Experiences of frontline nurses with adverse medical events in a regional referral hospital in northern Ghana: A cross-sectional study
Date
2019-05-13
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Medicine and Health
Abstract
Background: Adverse medical events (AMEs) are threats to delivery of quality healthcare services, particularly in
resource-poor settings such as Ghana. In sub-Saharan Africa, 30% of deaths are attributed to AMEs and a significant
proportion of these events are not reported. This study explored personal experiences of nurses with AMEs and the
constraints to reporting them.
Methods: This is a descriptive cross-sectional study among professional (n = 133) and auxiliary (n = 88) nurses in a
regional referral hospital in northern Ghana. A test for differences in experiences of professional and auxiliary nurses
was done using Wilcoxon Mann-Whitney test. Ordered logistic regression analysis (proportional odds ratio models)
and probit regression were used to ascertain the determinants of staff’s knowledge on AMEs and the odds of
exposure, respectively.
Results: Overall, knowledge and awareness level on AMEs was average (mean = 3.1 out of the five-point Likert scale of
1 = “Very poor” to 5 = “Excellent”). Knowledge levels among professional nurses (mean = 3.2) were relatively higher
than those among auxiliary nurses (mean = 3.0), (p = 0.006). The predominant type of AME experienced was wrongful
documentation (n = 144), and the least experienced type was wrong transfusion of blood and/or intravenous fluids (IVF)
(n = 40). Male staff had higher odds of experiencing medical errors relative to female staff, OR = 2.39 (95% confidence
interval (CI), 1.34–4.26). Inadequate logistics was the most perceived cause of AMEs. Knowledge on types of AMEs was
significantly associated with gender of the respondents, OR = 1.76 (95% CI, 1.05–2.94); moreover, male staff had higher
odds of knowing AME post-exposure action than female staff, OR = 1.75 (95% CI, 1.04–2.93).
Conclusion: Knowledge levels of nursing staff on AMEs were generally low, and even though exposures were high
they were not reported. There is the need to integrate AME modules into the pre-service and in-service training
curricula for nurses to enhance their knowledge on AMEs; reporting registers for AMEs should be made available in
clinical sites and staff incentives given to those who report AMEs. Lastly, protocols on AMEs should form part of the
quality assurance value chain for health facilities to promote compliance.
Description
Research Article
Keywords
Adverse medical event, Professional nurses, Auxiliary nurses, Regional referral hospital, Northern Ghana