Studies have indicated that successful integration of the traumatized patient is possible, provided that an early intensive care is succeeded by a comprehensive, individualized post-acute rehabilitation program, of which follow-up is a part, all within the frame of multidisciplinary collaboration 2).
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.
A retrospective observational study conducted at the Aga Khan University Hospital Karachi 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.
The 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.
There was no statistically significant difference in outcomes of patients nursed by family members when compared to the patients looked after by professional nurses 3).