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A major limitation in improving patient care has been the shortage of staff nurses. In the control phase
staff patient ratio was 1:3 , 1:4 which affected the delivery of quality care nursing, affecting the patient
outcome in terms of infection and mortality rate.
It is hypothesized that sudden influx of inexperienced nurses may be detrimental for patient care in the
short term especially in absence of structured training & mentorship program in place.
AIMS AND OBJECTIVES
To assess the effect of new joinees as staff nurses on patient care in neurosurgery ICU using infection
rate and mortality rate as the surrogate markers for nursing care.
MATERIALS AND METHODS
In this retro-prospective study in neurosurgery ICU over 6 months( Oct 2010- Mar 2011), the infection
rates (using blood, tracheal & urine culture reports) were calculated for a group of patients.
Hospital Mortality Rate and Gross Infection Rates in terms of tracheal, urine and blood cultures were
assessed . severity of head injury was also assessed as it can act as a ditermental factor affecting
Hospital mortality rate in control phase 18%, in training phase 16.4 % and final phase 15.3%
Gross infection rates: tracheal culture incidence in control phase 62.3%, traning phase 59.3%, final phase
22.3% . in terms of urine culture incidence control phase 48.9%, training phase 34.2%, final phase 12.6%
and for blood culture it was 24.9% in control phase, 14.5% in training phase and 4.2 in final phase.
There is significant decrease in mortality following introduction of 1:1 nursing in neurosurgery
The severity of head injury was approximately in the same range of all the phases hence it has
no significant role to play in the reduction of mortality rate.
Blood infection rate (4.25), tracheal infection rate (22.3%) & urine infection rate (12.6%) in the
final phase were significantly lower (p<0.001) than the preceding two phases
Structured programs and mentorship plays a vital role in improving the nursing practices .