The effect of a nurse-led multicomponent intervention on sleep quality and delirium in orthopedic surgery patients: A randomized clinical trial.

BACKGROUND: Sleep disturbances and postoperative delirium (POD) impair recovery and adversely affect cognitive and physical outcomes among orthopedic trauma patients. OBJECTIVE: This study aimed to evaluate the effects of a nurse-led multicomponent intervention on POD, sleep quality, and quality measures among orthopedic surgical patients. METHOD: This double-blind randomized clinical trial was conducted on 96 orthopedic surgical patients who were assigned into intervention (n=48) and control (n=48) groups using stratified block randomization. The intervention group received a multicomponent care program including multimodal pharmacological pain management, music therapy, inspiratory muscle training (IMT), and a structured sleep enhancement protocol, initiated 24 hours before surgery and continued for 48 hours postoperatively. The control group received standard care. Sleep quality and POD were assessed using the richards-campbell sleep questionnaire (RCSQ) and the confusion assessment method (CAM), respectively. The data on length of hospital stay and 30-day mortality were collected through electronic health records and self-reports. RESULTS: The mean total sleep quality score and its subscales were significantly higher in the intervention group compared to the control group (P 0.05). CONCLUSION: Results show, a perioperative multicomponent nurse-led intervention can effectively enhance sleep quality and reduce the length of hospital stay among orthopedic surgical patients. Nevertheless, it did not show a significant effect on delirium incidence or short-term mortality.