ABSTRACT
Introduction Formal prehospital emergency medical services cover only a small percent of the population in most low- and middle-income countries. Increasing the involvement of laypersons in prehospital first aid can be an important part of the response to injuries and other medical emergencies. We sought to understand factors associated with the willingness of laypersons in Ghana to provide first aid to road traffic crash victims. Method This cross-sectional study purposively sampled four crash-prone areas in the Ashanti Region and 385 participants were interviewed. A structured questionnaire was used to ask about their demographic characteristics, first aid knowledge, and perceptions about first aid. Factors affecting willingness to provide first aid were assessed using multivariable logistic regression. Results Most participants were male (57.7%) and young (median age 28 years). A large majority (82.9%) were willing to provide first aid to crash victims. However, only 43.1% had been trained in first aid and only 40.4% had adequate knowledge of first aid (≥ 70% correct). Factors associated with willingness to provide first aid included first aid knowledge (aOR 17.27 for moderate knowledge vs. low knowledge, p=0.018; aOR 13.63 for adequate knowledge vs. low knowledge, p=0.030) and positive attitudes towards first aid, including the feeling that: every person should be trained in first aid (aOR 2.98, p=0.025), first aid increases survival (aOR 2.79, p=0.046), it is important to learn first aid (aOR 2.40, p=0.005), and bystanders have the responsibility to give first aid (aOR 4.34, p<0.001). Conclusion A high percentage of people in these crash-prone areas of Ashanti Region, Ghana were willing to provide first aid. However, under half had been trained in first aid or had adequate knowledge of first aid. A major implication of these findings is the need to increase the availability of quality training in first aid in these areas.
Subject(s)
Humans , Wounds and Injuries , Adult , Prehospital Care , Advanced Trauma Life Support Care , Traffic Trauma CareABSTRACT
The use of paper for record keeping (or a manual system) has been the order of the day in almost all health care facilities in resource poor countries. This system has presented numerous challenges, which the use of Electronic Medical Records (EMR) seeks to address. The objectives of the study were to identify the facilitators and barriers to EMR implementation in Komfo Anokye Teaching Hospital's (KATH) Emergency Centre (EC) and to identify lessons learned. These will help in implementation of EMR in ECs in similar settings.Methods:This was a non-interventional,descriptive cross-sectional and purely qualitative study using a semi-structured interview guide for a study population of 24. The interviews were manually recorded and analysed thematically. EMR implementation was piloted in the EC. Some of the EC staff doubled as EMR personnel. An open source EMR was freely downloaded and customised to meet the needs of the EC. The EMR database created was a hybrid one comprising of digital bio-data of patients and scanned copies of their paper EC records.Results:The facilitators for utilising the system included providing training to staff, the availability of some logistics, and the commitment of staff. The project barriers were funding, full-time information technology expertise, and automatic data and power backups. It was observed that with the provision of adequate human and financial resources, the challenges were overcome and the adoption of the EMR improved.Discussion:The EMR has been a partial success. The facilitators identified in this study, namely training, provision of logistics, and staff commitment represent foundations to work from. The barriers identified could be addressed with additional funding, provision of information technology expertise, and data and power back up. It is acknowledged that lack of funding could substantially limit EMR implementation