Objective To analyze the application effect of risk nursing based on failure mode and effect analysis (FMEA) theory in the management of delirium in elderly patients after heart valve replacement surgery.

Methods A total of 210 elderly patients undergoing coronary artery bypass grafting were included in the study, and were randomly divided into control group (n=105) and experimental group (n=105) using a random number table method. The control group received routine care, while the experimental group received risk care based on FMEA theory on the basis of the control group. The incidence of delirium, degree of pain before and after intervention, negative emotions, and sleep quality between the two groups were compared.

Results The incidence of postoperative delirium and 24 h postoperative pain score in the experimental group were lower than those in control group (P < 0.05). After intervention, the scores of Self-rating Anxiety Scale, Self-rating Depression Scale in the experimental groups were lower than those in control group (P < 0.05). After the intervention, the scores of sleep quality, sleep time, sleep efficiency, sleep disorders, use of hypnotic drugs, daytime function and total score of Pittsburgh Sleep quality index (PSQI) in experimental group were lower than those in the control group (P < 0.05).

Conclusion Risk nursing based on FMEA theory can reduce the incidence of delirium in elderly patients after coronary artery bypass grafting, relieve the degree of postoperative pain, improve negative emotions, and enhance the quality of sleep.