| Project/Area Number |
16390626
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Fundamental nursing
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| Research Institution | Aino University |
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Principal Investigator |
WATANUKI Shigeaki Aino University, Faculty of Nursing and Rehabilitation, Associate Professor (20270902)
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| Co-Investigator(Kenkyū-buntansha) |
YANO Masako 藍野大学, 医療保健学部, Dean and Professor (00251215)
KANDA Katsuya University of Tokyo, Graduate School of Medicine, Professor (20143422)
SAKAI Ikuko Chiba University, Graduate School of Nursing, Associate Professor (10197767)
OHMACHI Yayoi Aino University, Faculty of Nursing and Rehabilitation, Professor (90269770)
武村 雪絵 東京大学, 大学院・医学系研究科, 助手 (70361467)
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| Project Period (FY) |
2004 – 2006
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| Project Status |
Completed (Fiscal Year 2006)
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| Budget Amount *help |
¥13,500,000 (Direct Cost: ¥13,500,000)
Fiscal Year 2006: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2005: ¥5,600,000 (Direct Cost: ¥5,600,000)
Fiscal Year 2004: ¥6,000,000 (Direct Cost: ¥6,000,000)
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| Keywords | elderly persons / delirium / fall / physical restraint / safety device / organizational culture / 組織文化 / 転倒 / 転落 / 北欧 / 北米 |
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| Research Abstract |
This study aimed at identifying association between postoperative delirium incidence among adult and elderly patients, patient risk factors and events, use of safety device, and nurses' organizational culture at a university hospital in an urban area.
1) Risk factors of delirium : A total of 109 patients (mean age=61.0 years) who underwent gastrointestinal or urinary surgery under general anesthesia participated the study. They were screened daily by the NEECHAM Confusion Scale. Five had postoperative delirium>=3 days (Group A) ; 19 had delirium<3 days (Group B) ; 85 had no delirium (Group C). Group A experienced significantly frequent self-removal of tubes, abrupt physiological changes, additional medical treatment, and use of fall prevention measures than other groups. These predictors and correlates can be used to predict early signs of delirium.
2) Nurses' assessment and interventions for delirium prevention and management : A total of 37 nurses (mean age=29.7 years, years of experie
… More
nce=6.1) participated the study. The investigators obtained textual data from chart review and nurse interview. Qualitative analysis yielded 708 "scenes," including 179 sets of documented patient conditions, nurses' assessment and interventions. The results indicated a tendency toward nurses' frequent use of safety measures and medications as compared to controlling pain or discomfort, or meeting patient basic needs. Effective use of communication with patients and other health care professionals was also warranted for quality of patient care.
3) Analyses of a series of case review sessions run by nurses at the hospital showed that the following activities contributed to the empowerment of nurses and fostered their positive attitude toward delirium care : improving care delivery system through inter-professional collaboration ; shifting nurses' mindset from task-oriented to patient-oriented care; educating nurses in improving their physical assessment skills and in providing comfort-focused care ; improving assessment and clinical judgment skills in predicting delirium onset or its early signs. Less
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