Practice and Evaluation of Perioperative Care of Elderly People with Dementia by the Cooperation between Nurses and Families

在急诊科医院外科病房，我们考察了以下几点：1)护士与家属之间的痴呆患者入院信息共享，以及利用这些信息对医疗环境的调整；Ii)在住院期间利用家庭职能；Iii)在家过夜对谵妄发作时睡眠环境安排的影响。结果，与“住院”组相比，“呆在家里”组的谵妄症状消失的时间约为住院天数的一半。提示居家过夜对改善老年痴呆患者术后谵妄是有效的。此外，在护理人员与患者家属合作的基础上，通过护士与患者家属之间的信息共享，在实践和评估老年痴呆患者围手术期护理的过程中，开始对患者进行积极干预，减少患者家属的焦虑。接下来，我们分析和评估在实践中的护理计划的结果。然后，为了标准化，我们对许多老年痴呆患者住院接受手术和外科治疗的三家医院的外科/心血管病房的中高层护士和病房管理人员进行了访谈。访谈是在重点小组和个人中进行的。因此，作为正在接受手术的老年痴呆患者的围手术期护理，我们从以下三点为老年痴呆患者制定了标准化的围手术期护理方案：(1)术前护理，包括如何有效应对以及从迄今为止的生活信息中得出的对痴呆行为和心理症状的了解；(2)营造患者熟悉的环境和术后护理，通过家属的个人护理保障患者的舒适和安全；(3)护理干预，带来患者与家属舒适度的互动。今后有必要利用这一方案对老年痴呆患者进行围手术期护理。此外，还需要对计划进行评估和修改。少

In acute care hospital surgical wards, we examined the following points: i) the sharing of the information of the dementia patients from the admission between the nurses and the families, and the adjustment of the medical treatment environment utilizing the information; ii) taking advantage of the family function during the hospitalization; iii) the effect of staying at home overnight for the arrangement of sleep environment at the time of the onset of delirium. As a result, the delirium symptoms of the "stay at home" group disappeared in about half of the number of days of stay compared with the "hospitalization" group. It was suggested that staying at home overnight is effective for improving the postoperative delirium of elderly people with dementia. Furthermore, by sharing the patients' information between the nurses and the families while practicing and evaluating the perioperative care of the elderly people with dementia based on the cooperation of nurses and the families of the … More hospitalized patients, active intervention to the patients and anxiety reduction of the families were begun.Next, we analyzed and evaluated the results of the care plan that was in practice. Then, for the purpose of standardization, we conducted interviews with mid-level or upper-level nurses and ward administrators working in the surgical/cardiovascular wards of the threehospitals where many elderly people with dementia were hospitalized for operative and surgical treatment. The interviews were conducted in both focused groups and with individuals. As a result, as the perioperative care of the elderly people with dementia who were undergoing surgeries, we created a standardized plan of perioperative care for them based on the following three points:(1)Preoperative care, including how to respond effectively and understanding of behavioral and psychological symptoms of dementia derived from life information so far;(2)Creating an environment in which the patients are familiar with and post-operative care for protecting the comfort and safety of the patients by personal care provided by their families;(3)Nursing intervention which brings the interaction of comfort of the patients and their families. In the future, it is necessary to practice the perioperative care for the elderly people with dementia by taking advantage of this plan. Furthermore, it is also necessary to evaluate and modify the plan. Less