Abstract
BackgroundIt is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relation to non-surgical (also called contaminated wounds) and surgical wounds (also called sterile wounds) is largely attributed to poor adherence to policy protocols for wound management by frontline clinical staff especially nurses.ObjectiveInvestigate the extent to which nursing staff adhere to the policy protocol for management of non-surgical and surgical wounds in selected public health facilities in Ghana.MethodologyThis is an analytic case study among nursing staff (n = 140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to policy protocols on non-surgical and surgical wound management.FindingsOverall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound management (Coef. = -0.49, CI = -0.93–0.05, p = 0.036). Being a senior nursing officer relative to lower nursing ranks increased staff likelihood of complying particularly with standard policy protocol for management of non-surgical wounds (Coef. 5.27, CI = 0.59 9.95, p = 0.027).ConclusionThere is the need for accelerated in-service training for staff on standard protocols for wound management coupled with supportive supervisions. Staff adherence to standard quality care protocols should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.
Highlights
It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year
There is the need for accelerated in-service training for staff on standard protocols for wound management coupled with supportive supervisions
According to a World Health Organization (WHO) report [1], infections associated with the continuum of healthcare delivery are the most frequent adverse medical events proven to be detrimental to the safety of patients globally
Summary
The study was an analytic case study involving professional and auxiliary clinical nursing staff from selected government hospitals in the Ho Municipality of the Volta region of Ghana. The study was conducted between 28th February and 20th March, 2019. The Volta region is one of the sixteen (16) administrative regions in Ghana with 2019 project population size of 1,865,332 million people, representing approximately 6% of the estimated 30,380,482 million people in Ghana [18]. The Volta region is along the eastern coast of the Gulf of Guinea to the south, Republic of Togo to the east, Oti region to the north and the Greater Accra and Eastern regions to the west [18]. The 2019 annual population projection for the Ho Municipality is 218,948 which constitutes approximately 12% of the total regional population [18].
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