Owing to the particularities of their physical characteristics, older patients undergoing surgery under general anesthesia experience great surgical traumas. Thus, exploring more refined and individualized nursing approaches is an urgent need to mitigate the negative effects of surgery on such patients.

To analyze the influence of preoperative comprehensive education on anxiety, depression, pain, and sleep in older patients who underwent surgery under general anesthesia.

In total, 163 older adults who underwent surgery under general anesthesia between June 2022 and November 2023 were selected, 77 of them received routine nursing care (control group), and 86 received preoperative comprehensive education (research group). Subsequently, comparative analyses were performed from the following perspectives: Surgical indicators (operation time, time to complete regain of consciousness, and temperature immediately after the procedure and upon recovery from anesthesia) before and after nursing care; negative emotions [self-rating anxiety scale (SAS)/self-rating depression scale (SDS)]; pain severity [visual analog scale (VAS)]; sleep quality [Pittsburgh sleep quality index (PSQI)]; incidence of sleep disturbances (difficulties in falling asleep for the first time, falling asleep again after waking up frequently at night, falling asleep again after waking up early, and falling asleep all night); and incidence of adverse events (airway obstruction, catheter detachment, aspiration, and asphyxia).

The research group had significantly lower operation time and time to complete regain of consciousness than the control group after nursing care and markedly better recovery of postoperative body temperature and body temperature at awakening. In addition, more notable decreases in SAS, SDS, VAS, and PSQI scores were observed in the research group than in the control group. Furthermore, the incidence rate of sleep disturbance (8.14% vs 29.87%) and adverse events (4.65% vs 19.48%) were lower in the research group than in the control group.

Preoperative comprehensive education in older patients who underwent surgery under general anesthesia can improve postoperative indicators, effectively reduce the occurrence of anxiety and depression, alleviate postoperative pain, and improve sleep quality.

Managing nutrition in critically ill patients involves many medical fields. However, the nutrition management of critically ill patients has not been comprehensive enough to achieve multidisciplinary team cooperation in China and many other countries. Furthermore, there is no standardized management model or process.

To explore the multidisciplinary cooperative nutrition management model for critically ill patients in the ICUs in China, verify its clinical effect and provide a clinical practice reference for the nutrition management of critically ill patients.

A multidisciplinary cooperative nutrition management team, including ICU doctors, ICU nurses, clinical nutritionists, clinical pharmacists and radiologists, was established for critically ill patients. According to a literature review and domestic guidelines, the standardized process of nutritional management for critically ill patients was constructed through the Delphi expert consultation method. One hundred thirty-two patients in the ICU were randomly divided into an experimental group and a control group. A routine nutrition management mode, which was the nutrition management plan mainly formulated by the ICU doctor in charge only and the ICU nurses responsible for the implementation and monitoring of nutrition support, was implemented in the control group. And a multidisciplinary nutrition management mode, which was the nutrition management implemented by the multidisciplinary teams with the standardized nutrition management process for critically ill patients, was adopted in the experimental group. The early nutritional support rate, nutritional indexes (serum albumin, preprotein, haemoglobin and hs-CPR), mechanical ventilation time, ICU hospitalization days and hospitalization expenses of the two groups were compared.

The early nutritional support rates of the experimental group and the control group were 89.39% and 69.7%, respectively (χ2  = .002, p = .031). Serum albumin (35.4 vs. 33.1 g/L), preprotein (153.2 vs. 125.9 mg/L) and haemoglobin (97.5 vs. 90.6 g/L) in the experimental group were significantly higher than in the control group (p = .000, .016, .033). The days of hospitalization in the ICU of the experimental group were shorter than in the control group (5.1 vs. 7.1, p = .039). High-sensitivity C-reactive protein, the days of mechanical ventilation and ICU hospitalization expenses of the experimental group were lower than in the control group; however, the difference was not statistically significant (p = .713, .068, .489).

Because of the severity and complexity of patients' diseases, it is necessary to implement multidisciplinary nutrition management for critically ill patients. Research shows that the multidisciplinary nutrition management standardized process for critically ill patients that was constructed in this study can effectively improve nutritional indexes such as serum albumin, preprotein and haemoglobin, shorten the length of stay in the ICU and promote the rehabilitation of patients, and this process be widely used in the clinic.

Structured multidisciplinary nutrition management operational processes can guide clinical practice. They could be widely used in the clinical nutrition management of critically ill patients in critical care units or other departments.