{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:12:54Z","timestamp":1786122774541,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp;amp; Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Postoperative delirium, pain, and sleep disturbances prolong recovery after cardiac surgery. Evidence for multicomponent, nurse practitioner\u2013led interventions is limited, especially in resource\u2010constrained settings. This study evaluated their effect on delirium, pain, sleep quality, and hospital stay. In a single\u2010blinded, post\u2010test only RCT at a tertiary cardiac hospital in India, 100 adults undergoing elective coronary artery bypass graft, mitral valve replacement, or aortic valve replacement were randomized to nurse practitioner\u2013led bundled care (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950) or routine care (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950). The intervention included preoperative orientation, early mobilization, cognitive reorientation, family engagement, relaxation, and sleep promotion. Outcomes\u2010delirium (CAM\u2010ICU), pain (VAS), and sleep quality (RCSQ) and length of stay were analyzed using chi\u2010square\/Fisher's exact tests, repeated\u2010measures ANOVA, GLM, and Mann\u2013Whitney\n                    <jats:italic>U<\/jats:italic>\n                    tests. All 100 participants completed the study (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200950 per group) with comparable baseline demographics and clinical profiles. The intervention group showed significantly lower postoperative delirium (Day 2: 6% vs. 32%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001; GLM group\u2009\u00d7\u2009time interaction\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009), reduced pain scores across Days 1\u20133 (F\n                    <jats:sub>1,98<\/jats:sub>\n                    \u2009=\u200972.18,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and improved sleep quality across Days 2\u20134 (F\n                    <jats:sub>1,98<\/jats:sub>\n                    \u2009=\u2009233.35,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001; group\u2009\u00d7\u2009time interaction\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) compared with controls. Recovery was faster, with shorter ICU stay (median 3 vs. 3\u20134 days,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.006), ward stay (5 vs. 6 days,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002), and total hospital stay (8 vs. 10 days,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Nurse practitioner\u2013led bundled care reduces delirium, improves pain and sleep, and shortens recovery, providing a feasible, low\u2010cost approach for cardiac surgery patients.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    CTRI\/2023\/06\/054180 Dated 6\/19\/2023\n                  <\/jats:p>","DOI":"10.1002\/nur.70117","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:59:24Z","timestamp":1786103964000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Nurse Practitioner\u2013Led Bundled Care on Postoperative Recovery in Cardiac Surgery Patients: A Randomized Controlled Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4590-6715","authenticated-orcid":false,"given":"Debajyoti","family":"Paul","sequence":"first","affiliation":[{"name":"Narayana Institute of Cardiac Sciences, Narayana Health City Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-4511","authenticated-orcid":false,"given":"Puvaneswari","family":"Kanagaraj","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Applied Medical Sciences University of Bisha Bisha Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8631-8471","authenticated-orcid":false,"given":"Padmapriya","family":"Pappaiya","sequence":"additional","affiliation":[{"name":"Narayana Hrudayalaya College of Nursing, Narayana Health City Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12741"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.4274\/TJAR.2023.231477"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2024.10.006"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.21470\/1678-9741-2021-0140"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2015.06.028"},{"key":"e_1_2_15_7_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/978-1-61779-579-4_10","volume-title":"Integrative Therapies in Lung Health and Sleep","author":"Casida J.","year":"2012"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2013.07.002"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.21.2703"},{"issue":"1","key":"e_1_2_15_10_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/JAD-189004","article-title":"Recommendations for the Nomenclature of Cognitive Change Associated With Anaesthesia and Surgery\u20142018","volume":"66","author":"Evered L.","year":"2018","journal-title":"Journal of Alzheimer's Disease"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.7779"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0855-3"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/6894693"},{"key":"e_1_2_15_14_1","volume-title":"StatPearls","author":"Janjua M. 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