Pregnant Women and Malaria Preventive Measures: A Case of Tamale Teaching Hospital, Ghana

Background. In Saharan Africa, an estimated 25 million pregnancies are all at risk of malaria every year, with substantial morbidity and death effects for both the mother and the fetus. Aim. To investigate the use of malaria preventive measures among pregnant women patronizing antenatal services of Tamale Teaching Hospital. Methodology. This study was conducted using a descriptive cross-sectional survey of 250 participants. Data analysis was done with SPSS version 20. Graphs and tables were used to present the study data. Bivariate analysis was done using Chi-square use to determine the relationships and binary logistics regression used for identification of predictor variables. Results. The mean age of the study participants was 30.0 ± 4.5 years and most of them (73.0%) were within the age group of 25–35 years. Respondents’ favorable knowledge, a favorable attitude, and favorable practice were 78.0%, 62.0%, and 57.6%, respectively. And the following variables were associated with malaria preventive practice: age of the respondent (X2 = 6.276, P = 0.043 ), religion (X2 = 6.904, P = 0.032 ), level of education (X2 = 41.482, P < 0.001 ), employment status (X2 = 20.533, P < 0.001 ), monthly income (X2 = 21.838, P < 0.001 ), and attitude level towards malaria prevention (X2 = 35.885, P < 0.001 ). Further analysis revealed educational level and attitude level as predictors of malaria preventive practice. Conclusion. This study recorded favorable knowledge, attitude, and practice with regards to malaria prevention among more than half of the study participants.

FACTORS INFLUENCING DOCUMENTATION IN NURSING CARE BY NURSES AT THE TAMALE TEACHING HOSPITAL, GHANA

In Ghana, nursing documentation practice by nurses is sub-optimal. This analytical cross-sectional study assessed socio-demographic determinants of nursing documentation practice among 278 nurses at the Tamale Teaching Hospital (TTH). Data was gathered using a questionnaire and both descriptive and inferential analyses were done to determine factors influencing nursing documentation practice. A large majority of the respondents (84.6%) had adequate knowledge on nursing documentation. Most of them (84.2%) had positive attitudes towards it and a large majority of them (77.1%) asserted to practice it always but only 74.0% adequately practiced nursing documentation. Knowledge of nursing documentation was statistically associated with age (AOR 0.12, 95% C1: 0.029-1.507; p=0.004) and work experience (AOR 15.29, 95% C1: 3.083-75.872; p=0.001), males were significantly more likely to have positive attitudes towards it (AOR, 2.81 CI, 1.434-5.501, p=0.003) whilst respondents aged 21-30 years (AOR, 5.85 (2.64-12.97), p

Role of Certified Registered Anesthetists (CRAs) in the Prevention and Management of Supine Hypotension during Cesarian Delivery under Spinal Anesthesia at the Tamale Teaching Hospital (TTH), Ghana

Background: Supine hypotensive syndrome is a pathophysiologic state in a parturient after 20 weeks’ gestation when put in the supine position during cesarian section under spinal anesthesia. Spinal anesthesia produces rapid, effective, reliable and safe anesthesia making it the preferred technique for cesarian section. Maternal hypotension is a known common side effect of spinal anesthesia and is generally managed pharmacologically and/or non Pharmacologically. The aim of this study was to assess the management of supine hypotension during cesarean section under spinal anesthesia among CRAs at Tamale Teaching Hospital (TTH). Methods: A cross-sectional study with both quantitative and descriptive approaches were employed. Thirty-eight (38) CRAs were conveniently sampled and a structured self-administered questionnaire was used for data collection after pretesting for validity and reliability. Data was analyzed with Stata I/C. Results: Non-Pharmacological interventions: 19(50%) of CRAs placed parturient in the supine position n after spinal anesthesia with head up, 15 (39.5%) in Supine position alone, 4 (10.5%), used lateral position alone. Pharmacological interventions (Use of Intravenous fluids): Lactated Ringers solution 6(15.8%), Normal saline solution 24(63.2%), Crystalloid and colloid combination 8(21%). Vasopressor of choice: Ephephrine alone 36(94.8%), Phenylephrine alone 1 (2.6%), Multiple agents 1 (2.6%). Preferred intervention: non-Pharmacological 21(55.3%), Pharmacological 17(44.7%). Determinants of choice of intervention: Severity of hypotension 29(76.3%), availability of intervention 7(18.5%), diagnosis of the patient 1(2.6%), frequency of hypotension 1(2.6%). Conclusions: Most CRAs placed parturient in the supine position with head up as a non-pharmacological approach to managing supine hypotension after spinal anesthesia. Normal saline solution and ephedrine were widely used as pharmacological agents. Majority of the CRAs preferred using the non-pharmacological techniques as compared with the pharmacological approaches and their choice of intervention was significantly influenced by the severity of the intervention.

Nursing Students’ Perceptions of Barriers to Standard Hand Hygiene Practice Amidst COVID-19 in the Tamale Teaching Hospital of Ghana: A Study conducted on First Degree Rotation Nurses of University for Development Studies

Background: Hand hygiene is recognized as the leading measure to prevent cross-transmission of COVID-19. The compliance of nurses with handwashing guidelines is vital in preventing COVID-19 disease transmission among patients. Globally, few studies have explored this subject, especially on the nursing students’ perceptions and barriers of standard hand hygiene precautionary measures amidst the COVID-19 pandemic. Purpose: The study aimed to assess the perceptions and barriers associated with standard hand hygiene practice during the COVID-19 era among first degree nursing students undertaking their clinical rotation at the Tamale Teaching Hospital of Ghana. This study was conducted in April 2021. Materials and methods: The study employed a descriptive cross-sectional design with a quantitative approach. The study population consisted of first degree student nurses of the University for Development Studies who were on clinical rotation at the Tamale Teaching Hospital in the Northern Region of Ghana. The exclusion criteria were nursing students from other tertiary institutions who were having their vacation practicum at the hospital. A simple random sampling technique was used to select the study participants from the wards of the hospital. A standard statistical formula was used to arrive at a sample size of 120. Data was collected by using a paper-based self-designed structured questionnaire in English language that has closed- and open-ended questions. Descriptive statistics involving frequencies and percentages were used in representing data. By using a chi-square test, a p-value <0.05 was considered statistically significant when the association between independent and dependent variables was cross-tabulated. The statistical software that was used for analyzing the data was SPSS version 23. Results: The study had a total of 120 participants with a mean age of 26.48 and a standard deviation of 3.49. On the distribution of perception about hand hygiene, findings indicated that 105 (87.5%) had good perception. Religion and sex respectively were significantly associated with hand hygiene perceptions (χ2= 13.118, p=0.011; χ2=12.49, p=0.014). Conclusion: Though few of the student nurses had a satisfactory perception regarding hand hygiene, it is a cause to worry about since there exist other barriers influencing standard hand hygiene practices at the Tamale Teaching Hospital. Recommendation: There is the need for the quality assurance unit of the hospital to ensure strict compliance to COVID-19 protocols by all categories of health professionals by seeing to it that standard hand hygiene practices are adhered to, irrespective of religious background.

Rising Trend of “Veil Entanglement Injuries” in Northern Ghana: A Case Series

Introduction: Veils are thin garments that are worn over the head, wrapped round the neck, and left hanging loosely over the torso up to the thighs. They are also known as scarf or “dupatta.” Veils can get entangled in spokes of motorbikes or in belt-driven machinery resulting in a variety of life-threating injuries. Case Reports: We report nine major cases of veil entanglement injuries (VEI) that presented to the Orthopedic Unit of Tamale Teaching Hospital from July 10, 2017 to June 12, 2020. All the patients were females with ages ranging from 5-months to 44-year. All the accidents involved either a motorbike or auto rickshaw. Head, neck, and extremity injuries were the most common. Eight out of nine patients had circumferential neck bruise referred to as “veil sign” in this report. One patient died. Conclusion: The rising trend of VEI is alarming among women in Northern Ghana. We recommend widespread public education and awareness creation. We also recommend modification of traffic regulations by policy makers to avert this avoidable injury. Keywords: “Dupatta,” long scarf injuries, “Isadora Duncan syndrome,” veil injuries.

Surgical Healthcare Workers Knowledge and Attitude on Infection Prevention and Control: A Case of Tamale Teaching Hospital, Ghana

Background. Most morbidities and mortalities related to clinical, diagnostic, and therapeutic procedures are related to infection and the solution to this is good infection prevention and control (IPC) compliance which is influenced by the right knowledge and positive attitude. Aim. This study aimed to assess infection prevention and control (IPC) knowledge and attitude among healthcare workers at the surgical department of Tamale Teaching Hospital (TTH). Methods. This study was conducted using a descriptive cross-sectional survey. Data entry and analysis were done using Statistical Package for the Social Sciences (SPSS) version 20 and Graph Pad Prism version 6.05. Tables, frequencies, and percentages were used for descriptive analysis and chi-square analysis for the associations. Results. Of the 156 participants who responded, 22 (14.1%) were doctors, with 107 (68.6%) nurses, 12 (7.7%) certified registered anesthetics (CRA), and 15 (9.6%) orderlies. Approximately, 50.6% of the respondents were knowledgeable with regard to IPC and 55.1% of the respondents had a good attitude towards IPC. Factors associated with knowledge level were educational level p ≤ 0.001 , occupation p ≤ 0.001 , marital status p = 0.030 , and age p = 0.030 . The occupation was the only factor associated with the attitude level p = 0.048 . Conclusion. More than half of the healthcare providers reported good knowledge and attitude towards IPC. Proportionally, more nurses had good IPC knowledge and attitude as compared to other professional groups. Firming up and assimilating universal precaution with routine services by providing training, protocol, rules, and regulation are recommended.

Timing and causes of neonatal mortality in Tamale Teaching Hospital, Ghana: A retrospective study

Neonatal deaths now account for more than two-thirds of all deaths in the first year of life and for about half of all deaths in children under-five years. Sub-Saharan Africa accounts up to 41% of the total burden of neonatal deaths worldwide. Our study aims to describe causes of neonatal mortality and to evaluate predictors of timing of neonatal death at Tamale Teaching Hospital (TTH), Ghana. This retrospective study was conducted at TTH located in Northern Ghana. All neonates who died in the Neonatal Intensive Care Unit (NICU) from 2013 to 2017 were included and data was obtained from admission and discharge books and mortality records. Bivariate and multivariate logistic regression were used to assess predictors of timing of neonatal death. Out of the 8,377 neonates that were admitted at the NICU during the 5-year study period, 1,126 died, representing a mortality rate of 13.4%. Of those that died, 74.3% died within 6 days. There was an overall downward trend in neonatal mortality over the course of the 5-year study period (18.2% in 2013; 14.3% in 2017). Preterm birth complications (49.6%) and birth asphyxia (21.7%) were the top causes of mortality. Predictors of early death included being born within TTH, birth weight, and having a diagnosis of preterm birth complication or birth asphyxia. Our retrospective study found that almost 3/4 of neonatal deaths were within the first week and these deaths were more likely to be associated with preterm birth complications or birth asphyxia. Most of the deaths occurred in babies born within health facilities, presenting an opportunity to reduce our mortality by improving on quality of care provided during the perinatal period.