A nursing protocol targeting risk factors for reducing postoperative delirium in patients following coronary artery bypass grafting: Results of a prospective before-after study.

Not randomised. Control and intervention patients were from different calendar periods, so changes over time could explain part of the difference. Single ICU and only CABG patients, so results may not apply to other hospitals, wards or surgical groups. The intervention was a bundle of seven strategies plus usual care, so the effect of any one component cannot be separated. Baseline groups were not identical: the intervention group had more distal anastomoses, a difference in surgical complexity. Delirium was assessed for a maximum of seven postoperative days while the patient was in the ICU, so longer-term outcomes were not captured.

The authors declared no conflicts of interest. The study was funded by the Committee of Health and Family Planning of Shanghai, China.

Do not conclude that any single nursing action caused the lower delirium rate. The intervention was a bundle of seven strategies added to usual care, and the study was not randomised, so the contribution of each component cannot be separated.