Volume 21 Issue 4
Apr.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(4): 709-712
CHEN Yu, XING Hongye, XU Zhaojun, ZHOU Xiaoyang. The effect of ABCDEF cluster nursing strategy on the incidence and duration of delirium after cardiac surgery[J]. Chinese Journal of General Practice, 2023, 21(4): 709-712. doi: 10.16766/j.cnki.issn.1674-4152.002965
Citation: CHEN Yu, XING Hongye, XU Zhaojun, ZHOU Xiaoyang. The effect of ABCDEF cluster nursing strategy on the incidence and duration of delirium after cardiac surgery[J]. Chinese Journal of General Practice, 2023, 21(4): 709-712. doi: 10.16766/j.cnki.issn.1674-4152.002965
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The effect of ABCDEF cluster nursing strategy on the incidence and duration of delirium after cardiac surgery

doi: 10.16766/j.cnki.issn.1674-4152.002965

  • Department of Intensive Care Unit, Ningbo Second Hospital, Ningbo, Zhejiang 315000, China

Funds:

 LY19H190001

 2019KY184

  • Received Date: 2022-12-22
    Available Online: 2023-05-31
    Abstract
  •   Objective  To analyze the application of ABCDEF cluster nursing strategy in patients after cardiac surgery and its impact on postoperative delirium.  Methods  A total of 120 patients after cardiac surgery admitted to the Department of Critical Care of Ningbo Second Hospital from June 2020 to June 2022 were selected as the study subjects. They were divided into control group and observation group of 60 cases each according to the random number table method. The patients in the control group were treated with routine nursing, while the patients in the observation group were treated with ABCDEF cluster nursing strategy on the basis of the control group. The risk score and occurrence of postoperative delirium, sleep quality and pain severity before and after nursing were compared between the two groups, as well as the duration of mechanical ventilation, ICU stay and hospital stay.  Results  There was no significant difference in delirium risk score between the two groups at admission and 1 day before operation (P>0.05); With the extension of time, the difference of delirium risk score between the two groups was statistically significant (Fbetween groups=10.233, Pbetween groups < 0.001); The incidence of delirium in the observation group was 10.0% (6/60), lower than 30.0% (18/60) in the control group, and the duration of delirium in the observation group was shorter than that in the control group (P < 0.05). After nursing, the scores of sleep quality and pain degree in the observation group were 8 (3, 12) points and (1.95±1.21) points respectively, which were lower than those in the control group [12 (7, 16) points and (2.56±1.21) points, all P < 0.05]; The mechanical ventilation time, ICU stay and hospital stay of patients in the observation group were less than those in the control group (all P < 0.05).  Conclusion  The ABCDEF cluster nursing strategy can reduce the incidence and duration of delirium in patients after cardiac surgery, reduce postoperative pain, improve sleep quality and reduce hospital stay.

     

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    • References(18)
  • [1]
    VLISIDES P, AVIDAN M. Recent advances in preventing and managing postoperative delirium[J]. F1000Res, 2019, 8(1): F1000. DOI: 10.12688/f1000research.16780.1.
    [2]
    王伟, 刘丹丹, 李志朋. 老年心脏术后谵妄的研究进展[J]. 保健医学研究与实践, 2021, 18(S1): 271-273. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ2021S1091.htm

    WANG W, LIU D D, LI Z P. Research progress of postoperative delirium in the elderly[J]. Health Medicine Research and Practice, 2021, 18(S1): 271-273. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ2021S1091.htm
    [3]
    STOLLINGS J L, KOTFIS K, CHANQUES G, et al. Delirium in critical illness: clinical manifestations, outcomes, and management[J]. Intensive Care Med, 2021, 47(10): 1089-1103. doi: 10.1007/s00134-021-06503-1
    [4]
    LUETZ A, GRUNOE J J, MÖRGELI R, et al. Innovative ICU solutions to prevent and reduce delirium and post-intensive care unit syndrome[J]. Semin Respir Crit Care Med, 2019, 40(5): 673-686. doi: 10.1055/s-0039-1698404
    [5]
    朱红艳, 徐维昉. 基于ERAS理念的麻醉苏醒期护理对老年髋部骨折全麻手术患者术后谵妄的影响[J]. 中华全科医学, 2022, 20(3): 519-522. doi: 10.16766/j.cnki.issn.1674-4152.002391

    ZHU H Y, XU W F. Influence of anaesthesia recovery nursing based on enhanced recovery after surgery on post-operative delirium in elderly patients under general anaesthesia for hip fracture surgery[J]. Chinese Journal of General Practice, 2022, 20(3): 519-522. doi: 10.16766/j.cnki.issn.1674-4152.002391
    [6]
    宋亚敏, 杨满青, 凌云, 等. 重症监护室预防谵妄的护理干预方案在心脏外科术后患者中的应用[J]. 中国护理管理, 2022, 22(4): 507-511. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202204006.htm

    SONG Y M, YANG M Q, LING Y, et al. Effects of Nursing Delirium Preventive Interventions in the Intensive Care Unit on delirium management in patients after cardiac surgery[J]. Chinese Nursing Management, 2022, 22(4): 507-511. https://www.cnki.com.cn/Article/CJFDTOTAL-GLHL202204006.htm
    [7]
    范洁, 张建平, 刘春霞, 等. 集束化护理干预对老年痴呆患者谵妄的预防效果研究[J]. 保健医学研究与实践, 2022, 19(01): 114-117. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202201025.htm

    FAN J, ZHANG J P, LIU C X, et al. A study on the effectiveness of care bundle intervention on the prevention of delirium in alzheimer's patients[J]. Health Medicine Research and Practice, 2022, 19(01): 114-117. https://www.cnki.com.cn/Article/CJFDTOTAL-GXBJ202201025.htm
    [8]
    杨磊, 张茂. 2013年美国ICU成年患者疼痛、躁动和谵妄处理指南[J]. 中华急诊医学杂志, 2013, 22(12): 1325-1326. doi: 10.3760/cma.j.issn.1671-0282.2013.12.004

    YANG L, ZHANG M. Guidelines for the treatment of pain, restlessness and delirium in adult patients in the US ICU in 2013[J]. Chinese Journal of Emergency Medicine, 2013, 22(12): 1325-1326. doi: 10.3760/cma.j.issn.1671-0282.2013.12.004
    [9]
    刘思伯, 刘赞华, 王虹, 等. 老年患者首次谵妄发生后的预后相关因素分析[J]. 中华老年医学杂志, 2019, 38(2): 161-164. doi: 10.3760/cma.j.issn.0254-9026.2019.02.011

    LIU S B, LIU Z H, WANG H, et al. Analysis of prognosis-relating factors in the elderly patients after the initial onset of delirium[J]. Chinese Journal of Geriatrics, 2019, 38(2): 161-164. doi: 10.3760/cma.j.issn.0254-9026.2019.02.011
    [10]
    路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析[J]. 重庆医学, 2014, 43(3): 260-263. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201403002.htm

    LU T Y, LI Y, XIA P, et al. Analysis on reliability and validity of the Pittsburgh sleep quality index[J]. Chongqing Medicine, 2014, 43(3): 260-263. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201403002.htm
    [11]
    李青栋, 万献尧. 机械通气患者的疼痛评估与镇痛策略演变[J]. 中华危重病急救医学, 2017, 29(9): 861-864.

    LI Q D, WAN X Y. Progress of pain assessment and analgesia strategy for mechanical ventilation patients[J]. Chinese Critical Care Medicine, 2017, 29(9): 861-864.
    [12]
    陈佳佳, 童莺歌, 黎晓艳, 等. 中文版行为疼痛评估工具的研究进展[J]. 护理研究, 2017, 31(32): 4043-4047. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201732002.htm

    CHEN J J, TONG Y G, LI X Y, et al. Research progress on Chinese version of behavior pain assessment tool[J]. Chinese Nursing Research, 2017, 31(32): 4043-4047. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201732002.htm
    [13]
    XAVIER I B M, BISCARRA V B, PICCOLI Â B, et al. Nursing guidelines on cardiac surgery and parents' anxiety: randomized clinical trial[J]. Braz J Cardiovasc Surg, 2020, 35(4): 437-444. http://www.xueshufan.com/publication/3045209320
    [14]
    陈国庆, 徐娟, 宋秀银, 等. ICU谵妄危险因素及集束化干预预防措施[J]. 国际护理学杂志, 2021, 40(15): 2716-2719.

    CHEN G Q, XU J, SONG X Y, et al. Risk factors of delirium in ICU and cluster intervention and prevention measures[J]. International Journal of Nursing, 2021, 40(15): 2716-2719.
    [15]
    周家梅, 徐晓君, 钟威, 等. ABCDE集束化护理措施在心脏瓣膜置换术后谵妄患者中的应用及效果观察[J]. 护士进修杂志, 2021, 36(16): 1489-1492. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202116011.htm

    ZHOU J M, XU X J, ZHONG W, et al. Application and effect observation of ABCDE cluster nursing measures in patients with delirium after cardiac valve replacement[J]. Journal of Nurses Training, 2021, 36(16): 1489-1492. https://www.cnki.com.cn/Article/CJFDTOTAL-FSJX202116011.htm
    [16]
    MEGJHANI M, TERILLI K, KAPLAN A, et al. Use of clustering to investigate changes in intracranial pressure waveform morphology in patients with ventriculitis[J]. Acta Neurochir Suppl, 2021, 131: 59-62. doi: 10.1007/978-3-030-59436-7_13
    [17]
    CHEN H Y, MO L, HU H J, et al. Risk factors of postoperative delirium after cardiac surgery: a meta-analysis[J]. J Cardiothorac Surg, 2021, 16(1): 113. http://doc.paperpass.com/foreign/rgArti2021406210091.html
    [18]
    刘娟, 刘薇萍, 喻欣, 等. 应用ABCDE集束化管理预防ICU患者谵妄的研究进展[J]. 中国实用护理杂志, 2018, 34(9): 716-720.

    LIU J, LIU W P, YU X, et al. Prevention of delirium in ICU patients: ABCDE bundle management[J]. Chinese Journal of Practical Nursing, 2018, 34(9): 716-720.
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