Providing Care Beyond Hospital; Perspective of a Tertiary Care Hospital from a Developing Country

Publication date: Available online 2 January 2016
Source:World Neurosurgery
Author(s): Saad Akhtar Khan, Muhammad Waqas, Badar Uddin Ujjan, Adnan Salim, Gohar Javed, Syed Ijlal Ahmed, Malikah Surani, Marium Khan
BackgroundNeuro-rehabilitation is an important aspect of continuing care for neurosurgical patients with functional disability. In developing countries, where formal home nursing is frequently unavailable, ensuring care after discharge is a difficult task. Training attendants to provide nursing care is an alternate option. In this study, we compared the outcomes of patients nursed by family members versus those looked after by professional nurse.MethodsThis was a retrospective observational study conducted at the Aga Khan University Hospital Karachi. The study consisted of two groups. Group 1 (consisted of patients cared for by professional nurse) included 94 patients and group 2(patients cared for by family members) included 102. All these patients had Activity of daily living (ADL) score of ≥ 3. Glasgow Outcomes Scale (GOS), time to decannulation, development/worsening of bedsores, and mortality were recorded and compared between the groups at follow up.ResultsThe study included 196 patients. Traumatic Brain Injury was the most common diagnosis. Nursing requirements were similar between the two groups and included tracheostomy care, PEG tube care, PICC line care, care of patients with no bone flap and logrolling. The outcomes of the two groups were comparable and included bedsore development/ worsening of grade, GOS at follow-up, time to decannulation and 30-day mortality.ConclusionsThere was no statistically significant difference in outcomes of patients nursed by family members when compared to the patients looked after by professional nurses.

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