Nurse practitioner-led bundled care reduces postoperative delirium, pain, and sleep disturbances, and shortens hospital stay in cardiac surgery patients.
In a randomized controlled trial of 100 cardiac surgery patients, nurse practitioner-led bundled care significantly reduced postoperative delirium on Day 2 (6% vs 32%, p=0.001), improved pain scores across Days 1-3 (F=72.18, p<0.001), and improved sleep quality across Days 2-4 (F=233.35, p<0.001). Total hospital stay was shorter (median 8 vs 10 days, p<0.001).
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Nurse practitioner-led bundled care reduces postoperative delirium, pain, and sleep disturbances, and shortens hospital stay in cardiac surgery patients. The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Nurse practitioner-led bundled care reduces postoperative delirium, pain, and sleep disturbances, and shortens hospital stay in cardiac surgery patients.
This conclusion is most relevant to: Adults undergoing elective coronary artery bypass graft, mitral valve replacement, or aortic valve replacement at a tertiary cardiac hospital in India..
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Effect of a Nurse Practitioner-Led Bundled Care on Postoperative Recovery in Cardiac Surgery Patients: A Randomized Controlled Trial. (Research in nursing & health, 2026) —
How It Works
The proposed biological pathway:
- ▸Preoperative orientation and cognitive reorientation reduce delirium risk factors
- ▸Early mobilization and family engagement enhance recovery and reduce complications
- ▸Relaxation and sleep promotion improve sleep quality and reduce pain perception
- ▸Result: Lower delirium, pain, and shorter hospital stay
Who Might Benefit
Evidence fit by population:
- ▸Adults undergoing elective coronary artery bypass graft, mitral valve replacement, or aortic valve replacement at a tertiary cardiac hospital in India.
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single-blinded design (outcome assessors blinded, but participants not blinded)
- ▸Post-test only design without baseline sleep or pain measures
- ▸Single-center study in a resource-constrained setting, limiting generalizability
Frequently Asked Questions
What is nurse practitioner-led bundled care?▼
It is a multicomponent intervention delivered by nurse practitioners, including preoperative orientation, early mobilization, cognitive reorientation, family engagement, relaxation, and sleep promotion.
How does this intervention affect postoperative delirium?▼
It significantly reduces delirium incidence on Day 2 (6% vs 32% in control, p=0.001).
Does this intervention improve sleep quality?▼
Yes, sleep quality measured by RCSQ was significantly better across Days 2-4 (p<0.001).
What is the impact on hospital length of stay?▼
Total hospital stay was reduced from median 10 days to 8 days (p<0.001).
References
- 1.Paul D, Kanagaraj P, Pappaiya P. “Effect of a Nurse Practitioner-Led Bundled Care on Postoperative Recovery in Cardiac Surgery Patients: A Randomized Controlled Trial..” Research in nursing & health, 2026. PMID: 42565486 DOI: 10.1002/nur.70117