Application of a Risk Assessment-Based Stratified Early Warning Nursing Model to Prevent Postoperative Delirium in Geriatric Patients Undergoing Orthopedic Surgery

AIM: To investigate the effectiveness of a risk assessment-based stratified early warning nursing model in preventing postoperative delirium (POD) in geriatric orthopedic patients. METHODS: A retrospective study was conducted. Elderly patients who underwent elective orthopedic surgery at The First Hospital of Jilin University between January 2024 and December 2025 were enrolled. Based on the nursing model received, patients were divided into two groups: those receiving routine care were assigned to the control group (98 patients), while those receiving the risk assessment-based stratified early warning nursing model were assigned to the intervention group (113 patients). In the intervention group, a delirium risk assessment tool was used for preoperative risk stratification (low, moderate, and high risk), and graded early warning measures and targeted interventions were implemented according to the risk level. The incidence of postoperative delirium, delirium duration, length of hospital stay, and nursing satisfaction were compared between the two groups. RESULTS: The incidence of postoperative delirium was significantly lower in the intervention group than in the control group (9.73% vs. 19.39%, p = 0.045). The intervention group also had a shorter median delirium duration (3.0 d vs. 5.0 d, p = 0.005), a shorter mean length of hospital stay (12.18 ± 2.60 d vs. 16.48 ± 3.13 d, p < 0.001), and a higher nursing satisfaction rate (96.46% vs. 85.71%, p = 0.032). CONCLUSIONS: The risk assessment-based stratified early warning nursing model may reduce the incidence of postoperative delirium in geriatric orthopedic patients, shorten delirium duration and hospital stay, and improve nursing satisfaction, highlighting its potential clinical value.