Evidence-Based Nursing Practice in Ghana.

Introduction: The nursing profession in the 21st century requires service delivery in a highly specialized nursing environment with a high degree of professionalism and optimum patient outcome. Evidence-Based Nursing Practice (EBP) may provide a great opportunity for moving nursing care to a level that may involve clinical reasoning to meet demand in the 21st century and beyond, improve patient outcome and cost containment. Objective: To investigate evidence-based nursing practice among nurses in Ghana. Methods: This is a descriptive cross-sectional survey and data was collected among clinical nurses and nurse educators from both private and public institutions across Ghana. Nurses were included if they have full-time or part-time appointment; were in active service and have a valid Personal Identification Number (PIN) from the Nursing and Midwifery Council of Ghana. Results: About half of the nurses disagreed or were neutral regarding formulation of answerable research questions and 40% do not critically track relevant scientific evidence. Also, more than 30% of the nurses disagreed or were neutral regarding the integration of scientific evidence into practice. Clinical nurses were about 2.1 times more likely to have difficulty determining the applicability of research findings in service delivery compared to nurse educators. Conclusion: The findings suggest EBP uptake and integration is suboptimal in Ghana.

Experiences of women undergoing assisted reproductive technology in Ghana: A qualitative analysis of their experiences.

OBJECTIVE: The study aimed to explore the experiences of women undergoing Assisted Reproductive Technologies namely; Invitro Fertilization and Intracytoplasmic Sperm Injection at the Finney Hospital and Fertility Centre, New Bortianor, Ghana. METHOD: A qualitative research design was employed to analyse and describe the experiences of the women seeking Assisted Reproductive Technologies. A total of 32 women were invited to take part in the interview, 15 of them accepted the invitation. However, saturation was reached before all interviews had been complete. RESULTS: Three themes emerged from the study: the women's experiences, challenges and the roles and contributions of significant others. The women were anxious, stressed-up, exhausted and financially burdened. Spouses and health professionals played significant roles by providing social, emotional and financial support for these women. Significant others such as spouses and close relatives were supportive and provided encouragement to the women. CONCLUSION: The experiences of women undergoing Assisted Reproductive Technologies are multi-dimensional. Thus, psychosocial interventions as part of ART services with health insurance cover may be client-centered and more appropriate for these group of women.

Predictors of adherence to HIV Post-Exposure Prophylaxis protocol among frontline healthcare workers at the Ho Teaching Hospital, Ghana.

BACKGROUND: Human Immunodeficiency Virus (HIV) is a global public health threat, and all frontline Health care workers (HCWs) are at a higher risk of exposure to body fluids from potential HIV patients and to sharp instruments. Though timely Post Exposure Prophylaxis (PEP) decreases the possibility of seroconversion to HIV after occupational exposure, most HCWs rarely adhere to the PEP protocol. This study aims to determine the predictors of adherence to PEP among frontline healthcare workers in the Ho Teaching Hospital, Ghana. METHODS: A facility-based cross-sectional study was conducted among 199 frontline HCWs. Data were collected using a pretested self-administered questionnaire and analyzed using STATA version 14 software. Binomial logistic regression was performed at the 0.05 level of significance and 95% confidence interval. FINDINGS: Overall, 17.9% of HCWs adhered to PEP. Frontline HCWs who perceived they had low and very low risk of occupational exposure to HIV transmission were 96% [AOR = 0.04 (95% C.I: 0.00, 0.39) P = 0.006] and 94% [AOR = 0.06 (95% C.I: 0.00, 0.62) P = 0.019] respectively less likely to adhere to PEP. HCWs who received training on PEP were 4 times more likely to adhere to PEP compared to those who had never received it [AOR = 4.24 (1.31, 13.19) P = 0.013]. CONCLUSION: Adherence to PEP protocol among HCWs was low. Therefore, there is a need for interventions to increase the perception of risk of occupational exposure to HIV transmission and to intensify training on PEP among frontline HCWs in the Ho Teaching Hospital. This will go a long way to increase their adherence to PEP.

Metal hypersensitivity screening among frontline healthcare workers-A descriptive study.

AIMS AND OBJECTIVES: The study aims were to (a) assess allergy screening practices, (b) determine the awareness of metal hypersensitivity among frontline healthcare workers and (c) examine perceived barriers to implementing metal hypersensitivity screening into clinical practice. BACKGROUND: Adverse device-related events, such as hypersensitivity to metals, are well documented in the literature. Hypersensitivity to metal is a type IV T-cell-mediated reaction that can occur after cardiac, orthopaedic, dental, gynaecological and neurosurgical procedures where a device with metal components is implanted into the body. Patients with hypersensitivity to metal are likely to experience delayed healing, implant failure and stent restenosis. Identifying patients with a history of metal hypersensitivity reaction could mitigate the risk of poor outcomes following device implant. Yet in clinical practice, healthcare workers do not routinely ask about the history of metal hypersensitivity when documenting allergies. The existing literature does not report why this is not included in allergy assessment. DESIGN: Following the STROBE checklist, a cross-sectional, descriptive study was conducted. METHODS: Frontline healthcare workers were recruited using professional contacts and social online media to complete an online questionnaire. Quantitative data were summarised descriptively while thematic analysis was used to examine barriers to implementation. RESULTS: Three hundred forty-five participants from 14 countries completed the questionnaire, with the majority (187/54%) practicing in Canada, in general medicine and intensive care units. Ninety per cent of the participants did not routinely ask about metal hypersensitivity when evaluating allergy history. Of the respondents, 86% were unaware of the association between metal hypersensitivity and poor patient outcomes. After presented with the evidence, 81% indicated they were likely or very likely to incorporate the evidence into their clinical practice. Common themes about barriers to implementing were 'Standards of Practice', 'Knowledge' and 'Futility of Screening'. CONCLUSION: The findings suggest lack of awareness as the main reason for not including metal in routine allergy assessment.

Psychosocial factors influencing contraceptive use among adolescent mothers in the Volta Region of Ghana: application of the Health Belief Model.

Background: Globally, complications arising from pregnancy and childbirth are the leading cause of death among pregnant women aged 15 to 19 years. This study investigated the psychosocial factors influencing contraceptive use among adolescent mothers in the Volta Region using the Health Belief Model (HBM). Methods: This was a cross-sectional study conducted among 422 adolescent mothers. An interviewer-administered structured questionnaire was used to collect data. Binary logistic regression was used to determine the strength of association between the independent and the dependent variables at a p-value less than 0.05. Results: The prevalence of contraceptive use was 18.7%. Concerning perceived susceptibility, there was a significant association between contraceptive use and the perception of being at risk of pregnancy complications (p<0.001). Perceived barriers showed a significant association between fear of side-effects of contraceptives and contraceptive use (p=0.007). Concerning perceived self-efficacy, there was a significant association between contraceptive use and confidence to suggest to a partner to use contraceptives (p=0.003); confidence to ask for contraceptives from health facilities (p<0.001) and confidence to use contraceptives (p<0.001). Conclusion: Programmes to increase contraceptive use should aim at heightening the perception of risk of pregnancy complications, reduce barriers to contraceptive use and increase the skills in negotiating contraceptive use.

Academic-Related Stress Among Ghanaian Nursing Students.

AIM: The life of a student may be affected by different stressors in both the internal and external environment. Although people from all walks of life experience stress on daily basis, students are more likely to experience stressful situations because of their academic requirements. To identify stressors among nursing students in Ghana. METHODS: A cross-sectional survey was conducted among 400 students sampled from first year to fourth year students. Students were included in the study if they are above 18 years, nursing students and have been registered by the university for the 2019/2020 academic year. RESULTS: A majority of the students (73.0%) perceived themselves to be stressed with academic-related work and cognitive, behavioural and emotional symptoms were highly prevalent among the students. Students enrolled in the regular programme were 0.09 times (p < .0001) less likely stressed than those in the modular stream of the training programme and female students compared to their male counterparts were 2.18 times (p < .0001) more likely feeling stressed. CONCLUSION: The students with high cognitive symptoms also show high emotional and behavioural symptoms and vice versa. Nursing training institutions may consider further studies to investigate the impact of stress on academic performances and identify appropriate support students.

Predictors of intention to use modern contraceptives among female senior secondary school students in the Kpando Municipality, Ghana.

BACKGROUND: Improving the reproductive health of young women in developing countries requires access to safe and effective methods of fertility control. Volta Region records one of the highest prevalence of teenage pregnancy and adolescents aged 15-19 years are the least acceptors of contraceptives in the Region. Guided by the Theory of Planned Behaviour, this study determined predictors of intention to use modern contraceptives among female Senior Secondary School students in the Kpando Municipality, Ghana. METHOD: A cross-sectional design was adopted, collecting data among a multistage sample of 270 participants, using a pretested self-administered questionnaire and analysing them using Stata software Version 16 at the 0.05 level of significance. RESULTS: The mean age of the respondents was 16.78 ± 1.31. About 40.2% of the sexually experienced participants used a modern contraceptive during ther first sexual encounter. However, the majority (69.3%) had the intention to use modern contraceptives. Regarding subjective norms, the majority of the significant others (63.0%) were not supportive of modern contraceptive use and more than half of the respondents (59.3%) had a positive attitude towards modern contraceptive use, while 54.1% perceived that they had control over modern contraceptive use. The majority (69.3%) had the intention to use modern contraceptives. Perceived behavioural control was the only significant predictor of the intention to use modern contraceptives [AOR= 9.80 (C.I: 5.11, 18.77); p< 0.001]. CONCLUSION: Interventions to increase the perception of control over contraceptive use is of the essence. This will help increase their intention to use modern contraceptives.

Barriers and facilitators of cervical cancer screening practices among African immigrant women living in Brisbane, Australia.

PURPOSE: To describe barriers and facilitators of cervical screening practices among African immigrant women living in Brisbane, Australia. METHOD: Nineteen African immigrant women (10 refugee and 9 non-refugee) were recruited using convenience sampling. The interviews were conducted with a semi-structured and open-ended questionnaire guide. All the interviews were audio recorded and transcribed verbatim. The data was manually analysed using interpretative thematic analysis. Thematic categories were identified and organised into coherent broader areas. RESULTS: Lack of knowledge about cervical cancer and Pap smear, the absence of warning signs, embarrassment, fear, concern about the gender of the service provider, lack of privacy, cultural and religious beliefs, and healthcare system factors were identified as barriers to screening. The results did not show any major differences between refugee and non-refugee women. Recommendation of the test by health professionals, provision of standardised information on the test, and preferences for female service providers were identified as facilitators of cervical screening. CONCLUSION: There is a need to provide culturally appropriate approaches to cervical screening practices and to enhance cultural competence among health professionals to apply service delivery models that honour group cultures.