Impact of Non-pharmacological Nursing Measures to Reduce Postoperative Delirium in Frail Elderly Undergoing Elective Non-cardiac Surgery

What this Trial Is About

This research aims to evaluate the effect of non-drug measures applied by nursing teams to reduce the risk of postoperative delirium (POD) in frail and pre-frail elderly people over 65 years old who undergo elective non-cardiac surgery. Frailty increases the risk of postoperative complications, including delirium, which can worsen recovery and increase mortality. The study addresses a gap in routine frailty assessment and seeks to improve outcomes by applying targeted nursing interventions during the post-surgical period. Participants will be randomly assigned to one of two groups: one group will receive a set of non-pharmacological interventions delivered by the nursing team, including sensory correction (use of glasses, hearing aids, dental prostheses), reorientation, early mobilization, environmental management, sleep promotion, and reduction of anticholinergic drugs. The other group will receive traditional postoperative care. Both groups will be monitored during surgery with electroencephalographic tools to guide anesthesia and maintain stable blood pressure and temperature. During the postoperative period, participants will undergo cognitive and delirium assessments at multiple time points up to 24 hours after anesthesia. The nursing team will apply cognitive stimulation and mobilization activities, coordinate visits, and monitor sleep. Delirium evaluations will be performed independently by staff not involved in the interventions. If delirium is detected, further geriatric consultation and care adjustments will be made. The study measures postoperative delirium incidence as the primary outcome, with additional cognitive and frailty assessments before surgery and monitoring of anesthesia and pain levels after surgery.

Non-pharmacological Prevention of POD in Frailty Elderly Undergoing Elective Surgery Applied by Nursing Teams