Availability of resources for emergency care at a second-level hospital in Ghana: A mixed methods assessment
Availability of resources for emergency care at a second-level hospital in Ghana: A mixed methods assessment
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DOI：
10.1016/j.afjem.2015.06.006
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发表时间：
2016-03-01
影响因子：
1.3
通讯作者：
Mock, Charles N.
中科院分区：
文献类型：
--
作者：
Japiong, Kennedy B.;Asiamah, Godfried;Mock, Charles N.
导言：急诊护理是卫生系统的重要组成部分，在低收入和中等收入国家尤其如此。我们试图评估加纳一家二级医院提供急诊护理的资源可用性。通过这样做，可以确定可以指导制定有针对性的干预策略以改善急诊护理的缺陷。方法：在加纳阿克拉的二级医院警察医院急救中心对急诊病人的护理能力进行定性和定量评估。对临床、护理员、行政人员和救护人员进行了直接检查和岗位调查。描述了对定量问题的回答。定性反应通过内容分析进行检验。结果：评估显示许多基本项目和服务明显不足。然而，也发现了一些成功，例如实验室能力。在无法获得的基本物品中，有些是低成本的，如基本的气道用品、胸管和几种紧急药物。当被问及如何改善急诊护理时，工作人员回答的主题包括：提供定期培训、增加急诊病房的床位、确保提供基本物品和为所有护理病人的工作人员提供个人防护装备。结论：本研究确定了改善加纳警察医院急诊病人护理的机会。培训、组织和规划方面的低成本改进可以改善项目和服务的提供，例如：为应急中心所有领域的工作人员制定继续教育课程；就现有的分诊和紧急护理规程进行在职培训；增加检查清单，以指导适当的分诊和安全转移患者；并对物品不可用进行根本原因分析，以制定有针对性的干预措施。
Introduction: Emergency care is an essential component of health systems, particularly in low-and middle-income countries. We sought to assess the availability of resources to provide emergency care at a second-level hospital in Ghana. By doing so, deficits that could guide development of targeted intervention strategies to improve emergency care could be identified.Methods: A qualitative and quantitative assessment of capacity for care of emergency patients was performed at the Emergency Centre of the Police Hospital, a second-level hospital in Accra, Ghana. Direct inspection and job-specific survey of clinical, orderly, administrative and ambulance staff was performed. Responses to quantitative questions were described. Qualitative responses were examined by content analysis.Results: Assessment revealed marked deficiencies in many essential items and services. However, several successes were identified, such as laboratory capacity. Among the unavailable essential items, some were of low-cost, such as basic airway supplies, chest tubes and several emergency medications. Themes from staff responses when asked how to improve emergency care included: provide periodic training, increase bed numbers in the emergency unit, ensure availability of essential items and make personal protective equipment available for all staff caring for patients.Conclusion: This study identified opportunities to improve the care of patients with emergency conditions at the Police Hospital in Ghana. Low-cost improvements in training, organization and planning could improve item and service availability, such as: developing a continuing education curriculum for staff in all areas of the emergency centre; holding in-service training on existing protocols for triage and emergency care; adding checklists to guide appropriate triage and safe transfer of patients; and perform a root cause analysis of item non-availability to develop targeted interventions.