ABSTRACT
INTRODUCTION: Successful cardiopulmonary resuscitation (CPR) relies, in part, on the availability and the correct functioning of resuscitation equipment. These data are often lacking in resource-constrained African settings. AIM: To assess the availability and the functional status of CPR equipment in resuscitation trolleys at district hospitals in Botswana. SETTING: The study was conducted across four district hospitals in Botswana. METHODS: A cross-sectional study was conducted using a checklist adopted following the Emergency Medical Services of South Africa (EMSSA) guidelines, modified and contextualised to Botswana. RESULTS: All the four district hospitals had inadequate number of CPR equipment available in the resuscitation trolleys. The overall availability of drugs and equipment ranged from 19% to 31.1%. Availability of equipment needed for maintaining circulation and fluids ranged from 27% to 49%, while availability of items for airway and breathing ranged from 9.2% to 24.1%. The overall availability of essential drugs for resuscitation was only 20.4%, and in some wards expired drugs were kept in the trolley. Out of 40 wards that participated in the study, only 10 kept CPR algorithms in the resuscitation trolley. The resuscitation trolley was checked on a daily basis only in the critical care units. CONCLUSION: The resuscitation trolleys were not maintained as per standards. Failure to improve the existing situation could negatively impact the outcome of CPR. Evidence-based standard checklists for resuscitation trolleys need to be enforced to improve the quality of CPR provision in district hospitals in Botswana.
Subject(s)
Cardiopulmonary Resuscitation/instrumentation , Equipment and Supplies, Hospital , Hospitals, District/organization & administration , Botswana , Cross-Sectional Studies , Emergency Service, Hospital/organization & administration , Equipment and Supplies, Hospital/standards , Equipment and Supplies, Hospital/supply & distribution , Heart Arrest/therapy , HumansABSTRACT
BACKGROUND: Nurses are usually the first to identify the need for and initiate cardiopulmonary resuscitation (CPR) on patients with cardiopulmonary arrest in the hospital setting. Cardiopulmonary resuscitation has been shown to reduce in-hospital deaths when received from adequately trained health care professionals. AIM: We aimed to investigate nurses' retention of CPR knowledge and skills at district hospitals in Botswana. METHODS: A quantitative, quasi-experimental study was conducted at three hospitals in Botswana. A pre-test, intervention, post-test, and a re-test after 6 months were utilised to determine the retention of CPR knowledge and skills. Non-probability, convenience sampling technique was used to select 154 nurses.The sequences of the test were consistent with the American Heart Association's 2010 basic life support (BLS) guidelines for health care providers. Data were analysed to compare performance over time. RESULTS: This study showed markedly deficient CPR knowledge and skills among registered nurses in the three district hospitals. The pre-test knowledge average score (48%) indicated that the nurses did not know the majority of the BLS steps. Only 85 nurses participated in the re-evaluation test at 6 months. While a 26.4% increase was observed in the immediate post-test score compared with the pre-test, the performance of the available participants dropped by 14.5% in the re-test 6 months after the post-test. CONCLUSION: Poor CPR knowledge and skills among registered nurses may impede the survival and management of cardiac arrest victims. Employers and nursing professional bodies in Botswana should encourage and monitor regular CPR refresher courses.
Subject(s)
Cardiopulmonary Resuscitation/standards , Clinical Competence , Health Knowledge, Attitudes, Practice , Heart Arrest/therapy , Nursing Staff, Hospital/standards , Adult , Botswana , Cardiopulmonary Resuscitation/education , Female , Hospitals, District , Humans , Inservice Training , Male , Nursing Staff, Hospital/educationABSTRACT
To forge strong relationships among nurse scholars from the University of Pennsylvania School of Nursing, Philadelphia, PA (USA); University of Botswana School of Nursing, Gaborone, Botswana; the Hospital of the University of Pennsylvania, Philadelphia; Princess Marina Hospital (PMH), Gaborone; and the Ministry of Health of Botswana, a strategic global partnership was created to bridge nursing practice and education. This partnership focused on changing practice at PMH through the translation of new knowledge and evidence-based practice. Guided by the National Institutes of Health team science field guide, the conceptual implementation of this highly successful practice change initiative is described in detail, highlighting our strategies, challenges and continued collaboration for nurses to be leaders in improving health in Botswana.
Subject(s)
Cooperative Behavior , Evidence-Based Nursing , Nursing Staff, Hospital/education , Botswana , Clinical Competence , Humans , Interinstitutional Relations , Leadership , Nurse Clinicians/education , Nurse Practitioners/education , PennsylvaniaABSTRACT
BACKGROUND: In Botswana nurses provide most health care in the primary, secondary and tertiary level clinics and hospitals. Trauma and medical emergencies are on the increase, and nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills in order to be able to implement effective interventions in cardiac arrest situations. OBJECTIVE: The objective of this descriptive study was to assess registered nurses' CPR knowledge and skills. METHOD: A pre-test, intervention and re-test time-series research design was adopted, and data were collected from 102 nurses from the 2 referral hospitals in Botswana. A multiple-choice questionnaire and checklist were used to collect data. RESULTS: All nurses failed the pre-test. Their knowledge and skills improved after training, but deteriorated over the three months until the post-test was conducted. CONCLUSION: The significantly low levels of registered nurses' CPR skills in Botswana should be addressed by instituting country-wide CPR training and regular refresher courses
Subject(s)
Cardiopulmonary Resuscitation , Clinical Competence , Health Knowledge, Attitudes, Practice , Nurses , Adult , Botswana , Female , Humans , Male , Young AdultABSTRACT
Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment; as well as staff members skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana's hospitals' wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswana were audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley; some units failed to check their emergency trolleys' contents daily. All 20 hospital wards or units that participated in this study; needed to improve the contents and maintenance of their emergency trolleys; otherwise in-hospital CPR efforts in Botswana might be doomed to failure; losing lives that could have been saved if emergency trolleys' equipment and supplies had been up to standard
