Errors in transfusion of blood and blood products can lead to preventable morbidity and mortality. Nurses constitute a significant aspect of the transfusion process as they are the last in the chain of getting blood directly to the patient. They must, therefore, be conversant with the current standard of national and international guidelines on blood transfusion and appropriate management of adverse transfusion events. This study assesses the knowledge and practices of blood transfusion safety among nurses at Komfo Anokye Teaching Hospital. A descriptive cross-sectional design was employed, and structured questionnaire (Routine Blood Transfusion Knowledge Questionnaire) was used to collect data from 279 nurses from seven clinical directorates of the hospital. The data were processed with Stata version 14.0. Variables were analyzed using descriptive statistics, and relationships were drawn using inferential statistics. Over 90% of the respondents had a minimum of a diploma in nursing or midwifery, 63% had performed blood transfusion at least 5 times, and 46% had never received any training on blood transfusion. The mean score obtained in all four categories of blood transfusion knowledge assessed was 29, with 54% of the respondents scoring below the mean. The highest overall score on knowledge was 53%. This indicates that nurses had poor knowledge regarding safe blood transfusion practices as stipulated in the clinical guidelines for blood transfusion by Ghana’s National Blood Service. There was no statistically significant relationship between training/experience and knowledge of safe blood transfusion practices. Regular and continuous update training and audit are needed to safeguard patient safety during blood transfusion.

ObjectiveTo describe self‐management recommendations for sickle cell disease (SCD) care among health professionals who manage SCD in Ghana.MethodNine health care professionals (nurses, doctors, and physician assistants) who work in SCD were interviewed. The semistructured interviews were recorded, transcribed, and analysed using the qualitative content analysis method. Self‐management recommendations were conceptualised as preventive health, self‐monitoring, self‐diagnosis, self‐treatment, and self‐evaluation.ResultsPreventive health recommendations were the commonest, where the professionals described similar topics including avoidance of cold temperature, frequent oral hydration, and healthy nutrition. Self‐monitoring recommendations included regular checks for pallor, urine colour, and splenic enlargement. Self‐diagnosis recommendations were captured as warning signs and included pain, fever, unusual feelings, and enlarged spleen. Pain and fever management were the focus of most self‐treatment advice, and there were some self‐treatment recommendations for dactylitis, anaemia, and priapism. There was considerable variation in the strategies recommended for the management of individual SCD‐related problems.ConclusionGhanaian health professionals involved in SCD care provide limited and inconsistent self‐management recommendations. There is a need for the development of SCD standards and guidelines that support effective self‐management. Health professionals working in SCD require continuing education in self‐management.

Background. Clinical teaching and learning are critical in bridging the theory-practice gap in nursing education. This study aimed at exploring nursing students’ perception of clinical teaching and learning in Ghana. In particular, this study sought to (1) describe the factors that promote clinical teaching, (2) examine students’ perception of clinical teaching, (3) describe the impact of clinical learning on students, and (4) explore ways of improving clinical teaching and learning. Methods. A descriptive qualitative study was conducted with 16 final-year nursing students using telephone-based interviews. Individual in-depth interviews were conducted with a semistructured interview guide, and data were analysed by the qualitative thematic analysis. Results. The findings indicate that being taught new things, being supervised, and having autonomy were the most significant factors that promoted clinical learning. Participants also reported that clinical experience created learning opportunities that helped develop clinical competence. They described learning experiences in the clinical setting as good, albeit gaps in practice. Poor staff attitude, lack of equipment, poor student attitude, inadequate learning opportunities, and lack of clinical supervisors were perceived as challenges in the clinical environment. Conclusions. Efforts to consciously teach, supervise, and challenge students to have independence in the clinical area will promote clinical teaching and learning. Therefore, nursing educational institutions and all other stakeholders need to collaborate in eliminating the numerous challenges students encounter in the clinical environment.

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Introduction Surgical operations are inevitable in alleviating certain disease conditions, however, surgical procedures are associated with pain. Pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". 1 Postoperative pain refers to the pain experienced after surgery. 2 Studies show that children feel pain just like the adult population. 3-5 Every individual is entitled to pain management. Pain assessment must first be performed before treatment commences. 6-9 Pain assessment involves the use of subjective and objective measures and the subjective measures involve the use of self-reports where patients verbalize or describe their pain. Objective measures comprising behavioural and physiological measures are commonly used to assess children's pain. Behavioural measures involve observing how a child behaves in response to pain such as facial expressions, crying, body postures and movements. 10 Physiological measures include assessment of heart rate, blood pressure, respiration, oxygen saturation, palmer sweating and temperature. 11 For pain, assessment to be practical, and consistent pain assessment tools and guidelines are used. Some of the common pain assessment tools used among children include Faces Pain Scale-Revised (FPS-R), the Wong-Baker Faces Scale and the Oucher Scale, the Face, Legs, Activity, Cry and Consolability (FLACC), the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), the Toddler-Preschooler Postoperative Pain Scale (TPPPS), and the Parents' Postoperative Pain Rating Scale (PPPRS). It has been established that inadequate assessment of post-operative pain leads to inadequate management which can lead to severe complications such as delayed wound healing, deep vein thrombosis, atelectasis, pneumonia and even death. 12-15 Despite the knowledge

Purpose The purpose of this study is to explore the information culture of people living with Diabetes Mellitus (DM) and how that impacts their self-management practices in Ghana. The study focuses on the information experiences and information cultural patterns and creates awareness of the need for people to be aware of effective information management for sustainable self-management support. Design/methodology/approach An interpretive qualitative approach was used. A total of 12 interviewees involving 10 diabetes patients and 2 health professionals provided data for the study. Allowing the participants to freely talk about their attitude and behaviour, defining their experiences around information for their self-management was the best approach to achieve an in-depth understanding this study seeks. Findings The specific elements defining the information of people living with DM in Ghana can be identified. People living with the condition are willing to share information about their condition not only with those within their diabetic community but also with anyone interested. They prefer to use information from sources they find reliable and trust, and they have good information-related competencies that are consistent with diabetic patients in other countries’ contexts to help them identify, access, use and share relevant information. Only a few of the interviewees have difficulty in evaluating the accuracy and currency of some of the information. But they receive a lot of support from experienced people from their community. People also prefer to have information about the condition in their ethnic language. It is important for people living with the condition in Ghana to get involved in the diabetic groups, clubs and community, as members appear to receive the most benefit and support from the community to self-manage the condition alone. Research limitations/implications The study is limited by the number of participants and the distances between the researchers and the research context. Also, even though two groups of participants were interviewed (diabetic patients and health professionals), the analysis did not separate the responses of the different groups of study participants. This paper provides a useful insight and understanding of the culture of people living with diabetes in Ghana in terms of how they access, use and share the information they need to support their self-management. It will create awareness of the importance of being mindful of information culture patterns in people in other groups in Ghana and beyond. The research processes and procedures described in the paper can be replicated by other researchers in other contexts. Originality/value Although there have been a lot of studies about diabetes and people living with the condition in Ghana, to the best of the authors’ knowledge, this is the first study looking at how people define their need for information, how they identify the source of the information and how they access and use the information, including their general behavioural patterns that influence these information experiences.

Background: Breast milk contains various micronutrients which nourishes a baby with nutrition, and therefore the endorsement for exclusive breastfeeding during the first six months after birth. Such micronutrients, if in excess, can have adverse effects on the baby. Objective: The levels of seven micronutrients in breast milk obtained from 27 lactating mothers in the Cape Coast Metropolitan area have been determined using Epithermal Neutron Activation Analysis (ENAA). This technique was used because it is suitable for performing both qualitative and quantitative multi-nutritional analyses on samples, and offers accuracies and sensitivities superior to those attainable by other methods. Materials and Methods: During the analysis, a- 3 mm thick flexible boron was used to cut-off thermal neutrons so as to assess epithermal neutrons, thereby creating an activation energy which measured the levels of micronutrients in the breast milk. The standard reference materials used were the International Atomic Energy Agency (IAEA)-336; IAEA-407, IAEA-350 and National Institute of Standard and Technology (NIST) USA SRM 1577b. The Relative standardization method was used in the quantification of the micronutrients, with an accuracy of about 94.7 %. The micronutrients are Sodium (Na), Magnesium (Mg), Potassium (K), Calcium (Ca), Manganese (Mn), Copper (Cu) and Iodine (I). Results: Except for iodine which had levels below the recommended dietary allowance (RDA), the remaining micronutrients had levels above the upper limit of the RDA, with Manganese being the highest. Conclusion: The levels recorded are directly linked to the food intake of the mothers, and therefore the need for pregnant and lactating mothers to be mindful about what they eat. Children could be exposed to metabolic disorders and diseases as a result of such high levels.

The authors acknowledge the Victoria University of Wellington for logistic support. We also acknowledge the efforts people who have created the sickle cell support websites that were included in this study.