Risk assessment and effect of cluster nursing intervention on postoperative delirium in elderly patients with hip fracture
老年髋部骨折患者术后谵妄的风险评估及集束化护理干预效果

摘要

目的 探讨老年髋部骨折患者术后谵妄风险因素及集束化护理效果，为改善预后提供参考。方法 选2024年10月至2025年10月38例70-80岁老年髋部骨折患者，随机分两组各19例。对照组术后常规护理，实验组基于风险评估实施集束化护理，护理周期均14天。比较两组术后谵妄发生率、持续时间，统计护理前后认知功能评分及满意度。用SPSS 22.0处理数据，计量资料用（͞x±s）表示、行t检验，计数资料用[n（%）]表示、行χ²检验，P<0.05有统计学意义。结果 实验组术后谵妄发生率10.53%（2/19），低于对照组42.11%（8/19）；谵妄持续时间（2.35±0.82）d，短于对照组（4.76±1.25）d，差异有统计学意义（P<0.05）。护理前两组认知功能评分无差异（P>0.05），护理后均提高且实验组更高，差异有统计学意义（P<0.05）。实验组护理满意度94.74%（18/19），高于对照组68.42%（13/19），差异有统计学意义（P<0.05）。结论 对70-80岁老年髋部骨折患者术后基于风险评估实施集束化护理，可降低谵妄发生率、缩短持续时间，改善认知功能，提高满意度，值得推广。

Abstract

Objective To investigate the risk factors of postoperative delirium and the efficacy of bundle nursing in elderly patients with hip fractures, providing references for improving prognosis.
Methods A total of 38 elderly patients with hip fractures aged 70–80 years from October 2024 to October 2025 were selected and randomly divided into two groups of 19 cases each. The control group received routine postoperative care, while the experimental group received bundle nursing based on risk assessment, with both groups undergoing a 14-day nursing period. The incidence and duration of postoperative delirium were compared between the two groups, and cognitive function scores and satisfaction were statistically analyzed before and after nursing. Data were processed using SPSS 22.0, with measurement data expressed as (͞x±s) and analyzed by t-test, and categorical data expressed as [n(%)] and analyzed by χ² test. P<0.05 was considered statistically significant.
Results The incidence of postoperative delirium in the experimental group was 10.53% (2/19), lower than that in the control group (42.11% (8/19)). The duration of delirium (2.35±0.82) days was shorter than that in the control group (4.76±1.25) days, with a statistically significant difference (P<0.05). Cognitive function scores showed no difference between the two groups before nursing (P>0.05), but both groups improved after nursing, with the experimental group showing a higher improvement (P<0.05). Nursing satisfaction in the experimental group was 94.74% (18/19), higher than that in the control group (68.42% (13/19)), with a statistically significant difference (P<0.05).
Conclusion   Implementing bundle nursing based on risk assessment for elderly patients with hip fractures aged 70–80 years after surgery can reduce the incidence of delirium, shorten its duration, improve cognitive function, and enhance satisfaction, making it worthy of promotion.