The prognosis of unknown and unattended during the hospital stay in neuro-surgical department,JPNATC,AIIMS and the problem faced during nursing care.

Anu Susan Mathew,Dr.Deepak AgrawalJPN Apex Trauma Center,A.I.I.M.S,New Delhi

INTRODUCTION

New Delhi

huge floating population

Accidents

7,516 road traffic accidents( 2009)

In hospitals

Many admitted as unknown and unattended

AIMS AND OBJECTIVES

Assess

Morbidity and mortality

Nursing problems faced

during hospital stay

MATERIALS AND METHODS

Retrospective analysis

Departmental case records

Computerized patient record system

January 2010 to December 2010

Analyse the problems faced by

nursing personnel

OBSERVATIONS

Number of patients for

study : 111

M/F :105/6

<18 : 7%(7)

>18 : 93%(104)

Unknown /Unattended : 95/16

86%

Average hospital stay in days

Unknown :13(1-101)

Index case : 368 days

Unattended : 21(7-120)

Mean GCS of unknown and unattended

Unknown Unattended

Admission Who D/S later 9(3-15) 12(13-15)

Who expired later 6(3-15) 8(3-15)

Discharge 13(1-15) 14(3-15)

Unknown Unattended

Went to home 42(44%) 4(25%)

Shifted to rehabilitation centre 24(25%) 10(63%)

Expired 29(31%) 2(12%)

Disposition of Unknown and Unattended

Unknown (95)

Became known : 66(69%)

Remained Unknown : 29(31%)

Unknown who became known : 66(69%)

D/S to home : 42(64%)

Shifted to rehab : 14(21%)

Expired :10(15%)

21%

Remained unknown : 29(31%)

Shifted to rehab : 10(34%)

Expired : 19 (66%)

34%

66%

In Pediatric age group (7)

Became known : 4 (57%)

Remained unknown: 3 (43%)

shifted to rehab : 1 (MR)

Expired : 2

43%

57%

A case of my study after shifted to rehabilitation

centre

During hospital stayAfter discharge

The nursing problems faced during care

VAP :19(20%)

Pressure sores : 8(8%)

Contractures :7(7%)

UTI :7(7%)

Corneal ulcers :4(4%)

Aspiration :2(2%)

CONCLUSION

Unique problem

Managing is difficult

Occupy hospital bed for long term

Require more nursing care

with higher mortality and morbidity

In spite of advancements in the field

of mass communication

almost 31% of the unknown

remain unidentified.

The prognosis of unattended is better

compared to unknown.

Review of Literature

Outcome of "unknown" head injury patients at a tertiary care

neurosurgical centre

Faiz Uddin Ahmad, Ashok Kumar Mahapatra, Veer Singh Mehta

Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi