School of Science, Edith Cowan University, Perth, WA, Australia.
Social Development, Takoradi Technical University, Sekondi-Takoradi, Ghana.
Intern Emerg Med. 2024 Nov;19(8):1-13. doi: 10.1007/s11739-024-03607-6. Epub 2024 Apr 29.
The healthcare landscape in Ghana is primarily composed of lower-tier providers, which serve as the initial point of contact for most medical emergencies. This study aimed to assess the emergency care preparedness and readiness of primary healthcare providers using a robust evaluation approach. A multicentre retrospective cross-sectional study was conducted on 460 healthcare facilities using the standardised Health Facilities Emergency Preparedness Assessment Tool (HeFEPAT). Data were analysed via Bayesian Belief network. Emergency preparedness was associated with facility location, type, ownership, and in-charge personnel. Over 70% of facilities lacked specialised emergency/critical care personnel. Although 65% of in-charges reported protocol knowledge, only 7.8% could execute cardiopulmonary resuscitation. 90% of facilities lacked onsite defibrillators, and over 80% had no cerebrovascular accident medications. Road traffic accident protocols were largely unavailable, with an estimated 53% probability of lacking such protocols. Private-owned facilities were more likely to lack protocols for road traffic accidents (76% vs 20% probability) and general acute care (62% vs 32%) compared to government-owned facilities. Significant gaps in emergency preparedness were identified across the studied health facilities, indicating limited capacity to manage critical situations effectively. Urgent investments in emergency medicine training, essential resources, and evidence-based protocols are needed. Standardised emergency preparedness assessments should be implemented for accreditation and quality improvement. Further research can inform the development of national guidelines and targeted interventions to strengthen emergency response capacities.
加纳的医疗保健格局主要由低层次的医疗机构组成，这些医疗机构是大多数医疗紧急情况的初始接触点。本研究旨在使用稳健的评估方法评估基层医疗保健提供者的急救准备情况和准备情况。采用标准化的卫生设施应急准备评估工具（HeFEPAT）对 460 家医疗保健机构进行了多中心回顾性横断面研究。通过贝叶斯信念网络对数据进行分析。应急准备与设施位置、类型、所有权和负责人有关。超过 70%的设施缺乏专门的紧急/重症护理人员。尽管 65%的负责人报告了协议知识，但只有 7.8%的人能够进行心肺复苏术。90%的设施缺乏现场除颤器，超过 80%的设施缺乏中风药物。道路交通伤害协议基本不存在，估计有 53%的可能性缺乏此类协议。与政府所有的设施相比，私营所有的设施更有可能缺乏道路交通伤害（76%与 20%的可能性）和一般急性护理（62%与 32%）的协议。在所研究的卫生设施中发现了急救准备方面的重大差距，表明有效管理危急情况的能力有限。需要紧急投资于急诊医学培训、基本资源和基于证据的协议。应实施标准化的应急准备评估，以进行认证和质量改进。进一步的研究可以为制定国家指南和有针对性的干预措施提供信息，以加强应急反应能力。
