The Impact of Recorded Music on Postoperative Delirium in Older Adults After Hip Fracture Surgery ( IPOD ): A Quasi‐Experimental Study

Background Hip fractures often lead to postoperative delirium in older adults, significantly impacting recovery, hospitalization, and nursing workload. While many delirium cases are preventable, implementation of non‐pharmacological strategies remains inconsistent. Music has emerged as a safe, effective, and low‐cost complementary strategy to prevent delirium by targeting its underlying mechanisms. However, evidence in hip fracture patients remains limited. This study evaluated whether a nurse‐led recorded music intervention could reduce the prevalence and influence the course of postoperative delirium, while ensuring practical feasibility. Secondary outcomes included postoperative pain, opioid use, and length of stay (LOS). Methods In this quasi‐experimental study, usual care was compared with the addition of a music intervention comprising twice‐daily, 30‐min sessions of self‐selected music over 5 postoperative days. Cognitively adequate patients aged 65 or older were assessed for postoperative delirium using the Delirium Observation Scale (DOS). Differences in postoperative pain, measured by the Numerical Rating Scale, were analyzed both between groups and within the intervention group. Results A total of 74 participants were included across control and intervention groups. Statistical power was achieved, and confounders were balanced between groups. Music adherence was 53.13%, with missed sessions approximately equally due to patient refusal and nurse non‐administration. DOS scores decreased significantly, especially on postoperative Day 2. Although delirium prevalence was halved in the intervention group, this did not reach statistical significance. No significant differences were found in LOS, opioid use, or postoperative pain between groups, however, a significant decrease in pain was observed within the intervention group. Conclusions Music influenced the course of postoperative delirium by reducing its intensity and lowered postoperative pain within the intervention group. Future research should build on these findings by implementing a 30‐min, once‐daily music intervention during the first 3 postoperative days.