%.Conclusion:A set of prevention strategies for delirium in the elderly including management,education and training,evaluation and intervention were constructed.Interventions included improving cognitive function and orientation,improving hearing and visual impairment,body fluid balance and nutrition management,excretion management,correction of hypoxia,prevention of infection,sedation and analgesia management,sleep management,activity program,drug management,traditional Chinese medicine nursing.The results of positive coefficient,authority coefficient and coordination coefficient of expert consultation prove that expert consultation has high representativeness and reliability.