Nursing diagnoses and interventions in the care of elderly patients undergoing surgery

SUMMARY

Aim: The aim of this study was to determine nursing diagnoses and interventions in the care plans of elderly patients undergoing surgery.

Methods: This descriptive and retrospective study was conducted with the files of 129 elderly patients undergoing surgery in a university hospital in Turkey. Data were collected using a questionnaire and nursing care plans. Frequency and percentage calculations were used to evaluate the data.

Results: The mean age of hospitalized patients was 72.8±5.8 years; 28.7% of patients were hospitalized at a general surgery clinic and 51.9% were male. Nurses had been using 14 nursing diagnoses and 171 different nursing interventions while planning their care of elderly patients undergoing surgery. The most frequently used nursing diagnoses were falling risk, infection and hypertension.

Conclusion: Nurses use limited diagnoses and standard interventions to plan the care of elderly surgical patients.

Keywords:

• elderly
• nursing care plan
• nursing diagnoses
• nursing interventions
• surgery

Key issues

• Compared with younger patients, older patients have longer and more frequent hospitalizations and the percentage of geriatric surgeries are increasing.

• There is no national nursing diagnosis classification in Turkey.

• Nurses use limited nursing diagnoses and standard nursing interventions while caring for elderly surgical patients in Turkey.

• A total of 100 elderly patient files were obtained and nursing diagnoses and interventions recorded.

• Only 14 of 74 possible nursing diagnoses were used by nurses for the care of elderly patients undergoing surgery. The nursing diagnoses used most frequently included falling risk, infection risk, high arterial blood pressure, constipation, impaired skin integrity and self-care deficit (100%, 15%, 12%, 4%, 3%, 2%, respectively)

Expert commentary and 5-year view

As population ages, demand for the good health care is increasing among the elderly, and percentage of geriatric surgeries is increasing due to functional disorders, chronic diseases, etc. Nurses, as part of the interdisciplinary team, have a pivotal role as providers of care for older people and are in a unique position to influence the quality of care. Nursing classification systems are important for increasing the quality of care and for establishing nursing care plans in the care of elderly patients undergoing surgery. However, hospitals develop their own nursing care plans because there is no national nursing diagnosis classification in Turkey. There has recently been a new international trend in the use of nursing diagnoses, but their use is limited to those in the education field and a few private and state hospitals in our country.

In the next 5 years, nurses and nurse managers will revise their standard nursing care plans or will use with international classifications for nursing practices. Using nursing diagnoses will allow for a better description of a patient’s actual situation and will provide a better basis for decisions about adequate interventions. In addition, the nurses’ workload will be reduced in this way and, consequently, the quality of nursing care of elderly people will increase.

Financial & competing interests disclosure

This study was presented as poster presentation at 8th Congress of the EUGMS, 26-28 September 2012, Brussels/Belgium. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.