Factors that influence the clinical utilization of the nursing process at a hospital in Accra, Ghana.

BACKGROUND: The nursing process is a tool that is recommended for use by all professional nurses working in Ghana, in order to provide nursing care. However, there is currently a limited use of this tool by nurses in Ghana. The purpose of this research study was to explore the various factors that influence the utilization of this nursing process. METHOD: An exploratory descriptive qualitative-research design was employed. Ten participants were involved by using the purposive sampling method. A semi-structured interview guide was used to collect the data from the research participants; and the data were analysed by using content analysis. One main theme, with five subthemes, emerged from the analysis. RESULTS: It was found that there are factors, such as nurses not having a better understanding of the nursing process, whilst in school; the absence of the care plan in the ward, as well as the lack of adequate staff, with limited time being available for coping with contributed to the non-usage of the nursing process. CONCLUSIONS: We conclude that the clinical utilization of the Nursing process at the clinical setting is influenced by lack of understanding of Nurses on the Nursing process and care plan as well as lack of adequate nurses and time. We recommend that the care-plan form be made officially a part of the admission documents. Furthermore, the nursing administration should put measures in place to provide nurses with the needed resources to implement the nursing process. Additionally, they should ensure that the care-plan forms and other resources needed by the nurses are regularly and adequately provided. Nurses should further see the nursing process as a means of providing comprehensive care to their patients and addressing their specific problems. They should therefore make time despite their busy schedules to use it in order to improve quality of care and the image of nursing in Ghana.

Reaching disenfranchised youth and mobile populations in Ghana through voluntary counselling and testing services for HIV.

This paper documents the evaluation of a 20-month project to provide voluntary counselling and testing (VCT) to a mobile population of youth surrounding the Agbogbloshie market in Accra, Ghana. The specific objectives of the evaluation were to determine: 1) to what extent targets for providing VCT services to the specified population were reached; 2) how HIV prevalence among clients compared to that of the general population; 3) to what extent former clients self-reported behaviour change; and 4) whether useful lessons could be drawn regarding fees, hours, and location of services, as well as use of peer educators to increase use of VCT services among the target population. Various methodologies, including questionnaires, focus group discussions, a review of the service statistics and an exit poll of clients were used to evaluate the project. The service statistics demonstrated that the project exceeded the life-of-project target for number of clients by nearly 40%. Prevalence for the VCT client population (aged 15-25) was higher than for the general population (aged 15-24), although the gender differentials were similar. Focus group data suggested that clients may have adopted behaviour changes as a result of VCT. Finally, focus group discussions and VCT service trends showed that the high number of clients was largely influenced by three factors: services being free, location and hours of services being convenient to the target population, and use of peer educators to promote the services. In addition, the evaluation highlighted the importance of the counselling component of VCT, even as counselling can get short-changed at the expense of HIV testing when large numbers of clients are involved. The evaluation stressed the need to appropriately remunerate peer educators for their work whenever possible. Finally, VCT programmes continue to face challenges such as: HIV stigma as a barrier to people coming to be counselled and tested; insufficient availability of medication, support and services for HIVpositive clients; and difficulty of ensuring the sustainability of VCT programmes.

Buruli ulcer in Ghana: results of a national case search.

A national search for cases of Buruli ulcer in Ghana identified 5,619 patients, with 6,332 clinical lesions at various stages. The overall crude national prevalence rate of active lesions was 20.7 per 100,000, but the rate was 150.8 per 100,000 in the most disease-endemic district. The case search demonstrated widespread disease and gross underreporting compared with the routine reporting system. The epidemiologic information gathered will contribute to the design of control programs for Buruli ulcer.

Community factors associated with malaria prevention by mosquito nets: an exploratory study in rural Burkina Faso.

Malaria-related knowledge, attitudes and practices (KAP) were examined in a rural and partly urban multiethnic population of Kossi province in north-western Burkina Faso prior to the establishment of a local insecticide-treated bednet (ITN) programme. Various individual and group interviews were conducted, and a structured questionnaire was administered to a random sample of 210 heads of households in selected villages and the provincial capital of Nouna. Soumaya, the local illness concept closest to the biomedical term malaria, covers a broad range of recognized signs and symptoms. Aetiologically, soumaya is associated with mosquito bites but also with a number of other perceived causes. The disease entity is perceived as a major burden to the community and is usually treated by both traditional and western methods. Malaria preventive practices are restricted to limited chloroquine prophylaxis in pregnant women. Protective measures against mosquitoes are, however, widespread through the use of mosquito nets, mosquito coils, insecticide sprays and traditional repellents. Mosquito nets are mainly used during the rainy season and most of the existing nets are used by adults, particularly heads of households. Mosquito nets treated with insecticide (ITN) are known to the population through various information channels. People are willing to treat existing nets and to buy ITNs, but only if such services would be offered at reduced prices and in closer proximity to the households. These findings have practical implications for the design of ITN programmes in rural areas of sub-Saharan Africa (SSA).