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Diango K, Mafuta E, Wallis LA, Cunningham C, Hodkinson P. Implementation and evaluation of a pilot WHO community first aid responder training in Kinshasa, DR Congo: A mixed method study. Afr J Emerg Med 2023; 13:258-264. [PMID: 37790995 PMCID: PMC10542602 DOI: 10.1016/j.afjem.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/30/2023] [Accepted: 09/03/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Prehospital care in many low- and middle-income countries is underdeveloped and needs strengthening for improved outcomes. Where formal prehospital care systems are under development, integration of a layperson first responder programme may help improve access for those in need. The World Health Organization recently developed the Community First Aid Responder (CFAR) learning program in support of this system, providing that it may require adaptation to be contextually suitable and sustainably implemented at country level. This study assesses a pilot WHO CFAR course in Kinshasa, Democratic Republic of Congo, to inform future rollouts and related research. Methods We conducted a 3-day in-person pilot CFAR training with 42 purposively selected community health workers. Data collection involved quantitative and qualitative phases. The first consisted of structured pre- and post-training surveys, and a course evaluation by participants. The second consisted of two focus group discussions involving purposively selected community health workers in one group, and a convenience sample of course instructors and organisers in the other. Perceptions regarding course content, perceived knowledge acquisition and self-confidence gain were analysed using descriptive statistics for the quantitative data and content analysis for qualitative data. Results Course participants were predominantly male (76.3 %) with a median age of 42 years and most (80.5 %) had no prior first aid training. Most were satisfied that the learning objectives were reached, the logistics were adequate, and that the content and teaching language were appropriately tailored to local context. The majority (94.7 %) found the 3-day duration insufficient. There was a significant self-confidence gain regarding first aid skills (average 17.9 % in pre- to 95.3 % in post-training, p < 0.001). Favourable opinions on the course structure, content, logistics and teaching methods were noted. Conclusion A CFAR course pilot was successfully conducted in Kinshasa. The course is appropriate for context and well received by participants. It can form a key component of developing prehospital care systems in resource-constrained settings.
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Affiliation(s)
- Ken Diango
- Division of Emergency Medicine, Department of Family, Community and Emergency Care, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Eric Mafuta
- Kinshasa School of Public Health, University of Kinshasa, Commune Lemba, Kinshasa, DR Congo
| | - Lee A. Wallis
- Clinical Services and Systems, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Charmaine Cunningham
- Division of Emergency Medicine, Department of Family, Community and Emergency Care, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Peter Hodkinson
- Division of Emergency Medicine, Department of Family, Community and Emergency Care, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town 7925, South Africa
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Koranda NW, Knettel BA, Mabula P, Joshi R, Kisigo G, Klein C, Bunting A, Lauritsen M, O'Tool J, Dunlop SJ. Evaluating the impact of a training program in prehospital trauma care and mental health for traffic police in Arusha, Tanzania. Int Emerg Nurs 2023; 70:101346. [PMID: 37708788 DOI: 10.1016/j.ienj.2023.101346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/03/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Tanzania does not have a formalized prehospital Emergency Medical Services (EMS) response. As a result, traffic police play an integral role in the emergency response system. This study examines the potential impact of a brief training program in prehospital trauma care and mental health to improve knowledge, self-efficacy, and practice intentions related to trauma care among police officers. METHOD A cohort of 45 police officers were enrolled to participate in the training and accompanying evaluation. The training was 12 h long, held over 3 days, and included education on how to manage traumatic injuries in a prehospital environment. The course included classroom instruction, hands on skills practice, and a training simulation. Officers received instruction on conducting a primary survey, managing common airway, spinal cord, and bleeding emergencies, as well as coping strategies for their own mental health. Before and after the course, a 26-item assessment was administered to measure knowledge, self-efficacy, and practice intentions specific to the training. The study used paired-samples t-tests to compare scores in each of the three domains before and after the training. RESULTS Participants demonstrated significantly improved knowledge (M = 0.30, SD = 0.27; t(34) = 6.67, p <.001), greater self-efficacy (M = 0.44, SD = 0.53; t(34) = 4.97, p <.001), and more evidence-informed practice intentions (M = 0.12, SD = 0.28; t(34) = 2.55, p <.05) at the conclusion of the course. CONCLUSION Police officers who received the 12-hour training focused on trauma management were better prepared to respond to emergencies and demonstrated a greater understanding of prehospital trauma care. Further studies are required to assess real world impact of the training and to determine how to increase support for traffic police as emergency medical responders in low-resource settings.
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Affiliation(s)
- Nathan W Koranda
- Koranda O'Tool Paramedics Incorporated (KOPI Medical), United States; PrairieCare, United States.
| | - Brandon A Knettel
- Duke University, School of Nursing, United States; Duke Global Health Institute, United States
| | - Peter Mabula
- Koranda O'Tool Paramedics Incorporated (KOPI Medical), United States; Same Qualities Foundation, United Republic of Tanzania
| | - Rupa Joshi
- Koranda O'Tool Paramedics Incorporated (KOPI Medical), United States
| | - Godfrey Kisigo
- The London School of Hygiene & Tropical Medicine, United Kingdom
| | - Christine Klein
- Koranda O'Tool Paramedics Incorporated (KOPI Medical), United States; PrairieCare, United States
| | - Alec Bunting
- Koranda O'Tool Paramedics Incorporated (KOPI Medical), United States; Hennepin Healthcare, United States
| | | | | | - Stephen J Dunlop
- Koranda O'Tool Paramedics Incorporated (KOPI Medical), United States; Hennepin Healthcare, United States
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Hosaka L, Tupetz A, Sakita FM, Shayo F, Staton C, Mmbaga BT, Joiner AP. A qualitative assessment of stakeholder perspectives on barriers and facilitators to emergency care delays in Northern Tanzania through the Three Delays. Afr J Emerg Med 2023; 13:191-198. [PMID: 37456586 PMCID: PMC10344688 DOI: 10.1016/j.afjem.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/09/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Emergency conditions cause a significant burden of death and disability, particularly in developing countries. Prehospital and Emergency Medical Services (EMS) are largely nonexistent throughout Tanzania and little is known about the community's barriers to accessing emergency care. The objective of this study was to better understand local community stakeholder perspectives on barriers, facilitators, and potential solutions surrounding emergency care in the Kilimanjaro region through the Three Delays Model framework. Methods A qualitative assessment of local stakeholders was conducted through semi-structured focus group discussions (FGDs) from February to June 2021 with five separate groups: hospital administrators, emergency hospital workers, police personnel, fire brigade personnel, and community health workers. FGDs were conducted in Kiswahili, audio recorded, and translated to English verbatim. Two research analysts separately coded the first two FGDs using both inductive and deductive thematic analysis. A final codebook was then created to analyze the remaining FGDs. Results A total of 24 participants were interviewed. Thematic analysis revealed that participants identified significant barriers within the Three Delays Model as well as identified an additional delay centered on community members and first aid provision. Perceived delays in the decision to seek care, the first delay, were financial constraints and the lack of community education on emergency conditions. Limited infrastructure and reduced transportation access were thought to contribute to the second delay. Potential barriers to receiving timely appropriate care, the third delay, included upfront payments required by hospitals and emergency department intake delays. Suggested solutions focused on increasing education and improving communication and infrastructure. Conclusion The findings outline barriers to accessing emergency care from a stakeholder perspective. These themes can support recommendations for further strengthening of the prehospital and emergency care system. Due to logistical constraints, emergency care workers interviewed were all from one hospital and patients were not included.
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Affiliation(s)
- Leah Hosaka
- University of Hawaii at Manoa School of Nursing, Honolulu, HI, United States
| | - Anna Tupetz
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Francis M. Sakita
- Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Durham, NC, United States
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Frida Shayo
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Catherine Staton
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Durham, NC, United States
- Department of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
| | - Blandina T. Mmbaga
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Durham, NC, United States
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Anjni Patel Joiner
- Duke Global Health Institute, Duke University, Durham, NC, United States
- Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center, Durham, NC, United States
- Department of Emergency Medicine, Duke University Medical Center, Durham, NC, United States
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Pearkao C, Potisopha W, Ienghong K, Cheung LW, Apiratwarakul K. Development of First Aid Self-learning Web Application for Road Accident Victims. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Knowledge of prehospital scene care for injured person in road accidents is essential for improving outcome and saving lives of traffic accident victims. However, the situation of the COVID-19 pandemic may cause people’s inability to access in-person first aid training.
AIM: This study aimed to determine the effect of first aid self-learning web application for road accident victims on the knowledge and satisfaction of the web application users.
METHODS: A prospective, single-arm, and educational cohort study was conducted among second-year physical education participants at Khon Kaen University attending first aid self-learning web application for road accident victims in July 2021. All participants were attended ten lessons covering important content of first aid for an injured person in road accidents. Each lesson includes reading texts, 3-min animation videos, and pre-test and post-test. Data analysis includes a comparison of the pre-test and post-test knowledge scores using the paired t-test. The participant’s satisfaction was analyzed using descriptive statistics.
RESULTS: The 42 participants were participated in this study. Sixty-two percent of the participants had no previous first aid experience for an injured person in road accidents. The mean pre-test and post-test scores were 25.31 ± 3.87 and 27.50 ± 2.91, respectively. There was a significant difference between the pre-test and the post-test scores (p < 0.001). The participant’s level of satisfaction score was very good (4.25 ± 0.95).
CONCLUSIONS: The first aid self-learning web application significantly improved the first aid knowledge of the web application users. Moreover, most participants reported good level of satisfaction for using this tool. This emphasized that the first aid self-learning web application was the great tool in COVID-19 learning.
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Investigation on the Effect of Graded Emergency Nursing Group under the Assistance of Multidisciplinary First Aid Knowledge Internet-Based Approach on the First Aid of Acute Myocardial Infarction. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8469930. [PMID: 35087651 PMCID: PMC8789469 DOI: 10.1155/2022/8469930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze the effect of a graded emergency nursing group under the assistance of multidisciplinary first aid knowledge Internet-based approach on the first aid of acute myocardial infarction (AMI). METHODS The clinical data of 90 AMI patients treated in our hospital from March 2019 to March 2020 were selected for the retrospective analysis, and the patients were divided into the observation group and the routine group according to the first aid order, with 45 cases each. The patients in the routine group received the conventional first aid measures, and the graded emergency nursing group mode with the help of multidisciplinary first aid knowledge Internet-based approach was adopted for those in the observation group so as to compare the prognosis, nursing satisfaction scores, etc., between the two groups. RESULTS Compared with the routine group, patients in the observation group obtained significantly lower various fast reaction indicators and quality of life score (P < 0.001), higher nursing satisfaction score (P < 0.001), lower total complication rate (P < 0.05), higher successful rescue rate (P < 0.05), and lower AMI recurrence rate and PCI reuse rate (P < 0.05). CONCLUSION Rescue measures by the graded emergency nursing group with the help of multidisciplinary first aid knowledge Internet-based approach are a reliable method for improving AMI patients, and such strategy greatly promotes patients' quality of life and reduces the PCI reuse rate. Further research will be conducive to establishing a better solution for AMI patients.
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Glèlè-Ahanhanzo Y, Kpade A, Kpozèhouen A, Levêque A, Ouendo EM. Can Professional Motorcyclists Be an Asset in the Immediate Post-Crash Care System in Benin? Baseline of Knowledge and Practices in the City of Cotonou (Benin). Open Access Emerg Med 2021; 13:1-11. [PMID: 33442307 PMCID: PMC7797346 DOI: 10.2147/oaem.s267828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/27/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The situation of road crashes-related deaths remains problematic in low-income countries. The present study aims at analyzing the first-aid knowledge and practices of professional motorcyclists (PMs) in the city of Cotonou in Benin. Materials and Methods This is a cross-sectional analytical study conducted from 25 March to 19 April 2019 in Cotonou and concerned PMs registered in a fleet who gave their consent to participate in the study. The World Health Organization's two-stage adaptive cluster sampling technique was applied to select the eligible PMs while respecting the proportionality rate per fleet. A logistic regression analysis was done and the odds ratios were estimated with 95% confidence interval. Results The 430 PMs surveyed were all middle-aged men with an average age of 38.38 (±8.70). Among them, 62.56% knew at least one of the emergency phone numbers for the ambulance, police or fire services and 49.53% of the PMs knew at least one of the 3 techniques evaluated. In addition, 33.23% of PMs who had witnessed at least an RC stated that they had alerted the emergency services, and 32.27% said they had helped the victims. The main reason given for the lack of initiative in RCs was lack of knowledge of the course of action to take (19.64%). The level of knowledge was associated with the level of education (AOR: 3.11; CI 95%: 1.79-5.43) and with the length of experience (AOR: 2.56; CI 95%: 1.58-4.18). Conclusion This study reveals that the level of knowledge and practice of PMs in the field of first aid in Cotonou is low and demonstrates the relevance and the need to include this target group in the first-aid chain for road crashes in Benin.
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Affiliation(s)
- Yolaine Glèlè-Ahanhanzo
- Multidisciplinary Research Unit for Road Crashes Prevention (ReMPARt), Epidemiology and Biostatistic Department, Regional Institute of Public Health, Ouidah, Benin
| | | | - Alphonse Kpozèhouen
- Multidisciplinary Research Unit for Road Crashes Prevention (ReMPARt), Epidemiology and Biostatistic Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alain Levêque
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School (Université Libre de Bruxelles), Brussels, Belgium
| | - Edgard-Marius Ouendo
- Health Policies and Systems Department, Regional Institute of Public Health, Ouidah, Benin
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Ndile ML, Saveman BI, Lukumay GG, Mkoka DA, Outwater AH, Backteman-Erlanson S. Traffic police officers' use of first aid skills at work: a qualitative content analysis of focus group discussions in Dar Es Salaam, Tanzania. BMC Emerg Med 2020; 20:72. [PMID: 32912156 PMCID: PMC7488336 DOI: 10.1186/s12873-020-00368-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/03/2020] [Indexed: 11/10/2022] Open
Abstract
Background The World Health Organisation (WHO) recommends involving lay people in prehospital care. Several training programmes have been implemented to build lay responder first aid skills. Findings show that most programmes significantly improved participants’ first aid skills. However, there is a gap in knowledge of what factors influence the use of these skills in real situations. The current study aimed to describe police officers’ views on and experiences of factors that facilitate or hinder their use of trained first aid skills at work. Methods Thirty-four police officers participated in five focus group discussions. A structured interview guide was used to collect data. Interviews were audio-recorded and transcribed verbatim. Data were analysed using qualitative content analysis. Results We identified five categories of facilitators or hindrances. Training exposure was considered a facilitator; work situation and hospital atmosphere were considered hindrances; and the physical and social environments and the resources available for providing first aid could be either facilitators or hindrances. Conclusion Practical exposure during training is perceived to improve police officers’ confidence in applying their first aid skills at work. However, contextual factors related to the working environment need to be addressed to promote this transfer of skills.
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Affiliation(s)
- Menti L Ndile
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences (MUHAS), P.O. Box 65001, Dar es Salaam, Tanzania.
| | | | - Gift G Lukumay
- Department of Community Nursing, MUHAS, Dar es Salaam, Tanzania
| | - Dickson A Mkoka
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences (MUHAS), P.O. Box 65001, Dar es Salaam, Tanzania
| | - Anne H Outwater
- Department of Community Nursing, MUHAS, Dar es Salaam, Tanzania
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