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

在急诊医院外科病房中，我们考察了以下几个方面：(1)护士与家属从入院到治疗环境的信息共享，以及利用这些信息调整医疗环境；(2)住院期间利用家庭功能；(3)在精神错乱发生时呆在家里过夜对睡眠环境的安排的影响。结果，相比于住院天数的一半左右，“待在家里”组的神志不清症状消失了。提示呆在家中过夜对改善老年痴呆患者术后神志不清是有效的。此外，在护士和…家属的配合下，通过在实践和评估老年痴呆患者围手术期护理的同时，在护士和家属之间共享患者信息增加住院病人，对病人进行积极干预，减轻家属焦虑。其次，对实施的护理方案的效果进行分析和评价。然后，为了标准化的目的，我们对在外科/心血管病房工作的中高级护士和病房管理人员进行了访谈，这些医院是许多老年痴呆患者住院进行手术和外科治疗的地方。访谈是在两个重点小组和个人中进行的。因此，作为老年痴呆手术患者的围手术期护理，我们从以下三个方面为他们制定了标准化的围手术期护理计划：(1)术前护理，包括如何有效地应对和了解迄今为止生活信息衍生的痴呆患者的行为和心理症状；(2)创造患者熟悉的环境和术后护理，通过家属提供的个人护理来保护患者的舒适和安全；(3)护理干预，带来患者和家人之间的舒适互动。今后，有必要利用这一计划实践老年痴呆患者的围手术期护理。此外，还需要对计划进行评估和修改。较少

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