Patient-related Effects of Primary Nursing

Inclusion Criteria: * All patients are included who are at least 65 years old, * understand German language, * whose health insurance company has concluded a quality contract with the Heart and Diabetes Center NRW (HDZ NRW), * Elective thoracic and cardiovascular surgery, * Intensive care for at least three days on ICU. Relatives: * at least 18 years old, * patients have to receive PP. Focus group interview with nurses of the intervention-ICU: * Nurses have to be at least 18 years old, * Nurses belong the the intervention-ICU. Exclusion Criteria: Patients who * are \< 65 years old, * whose health insurance company has not concluded a quality contract with the HDZ NRW, * cannot be admitted due to allocation by randomization and a lack of free bed on the destination ICU, * have not given their informed consent, * cannot participate in the CAM-ICU screening due to neurological diseases, * in whom the screening using CAM-ICU could not be carried out over the entire intensive care stay and/or * belong to the target group but stay less than three days after their elective operation in the ICU. Relatives: * not at least 18 years old and/or * the patients do not receive PP. Focus group interview with nurses of the intervention-ICU: * Nurses who are not at least 18 years old and * Nurses do not belong to the intervention-ICU.