Quality improvement in emergency service delivery: Assessment of knowledge and skills amongst emergency nurses at Connaught Hospital, Sierra Leone

Abstract

IntroductionThe ability to deliver quality emergency care services is reliant on a well-trained workforce. Since Sierra Leone was declared Ebola free in December 2015, the country has now moved into the post-Ebola reconstructive phase focusing on specialty training of healthcare workers. This development aligns well to the growing momentum for improved emergency medicine as a speciality in other regions of Sub-Saharan Africa. The first stage in assessing how to develop an emergency nursing speciality in Sierra Leone is to conduct an assessment of what is needed in terms of educational interventions. Concurrently enhancing emergency nursing capacity requires a comprehensive understanding of the role, function and emergency nurse educational requirements. This study was conducted to fully understand the current context, elucidate current nursing functions and gain knowledge of the educational desires and needs of nurses in the emergency centre at Connaught Hospital, the largest referral hospital in Sierra Leone.MethodsThis mixed-methods study comprised self-assessment, one multiple-choice questionnaire, focus group interviews and observational methods.ResultsEmergency nurses scored relatively low on the multiple-choice questionnaire, indicating through the self-assessment that they aspired to learn more about several topics within emergency care, and identified several themes which were considered to be barriers to delivery of care through focus group discussions and observations in the emergency centre.ConclusionThis study has identified key aspects of emergency nursing speciality training to be developed through theoretical and skill-based education provided by the nursing schools and hospital clinical facilities in Sierra Leone.

A description of the self-perceived educational needs of emergency nurses in Durban, KwaZulu-Natal, South Africa

“…The majority of the respondent nurses working in the ECs did not have any formal education/training in emergency nursing, and almost half the respondents scored less than the mean score, indicating low self-perceived competency levels overall. These findings are in keeping with other studies conducted in Africa that have drawn attention to the educational deficiencies of nurses in the emergency departments [16] , [18] , [19] , [20] .…”

“…The findings in our study highlight pressing educational needs of emergency nurses, similar to findings by Nyhus and Kamara [20] in a study carried out in Sierra Leone. In an Australian study showing urgent need for education and training in emergency nursing, preference was indicated for ongoing professional development using scenario-based, context-specific education [15] .…”

Evidence-informed framework for gender transformative continuing education interventions for midwives and midwifery associations

“…Understand and include impacts of external forces such as climate change, pandemics, conflict, etc 2–4 28 32 34 36 39 40 46 53–57…”

Health system assessment for access to care after injury in low- or middle-income countries: A mixed methods study from Northern Malawi

“…It evidenced the largest numbers of barriers within our analysis, perhaps as it encouraged participants to consider specific differences between injury mechanisms and contexts. As with any group-based method, workshop discussions may be tempered by hierarchical power dynamics [ 84 , 85 ], perhaps leading to disproportionate contributions from clinicians, especially more senior clinicians, compared to nonclinical staff. Since we used process mapping in facilities with healthcare workers as participants, patient or community perspectives were missing.…”