Surgical Nurses’ Role in Preventing Postoperative Delirium in Elderly Patients Undergoing Surgery

Background: Postoperative delirium (POD) commonly affects elderly patients (>65 years), leading to longer hospital stays, increased mortality, and higher healthcare costs. While surgical nurses play a vital role in POD prevention through risk assessment, non-pharmacological strategies, and environmental improvements, their efforts are often limited by inadequate training and resources. Aim: This study aimed to assess surgical nurses’ knowledge, attitudes, and practices regarding POD prevention in elderly patients and examine the relationship between protocol adherence and POD incidence. Methodology: A descriptive quantitative study was conducted at a tertiary hospital in Swat. Sixty surgical nurses completed structured questionnaires, and medical records of 100 elderly surgical patients were reviewed using the confusion assessment method (CAM). Data were analyzed using the Statistical Package for the Social Sciences (SPSS) v27, including descriptive statistics and chi-square tests. Results: Ninety percent of nurses recognized sedation reduction as helpful, and 85% supported early mobilization. However, only 60% routinely implemented cognitive orientation strategies. Although 92% had positive attitudes, only 40% felt adequately trained. The overall POD incidence was 20%. Notably, nurses with high adherence to preventive protocols had significantly lower POD rates (only 8%). Conclusion: Surgical nurses possess good knowledge and strong motivation to prevent POD, but gaps in consistent practice remain. Strengthening training, especially in cognitive orientation and reinforcing adherence to evidence-based protocols, is essential for improving outcomes in elderly postoperative patients.