Clinical Placement: Experiences, School and Hospital-based Gaps and Challenges of Undergraduate Nursing Students of the University of Cape Coast

The goal of the study was to assess the school-based and hospital-based gaps and challenges among undergraduate nursing students. The specific objectives of the study was identify the gaps between school-based and hospital-based learning, explore students’ clinical practice experiences and to determine the challenges students encounter during clinical placement. The Explanatory Mixed Method Design was used for the study. For the quantitative part, the simple random sampling technique was used to select 141 study participants. Questionnaires were used to collect numeric data. Quantitative data was analysed using IBM SPSS version 21. For the qualitative part, purposive sampling was used to select five participants for interviewing. Braun and Clarke (2006) steps for thematic analysis was employed to analyse the responses for the interviewing. The qualitative data was used to validate the quantitative results.The findings from the quantitative and qualitative aspects of the study point to common gaps and challenges and experiences of nursing students. The findings showed a consensus on differences in types of equipment and availability of equipment, learning experiences and clinical nursing practices between the hospital and school settings. Challenges with students attending more errands, poor supervision and combining school and academic work were also highlighted in the two data sets. However, the two data sets suggest that nurses create an enabling environment for the students to meet their learning objectives. This study has highlighted areas that require improvement and further research. Gaps and challenges with school learning and clinical placement in terms of making students aware of their objectives, availability of equipment, ensuring proper supervision and feedback need to be addressed. Keywords: Undergraduate nursing, clinical placement, hospital learning, theory-practice DOI: 10.7176/JEP/11-5-04 Publication date: February 29th 202

Self management strategies for people with sickle cell disease in Ghana

Sickle cell disease (SCD) is the commonest inherited haemoglobinopathy worldwide. Although it is a chronic disease, there is presently no international best practice for self-management of SCD. This exploratory sequential mix-methods study was designed to describe the self-management strategies utilised and their effectiveness for persons with SCD in Ghana. Self-management was conceptualised as actions that concerned preventive health, self-monitoring, self-diagnosing, self-treatment and self-evaluation. A four-stage sequential data collection and analysis process was used. Methods included website review, key informant interviews and surveys. The website review extracted from publically available websites the advice provided to people with SCD regarding keeping well, minimising the development of complications and managing complications. Health professional (n=9) interviews concerned self-management advice and the experiences patients shared of their self-management. Patients with SCD (n=9) and parents of children with SCD (n=10) interviews captured their experiences of self-management; and 112 patients (≥ 16 years) and 201 parents of children (≤15 years) were surveyed about their self-management strategies. Analysis used descriptive and inferential statistics and content and thematic techniques. Patients and parents reported that despite receiving limited clinical advice on self-management they undertook at least one self-management action daily. Most patients reported using multiple strategies; preventive health and maintenance actions were the commonest. Whilst most actions were directed at pain, patients and parents also outlined strategies for managing problems such as fever, leg ulcers, anaemia, priapism, abdominal swelling, jaundice, and hip pain. Most self-management actions were clinically safe, however several unsafe actions identified could pose health risks to patients. Overall, parents tended to be more frequent users of self-management actions for their children than the adults were for themselves. Apart from being an adult or child, self-management was not significantly influenced by key vulnerabilities and contextual factors. Although, many patients and parents had tried traditional practices, most only utilised recommendations from health professionals. Most patients and parents had rated the quality their or their child’s quality of life as good. There is a need for the development of an international, evidenced-informed approach to self-management of SCD. The Ministry of Health, health professionals and the Sickle Cell Association of Ghana could work collectively on this to ensure a culturally appropriate and economically viable approach is developed and implemented.</p

Safe Blood Transfusion Practices among Nurses in a Major Referral Center in Ghana

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

Healthcare Professionals’ Knowledge, Attitudes, and Practices in the Assessment, and Management of Sickle-Cell Disease: A Meta-Aggregative Review

Background: Sickle Cell Disease (SCD) presents significant health challenges globally. Despite its prevalence in diverse geographical regions, there is a paucity of literature synthesizing evidence on healthcare professionals’ knowledge, attitudes, and practices (KAP) toward SCD assessment and management. This meta-aggregative review systematically examined and synthesized existing qualitative research to elucidate healthcare professionals’ KAP regarding SCD assessment and management. Methods: This meta-aggregative review followed Aromataris and Pearson’s guidelines and the PRISMA framework for systematic review reporting. The search was conducted in Scopus, PubMed, Embase, CINAHL Web of Science, Google Scholar, Dimensions AI, and HINARI. Quality appraisal was performed using the Joanna Briggs Institute tool. Results: Healthcare professionals (HCPs) demonstrate varying levels of KAP toward SCD assessment and management. Studies reveal low-to-moderate levels of general knowledge among HCPs, with nurses often exhibiting poorer understanding than physicians. Deficiencies in awareness of specific interventions, such as chemoprophylaxis and prenatal diagnosis, are noted, along with gaps in SCD assessment and diagnosis, particularly in pain management and premarital screening. Attitudes toward SCD patients vary, and practices reveal inconsistencies and deficiencies, including inadequate nutritional counseling and barriers in emergency departments. However, interventions aimed at improving HCPs’ KAP show promise in enhancing understanding and attitudes toward SCD, suggesting potential avenues for improvement. Conclusions: Educational initiatives targeted at both student nurses and practicing healthcare providers, coupled with the implementation of standardized protocols and guidelines, can enhance knowledge acquisition and promote consistent, high-quality care delivery. Future studies should improve the quality of their methods in this area of study