Neurosurgical speciality nursing training for neurosurgical facilities in West Africa: A pivotal, prospective single – Hospital study in Nigeria

Abstract

Background: The diversity of medical and surgical specialities unequivocally places a great demand for continuing subspecialisation within nursing services for safe and efficient patient care, especially in tertiary institutions. Although orthopaedic, psychiatric, obstetrics, intensive care and ophthalmic nursing are established, neurosurgical nursing is almost unknown in West Africa. Aim: The aim of this study is to document the indigenous training of dedicated subspeciality nursing staff for neurosurgical facilities in West Africa using a simple, reproducible design. Study Design/Setting: A prospective observational study of the effect of specialised neurosurgical nursing care on the volume and outcomes of patient care in a new neurosurgical unit in a tertiary hospital in Nigeria. Methods: Twenty-six nurses (from nursing officer II to chief nursing officer cadres) were selected from various hospital units for training in neurosurgical nursing. None had previous exposure to neurosurgery, although they had between them 6 months to 30 years of nursing experience in tertiary institutions. They received structured training in neurosurgical patient care. Results: Over 13 years, we established a fully dedicated neurosurgical facility with 30 speciality nurses and other in-house staff. The pre- and post-training tests showed significant gain in the knowledge of basic neurosciences and neurosurgical patient care. Yearly re-training showed similar results. The increase in numbers of in-patient admissions and operations, as well as reduction in mortality, underscored improved patient care. Conclusion: Subspeciality training of dedicated nurses in neurosurgical care facilitates the rapid growth of new neurosurgical units, facilitates nursing expertise and improves outcomes of patient care when compared with the lack of neurosurgical training for nurses.