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Journal of Nursing ›› 2019, Vol. 26 ›› Issue (7): 34-39.doi: 10.16460/j.issn1008-9969.2019.07.034

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Evidence Summary of Preoperative Evaluation and Management of Older Patients with Frailty

YANG Ji-pinga, SHI Ze-yab, ZHOU Yi-fenga, CHEN Chengc, YIN Shu-huid, YUAN Haoe   

  1. a. Dept. of Operating Room; b. Dept. Nursing Administration; c. Dept. of Nephrology; d. Dept. of Pediatrics; e. Dept. of Laboratory Medicine, Hunan Provincial People’s Hospital, Hunan Normal University, Changsha 410005, China
  • Received:2019-02-25 Published:2020-07-14

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Abstract: Objective To search and obtain relevant evidences of preoperative evaluation and management of older patients with frailty, to provide references for their preoperative evaluation, and to reduce the surgical complication risk. Methods Operation risk for older frailty patients was assessed and guidelines, evidence summary (ES), best practice information sheet (BPIS), recommended practices (RP), system evaluation (SR) of preoperative evaluation on preoperative assessment of older patients with frailty were searched in medical databases at home and abroad. JBI evidence-based nursing practice model was used to screen the literatures, and 2 researchers evaluated the literatures quality and extracted the evidence independently. Results Fourteen articles including 7 guidelines,2 expert consensus and 5 systematic reviews were identified and 32 evidences of preoperative evaluation and management of older patients with frailty were summarized. Clinical experts made professional judgments on evidences by employing FAME principle, and developed review indicators to guide pre-operative assessment and management of older patients with frailty. Preoperative evaluation included frailty, consciousness, activity function and related complications for older patients with frailty. Patients' physiological function, condition disease management, exercise, medication, nutrition, and mobility should be improved according to the evaluation results. Conclusion Medical staff should update the latest best evidences for preoperative assessment of older frailty patient and evidences should be employed based on clinical context, existing medical environment, facilitating factors and obstacles of the applied evidence, patient's intention and preference. The preoperative evaluation of evidence-based scientific nursing methods is conducive to improving preoperative physical incapacity of patients with frailty, enhance their ability to cope with surgery and related injury stressors, and reduce related surgery risk.

Key words: geriatric, frailty, preoperative evaluation, surgery risk, postoperative complications

CLC Number: 

  • R473.59
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