108 Knowledge, Attitudes and Practices Regarding Vital Signs Amongst EMTs of the Ghana Ambulance Service

Abstract

Study Objectives: Accurately checking and interpreting vital signs constitutes a fundamental and critical part of patient care. As part of a preliminary educational assessment of the emergency medical technicians of the Ghana Ambulance Service, this study aims to describe emergency medical technicians' knowledge, attitudes and practices regarding vital signs in trauma patients.Methods: A pre-tested questionnaire was verbally administrated in a standardized manner by one investigator to Ghana Ambulance Service emergency medical technician-basics. The questionnaire surveyed emergency medical technicians' knowledge of normal vital signs (blood pressure, pulse rate, respiratory rate, temperature, and oxygen saturation) and their attitudes regarding the importance of checking vital signs in injured patients. Descriptive statistics were used to characterize questionnaire responses. Each respondent's skills at obtaining vital signs were also tested using a clinically standardized patient-simulation. Emergency medical technicians' clinical practice of documenting out-of-hospital vital signs was measured by retrospectively auditing respondents' out-of-hospital patient care reports in the 6 months preceding the study.Results: Forty-one (93%) emergency medical technicians completed the questionnaire. Fifty-one percent of emergency medical technicians recalled at least 3 vital sign values correctly, 17% recalled at least 4, and 2% recalled all 5 correctly. The vital signs for which emergency medical technicians most frequently recalled normal values were temperature (80%), pulse rate (68%) respiratory rate (63%) and blood pressure (50%). One hundred percent of emergency medical technicians felt checking vital signs was important in trauma cases. Eighty-seven percent felt confident with their skills. One hundred percent appropriately checked the 5 vital signs when tested. Of the 153 trauma-related patient care reports reviewed, 36% had at least blood pressure and pulse rate documented. Twenty-eight percent of patient care reports had 1 complete set of vital signs, and 26% had none documented.Conclusion: Ghana Ambulance Service emergency medical technicians felt confident, were skillful and regarded checking vital signs in trauma patients as important. However, a marked discrepancy existed when compared to their knowledge of vital sign values and their actual out-of-hospital clinical practice of checking these vital signs. These results have guided emergency medical technician continuing medical education, quality assurance and quality improvement initiatives within this young and growing emergency medical services service functioning in a challenging low-resource setting. Study Objectives: Accurately checking and interpreting vital signs constitutes a fundamental and critical part of patient care. As part of a preliminary educational assessment of the emergency medical technicians of the Ghana Ambulance Service, this study aims to describe emergency medical technicians' knowledge, attitudes and practices regarding vital signs in trauma patients. Methods: A pre-tested questionnaire was verbally administrated in a standardized manner by one investigator to Ghana Ambulance Service emergency medical technician-basics. The questionnaire surveyed emergency medical technicians' knowledge of normal vital signs (blood pressure, pulse rate, respiratory rate, temperature, and oxygen saturation) and their attitudes regarding the importance of checking vital signs in injured patients. Descriptive statistics were used to characterize questionnaire responses. Each respondent's skills at obtaining vital signs were also tested using a clinically standardized patient-simulation. Emergency medical technicians' clinical practice of documenting out-of-hospital vital signs was measured by retrospectively auditing respondents' out-of-hospital patient care reports in the 6 months preceding the study. Results: Forty-one (93%) emergency medical technicians completed the questionnaire. Fifty-one percent of emergency medical technicians recalled at least 3 vital sign values correctly, 17% recalled at least 4, and 2% recalled all 5 correctly. The vital signs for which emergency medical technicians most frequently recalled normal values were temperature (80%), pulse rate (68%) respiratory rate (63%) and blood pressure (50%). One hundred percent of emergency medical technicians felt checking vital signs was important in trauma cases. Eighty-seven percent felt confident with their skills. One hundred percent appropriately checked the 5 vital signs when tested. Of the 153 trauma-related patient care reports reviewed, 36% had at least blood pressure and pulse rate documented. Twenty-eight percent of patient care reports had 1 complete set of vital signs, and 26% had none documented. Conclusion: Ghana Ambulance Service emergency medical technicians felt confident, were skillful and regarded checking vital signs in trauma patients as important. However, a marked discrepancy existed when compared to their knowledge of vital sign values and their actual out-of-hospital clinical practice of checking these vital signs. These results have guided emergency medical technician continuing medical education, quality assurance and quality improvement initiatives within this young and growing emergency medical services service functioning in a challenging low-resource setting.