Omaha System-Based Extended Nursing Care in Hypertensive Cerebral Hemorrhage: A Randomized Study

Abstract

BACKGROUND: Traditional nursing care often fails to meet the complex needs of hypertensive cerebral hemorrhage patients. Limited evidence exists on the efficacy of structured nursing frameworks such as the Omaha System in postoperative care for these patients. OBJECTIVE: This study aims to evaluate the efficacy of Omaha-based extended nursing care in improving patients’ outcomes. METHODS: This randomized controlled trial included 53 patients with hypertensive cerebral hemorrhage admitted to the neurosurgical department of a large tertiary hospital in Chengdu, China, from March to September 2023. Participants were randomly assigned to either the traditional nursing care (n = 26) or the Omaha-based nursing care in addition to the traditional nursing care (n = 27). Outcomes included self-health management abilities, anxiety and depression levels, quality-of-life, and functional independence. Data were collected before nursing care and 1- and 3-months post-nursing care. RESULTS: Omaha-based nursing care demonstrated improvements in self-health management abilities, with cognition scores increasing from a baseline of 31.65 (4.37) to 57.32 (5.11) at 3-months (mean difference: 25.67, 95%CI [23.45, 27.89], p = .01). Anxiety levels decreased in the Omaha-based nursing group, with SAS scores reducing from 45.71 (3.48) to 28.26 (2.74) at 3-months (mean difference: −17.45, 95% CI [−19.02, −15.88], p < .01). Quality-of-life scores improved in the Omaha-based nursing group, increasing from 6.3 (1.2) to 7.9 (0.9) at 3-months (mean difference: 1.6, 95% CI [1.12, 2.08], p = .03). Functional independence scores were also higher in the Omaha-based nursing group at 3-months (mean difference: 9.2, 95% CI [6.11, 12.29], p = .03). CONCLUSION: Our findings support the integration of the Omaha System into postoperative care protocols for this patient population. However, further validation is warranted by larger trials.