Factors influencing willingness to intervene as bystanders among adult residents living in crash-prone areas in the Ashanti region of Ghana

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.

COVID-19 pandemic and dental practice in Ghana

With the advent of the COVID-19 pandemic, healthcare systems and their provision of care has globally been challenged, including the delivery of Oral healthcare. In Ghana, it has become imperative that healthcare delivery including the practice of Dentistry and its sub-specialties be re-oriented in our peculiar setting to ensure minimal risk of spread of the infection. This article discusses the impact of COVID-19 on the practice of Dentistry in the country

Barriers and facilitators to Electronic Medical Records usage in the Emergency Centre at Komfo Anokye Teaching Hospital, Kumasi-Ghana

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

The implementation of the South African Triage Score (SATS) in an urban teaching hospital, Ghana

Introduction:Triage is the process of sorting patients based on the level of acuity to ensure the most severely injured and ill patients receive timely care before their condition worsens. The South African Triage Scale (SATS) was developed out of a need for an accurate and objective measure of urgency based on physiological parameters and clinical discriminators that is easily implemented in low resource settings. SATS was introduced in the emergency center (EC) of Komfo Anokye Teaching Hospital (KATH) in January 2010. This study seeks to evaluate the accurate use of the SATS by nurses at KATH.Methods:This cross-sectional study was conducted in the EC at KATH in Kumasi; Ghana. Patients 12years and over with complete triage information were included in this study. Each component of SATS was calculated (i.e. for heart rate of 41-50; a score of 1 was given) and summed. This score was compared to the original triage score. When scores did not equate; the entire triage record was reviewed by an emergency physician and an advanced practice emergency nurse separately to determine if the triage was appropriate. These reviews were compared and consensus reached. Results :52 of 903 adult patients (5.8) were judged to have been mis-triaged by expert review; 49 under-triaged (sent to a zone that corresponded to a lower acuity level than they should have been; based on their vital signs) and 3 over-triaged. Of the 49 patients who were under-triaged; 34 were under-triaged by one category and 7 by two categories.Conclusion:Under-triage is a concern to patient care and safety; and while the under-triage rate of 5.7 in this sample falls within the 5-10 range considered unavoidable by the American College of Surgeons Committee on Trauma; concentrated efforts to regularly train triage nurses to ensure no patients are under-triaged have been undertaken. Overall though; SATS has been implemented successfully in the EC at KATH by triage nurses