. 2021 Aug 26;9(9):1103. doi: 10.3390/healthcare9091103

Table 3.

Nursing interventions to reduce postoperative delirium.

Nursing Interventions
Physiological Maintain good nutrition and hydration [3,9,16,33,44,69,81,83,94,119] Manage pain adequately [7,9,10,33,34,55,59,69,82] Remove catheters promptly [3,7,9,55,79,82] Ensure adequate oxygenation [2] Manage bladder and bowel care [94] Minimize the risk of aspiration pneumonia [94] Avoid prolonged hypotension [107] Cognitive Place clocks and calendars in the patient’s room to aid in temporal reorientation [3,7,8,13,55,62,76,81,94,119] General reorientation [55,64,82,119] Cognitive stimulation [7,44,76,81,94,119] Read letters or books to the patient or show the patient family photographs [13,55] Implement strategies to help the patient differentiate between day and night by, for example, showing them pictures of the sun or moon [7,55] Use music [7,55] Give the patient access to objects that will help them orient themselves [119] Encourage reading, watching TV, and listening to music [7,55] Place objects such as photographs where they are easily visible to the patient [55] Avoid excessive perioperative and postoperative sedation [2] Behavioural Reduce preoperative anxiety [107] Give psychosocial support [16] Show concern and empathy; listen attentively [55] Do not dismiss concerns expressed by the patient [107] Offer realistic solutions and avoid threats [55] Use open questions and try to discover the source of patient concerns Be assertive; use sentences that are short and clear [107] Use acupuncture and acupressure (at the “Shenmen” and “Point Zero” auricular acupuncture points) [107]	Sensory Maintain a good level of illumination [7,13,55,62,70,76,79,94,119] Facilitate the use of hearing aids at an early stage [3,7,33,55,62,69,76,79,102,119] Facilitate the use of glasses [3,7,11,13,62,69,79,102] Avoid excessive noise [3,7,33,55,81,95,119] Facilitate the use of dentures [10,13,50] Visual and auditory stimulation [76,81] Avoid artificial lighting [81,82] Sleep and Environment Establish a daily routine in order to prevent disruption of the sleep–wake cycle [13,81,95] Where possible, avoid the administration of medication or the taking of vital signs during the night [55,64,81] Adjust routines in order to ensure uninterrupted sleep [119] Back massage [46,119] Enable the patient to obtain adequate rest [11,35] Give the patient peace and quiet and maintain a pleasant environment (without unwanted noise or visits) [55,95] Enquire as to whether the patient was already taking medication to aid sleep [119] Allow a warm milky drink to be taken before sleep [46] Provide warm drinks for the patient [119] Family involvement Involve the patient’s family [10,55,62,64,69] Avoid changes in personnel [13,62,94] Allow the family to be present at meal-times [7,55] It may be necessary to require a family member or someone who is close to accompany the elderly patient [95] Use carers’ names [119] Patient Safety and Skin Integrity Where possible, avoid mechanical restraints [2,16,55,64,79,81,95,119] Promote early mobility [3,7,10,33,34,44,55,59,69,76,82,95] Walking or directed exercise at least three times daily [7,55,76,119] Protect the patient from falls [94] Care of pressure points [2,94]

Nursing Interventions

Physiological
Maintain good nutrition and hydration [3,9,16,33,44,69,81,83,94,119]
Manage pain adequately [7,9,10,33,34,55,59,69,82]
Remove catheters promptly [3,7,9,55,79,82]
Ensure adequate oxygenation [2]
Manage bladder and bowel care [94]
Minimize the risk of aspiration pneumonia [94]
Avoid prolonged hypotension [107]
Cognitive
Place clocks and calendars in the patient’s room to aid in temporal reorientation [3,7,8,13,55,62,76,81,94,119]
General reorientation [55,64,82,119]
Cognitive stimulation [7,44,76,81,94,119]
Read letters or books to the patient or show the patient family photographs [13,55]
Implement strategies to help the patient differentiate between day and night by, for example, showing them pictures of the sun or moon [7,55]
Use music [7,55]
Give the patient access to objects that will help them orient themselves [119]
Encourage reading, watching TV, and listening to music [7,55]
Place objects such as photographs where they are easily visible to the patient [55]
Avoid excessive perioperative and postoperative sedation [2]
Behavioural
Reduce preoperative anxiety [107]
Give psychosocial support [16]
Show concern and empathy; listen attentively [55]
Do not dismiss concerns expressed by the patient [107]
Offer realistic solutions and avoid threats [55]
Use open questions and try to discover the source of patient concerns
Be assertive; use sentences that are short and clear [107]
Use acupuncture and acupressure (at the “Shenmen” and “Point Zero” auricular acupuncture points) [107]

Sensory
Maintain a good level of illumination [7,13,55,62,70,76,79,94,119]
Facilitate the use of hearing aids at an early stage [3,7,33,55,62,69,76,79,102,119]
Facilitate the use of glasses [3,7,11,13,62,69,79,102]
Avoid excessive noise [3,7,33,55,81,95,119]
Facilitate the use of dentures [10,13,50]
Visual and auditory stimulation [76,81]
Avoid artificial lighting [81,82]
Sleep and Environment
Establish a daily routine in order to prevent disruption of the sleep–wake cycle [13,81,95]
Where possible, avoid the administration of medication or the taking of vital signs during the night [55,64,81]
Adjust routines in order to ensure uninterrupted sleep [119]
Back massage [46,119]
Enable the patient to obtain adequate rest [11,35]
Give the patient peace and quiet and maintain a pleasant environment (without unwanted noise or visits) [55,95]
Enquire as to whether the patient was already taking medication to aid sleep [119]
Allow a warm milky drink to be taken before sleep [46]
Provide warm drinks for the patient [119]
Family involvement
Involve the patient’s family [10,55,62,64,69]
Avoid changes in personnel [13,62,94]
Allow the family to be present at meal-times [7,55]
It may be necessary to require a family member or someone who is close to accompany the elderly patient [95]
Use carers’ names [119]
Patient Safety and Skin Integrity
Where possible, avoid mechanical restraints [2,16,55,64,79,81,95,119]
Promote early mobility [3,7,10,33,34,44,55,59,69,76,82,95]
Walking or directed exercise at least three times daily [7,55,76,119]
Protect the patient from falls [94]
Care of pressure points [2,94]

The numbers in the table refer to the reference numbers indicated in Table 6.