Development of a Nursing Care Model to Prevent Emergence Delirium in Preschool Children

Abstract

This mixed-methods research and development (R&D) study aimed to explore the situational context, and develop and evaluate the effectiveness of a nursing model for preventing emergence delirium (ED) in preschool children. The study was conducted between January 2025 and February 2026. The participants consisted of 55 nurse anesthetists, 84 preschool patients, and 84 parents. Data were analyzed using descriptive statistics, independent t-tests, Mann-Whitney U tests, Chi-square tests, and Fisher’s exact tests. The research process, instruments, and findings across the four phases were as follows:  Phase 1: Situational Analysis, data was collected via a focus group discussion guide and revealed that existing nursing practices were diverse and lacked specificity for preventing ED. Phase 2: Model Development:  the experimental instrument, a nursing model covering all phases of anesthesia, was developed by integrating Soukup’s evidence-based practice model, nurse anesthesia standards, and Piaget’s cognitive development theory. Phase 3: Implementation and Refinement: the developed model demonstrated the highest level of clinical feasibility for practical application. Phase 4: Outcomes Evaluation: data were collected using an ED assessment tool, pain assessment tool, model compliance evaluation, and parents' anxiety and satisfaction questionnaires. The findings indicated that, after implementation, the incidence and severity of ED significantly decreased. Nurse anesthetists reported very high levels of compliance and satisfaction, while parents exhibited lower levels of anxiety and higher levels of satisfaction.

Conclusion: This nursing model possesses high clinical quality and effectively reduces the incidence of ED. It should be implemented to elevate the standard of pediatric patient care within the Nurse Anesthesia Department.