Factors affecting access to dialysis for patients with end-stage kidney disease in Sub-Saharan Africa: A scoping review.

AIMS: This scoping review examined the factors affecting access to dialysis for patients with end-stage kidney disease in Sub-Saharan Africa. DESIGN: Scoping review. METHODS: The scoping review is conducted following the Joanna Briggs Institute methodology for scoping reviews and modelled by Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review. RESULTS: A descriptive content analysis of 30 included articles revealed three main findings affecting access and use of dialysis: Health system-related factors, health provider-related factors and patient factors. PATIENT OR PUBLIC CONTRIBUTION: Equity in renal replacement therapy access and use will require concerted advocacy for good public policy, healthcare delivery, workforce capacity and education.

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention.

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

New Graduate Nurses' Experiences and Challenges during a One-Year Clinical Rotation Programme in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention.

Background: To help improve the standards and quality of nursing practice, newly graduated nurses and midwives are required after passing the Nursing and Midwifery Council's Licensing Examination to undertake a one-year mandatory clinical rotation at health facilities before registration. However, there is a lack of scientific studies to explore new graduate nurses' experiences and challenges during the one-year mandatory clinical rotation programme. Aim: This study is aimed at exploring newly qualified nurses' experiences and challenges during the one-year mandatory clinical rotation in health facilities in the Volta Region of Ghana. Methods: This qualitative exploratory study used a combination of focus group discussions (FGDs) and individual interviews. Thirty (30) newly qualified nurses were selected from two secondary and one tertiary health facilities, where newly qualified nurses are posted for a clinical rotation programmes to participate in the study. A total of two focus group discussions (FGDs) were conducted, comprising five (5) members in each group. Moreover, twenty (20) newly qualified nurses were interviewed individually, and their data were added to what was obtained from the focus group discussions. This study adopted the thematic analysis approach to analyze the data. Results: The results of this study showed that newly qualified nurses experienced the following during the one-year clinical rotation programme: acquisition of more knowledge and competencies to assume professional nursing roles; lack of knowledge of the objectives of the clinical rotation programme by hospital staff; experience of frustration during the clinical rotation programme; inadequate supervision and support; accommodation and financial challenges. Conclusion: The study revealed important challenges experienced by new graduate nurses during the clinical rotation programme, including hospital staff's lack of knowledge regarding the objectives of the rotation programme, inadequate supervision and support, and accommodation and financial challenges. There is a need for the Nursing and Midwifery Council to develop guidelines for the one-year mandatory clinical rotation for newly graduated nurses and midwives to make the programme more effective.

Factors affecting care of elderly patients among nursing staff at the Ho teaching hospital in Ghana: Implications for geriatric care policy in Ghana.

INTRODUCTION: The population of the aged is increasing globally and in Ghana. In 2020, the population aged over 60 years in Ghana was 2,051,903 and this is expected to reach 2.5 million by 2025 and 6.3 million by 2050. Despite the envisaged increase in the number and life expectancy of the older population in Ghana that will require nursing care, there is a paucity of data on nursing staff knowledge and attitudes toward elderly patients in Ghana. OBJECTIVES: This study, therefore, assessed factors affecting the care of elderly patients among nursing staff in a tertiary referral health facility in the Volta region of Ghana. METHODS: The study employed a descriptive cross-sectional design using quantitative data collection approaches. A total of 150 nurses were sampled with a response rate of 95%. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. The analysis included logistic regression to predict factors associated with nurses' knowledge and attitude in caring for elderly patients, after multicollinearity diagnosis and controlling the effect of confounding variables. RESULTS: Majority (83.8%) of the nurses demonstrated good knowledge of the aging process, knowledge in the care of the elderly (88.7%), and (84.5%) had a positive caring attitude towards the elderly. Professional education, professional qualification, and knowledge on aged care were significantly associated with nurses' attitude towards the elderly (p<0.001), (p<0.005), and (p<0.010), respectively. Lack of special wards/facilities emerged as the predominantly perceived barrier to caring for the elderly as per the nurses' responses. CONCLUSION: The majority of nurses demonstrated good knowledge and attitude in the aging process and care of the aged. Lack of special wards/facilities and lack of staff motivation were the leading perceived barriers to rendering care to the elderly. Scaling up gerontological nursing programs and establishing special aged care facilities in Ghana with appropriate policy guidelines and regulations for implementation of care will help improve nurses' knowledge and caring attitudes toward the care of elderly patients. Likewise, a national geriatric care policy would help consolidate standard geriatric care in Ghana.

Leveraging breast cancer screening to promote timely detection, diagnosis and treatment among women in sub-Saharan Africa: a scoping review protocol.

INTRODUCTION: Female breast cancer is now the most often diagnosed cancer in the world. Breast cancer screening aims to reduce mortalities related to cancer, and morbidity associated with advanced stages of the disease, through timely detection in asymptomatic women. This study aims to conduct a comprehensive assessment and evaluation of the evidence on the factors that influence the provision and uptake of breast cancer screening among women in sub-Saharan Africa (SSA). METHODS AND ANALYSIS: PubMed, Web of Science, EMBASE and the Cumulative Index to Nursing and Allied Health Literature including Google Scholar will be searched to identify published studies on barriers and facilitators to breast cancer screening from January 2010 to 2021. Two reviewers will independently assess the quality of all the included studies using the Mixed Methods Appraisal Tool version 2018. We envisage that this review will adduce evidence on common barriers and facilitators to breast cancer screening in SSA. Identifying these barriers and facilitators will help guide the initialisation of effective interventions that will improve breast cancer screening uptake among women in SSA. This review will also guide future research in developing, implementing and evaluating appropriate interventions tailored toward increasing breast cancer screening uptake. ETHICS AND DISSEMINATION: Ethics approval for this protocol is not required since it does not involve collecting data from human participants. The outcomes of this study will be published in a peer-reviewed journal.

Knowledge, attitudes and practices regarding neonatal jaundice among caregivers in a tertiary health facility in Ghana.

BACKGROUND: Neonatal jaundice is a major reason babies are frequently re-admitted after hospital discharge following delivery. One means of improving neonatal care and reducing potential mortality associated with neonatal jaundice in resource-limited settings is to create awareness among caregivers. Caregivers who tend to have higher knowledge and awareness, also have positive attitudes, and are not guided by outmoded socio-cultural beliefs and practices are more likely to seek early care and treatment for neonatal jaundice. OBJECTIVE: This study investigated caregivers' knowledge, attitude and practices regarding neonatal jaundice in a tertiary health facility in the Volta region of Ghana. METHODS: This was a descriptive cross-sectional study that employed a quantitative approach for data collection. A total of 202 caregivers from the Ho Teaching Hospital in the Volta region of Ghana were sampled using a systematic random sampling strategy where quantitative data was collected using a questionnaire and analyzed with STATA version 14.0. Ordered logistic regression was used to determine the factors that were associated with caregivers' knowledge regarding neonatal jaundice and attitude after controlling for relevant covariates. RESULTS: Less than half of the caregivers demonstrated good knowledge (45.5%) and attitude (47.5%) but 58.9% had good practices regarding neonatal jaundice. Caregivers who had prior awareness and education on neonatal jaundice were three times more likely to have good knowledge about jaundice than those without previous education [AOR = 3.02, (95%CI: 1.59-5.74), p = 0.001]. A caregiver employed in the public sector was two times more likely to have a good attitude about jaundice than those employed in the private sector [AOR = 2.08, (95%CI: 1.03-4.21), p = 0.042]. CONCLUSION: Less than two thirds of the caregivers demonstrated good practice with limited knowledge and poor attitude. Efforts to promote well informed and improved caregivers' attitude will advance positive maternal health-seeking behavior and reduce disabilities and death through early detection and intervention of infants with neonatal jaundice. Public awareness and education about neonatal jaundice especially among caregivers in the private sector should also be intensified.

Challenges experienced by midwives working in rural communities in the Upper East Region of Ghana: a qualitative study.

BACKGROUND: In 2017, a total of 295,000 women lost their lives due to pregnancy and childbirth across the globe, with sub-Saharan Africa and South Asia accounting for approximately 86 % of all maternal deaths. The maternal mortality ratio in Ghana is exceptionally high, with approximately 308 deaths/100,000 live births in 2017. Most of these maternal deaths occur in rural areas than in urban areas. Thus, we aimed to explore and gain insights into midwives' experiences of working and providing women-centred care in rural northern Ghana. METHODS: A qualitative descriptive exploratory design was used to explore the challenges midwives face in delivering women-centred midwifery care in low-resource, rural areas. A total of 30 midwives practicing in the Upper East Region of Ghana were purposefully selected. Data were collected using individual semistructured interviews and analysed through qualitative content analysis. RESULTS: Five main themes emerged from the data analysis. These themes included were: inadequate infrastructure (lack of bed and physical space), shortage of midwifery staff, logistical challenges, lack of motivation, and limited in-service training opportunities. CONCLUSIONS: Midwives experience myriad challenges in providing sufficient women-centred care in rural Ghana. To overcome these challenges, measures such as providing adequate beds and physical space, making more equipment available, and increasing midwifery staff strength to reduce individual workload, coupled with motivation from facility managers, are needed.

"We are left with nothing to work with"; challenges of nurses working in the emergency unit at a secondary referral hospital: A descriptive qualitative study.

INTRODUCTION: In recent times, there has been an increasing burden in traumatic, medical, and surgical emergency conditions, placing more emphasis on the need for quality emergency care. This study aimed to explore the challenges experienced by nurses working in the emergency unit of a secondary referral hospital. METHODS: The study used an exploratory qualitative research design with a constructivist approach and a grounded theory method. Data were collected through in-depth interviews lasting between 30 to 45 minutes using a semi-structured interview guide. Inductive content analysis was used to analyse data. RESULTS: Eleven (11) participants were interviewed. The majority were female (9), aged between 31-40 years. From the inductive content analysis, four themes emerged. These were; 1) overcrowding in the emergency unit, 2) understaffing at the emergency unit, 3) lack of emergency equipment, 4) inadequate managerial support. CONCLUSION: The study identified several major challenges confronting nurses working in the emergency unit which are linked with managerial processes and inadequate managerial support. These challenges need to be addressed to promote quality emergency nursing care. To foster a positive working environment, hospital management should validate and address the aforementioned concerns of the Emergency Department nurses.

Older people's challenges and expectations of healthcare in Ghana: A qualitative study.

BACKGROUND: The increase in the number of elderly persons in developing countries has not had a corresponding increase in social and health care support systems for the elderly. There is a substantial difference in the quality of healthcare received by older people in developing and developed countries. Elderly persons in developing countries including Ghana are increasingly becoming marginalised and isolated. There is, however, limited evidence of healthcare challenges and expectations by elderly persons in Ghana. This study explored healthcare challenges and expectations of elderly persons to inform policy that could lead to improved quality of life for elderly persons in Ghana. MATERIALS AND METHODS: Qualitative exploratory descriptive study design was used in conducting this study. Semi-structured interviews were used in collecting data from 30 participants from three regions in Ghana (10 from each region). Data analysis was carried out through content analysis. RESULTS: Four themes were extracted from data. These themes were: 1. Inadequate information from health workers regarding care of the older person. 2. Queuing frustrations. 3. Financial burden. 4. Focused elderly care demand. CONCLUSION: The elderly in Ghana experience challenges of healthcare which include inadequate information, queuing frustrations and financial burdens. Elderly persons also have expectations of healthcare which include having dedicated professionals and units that will attend to them during their hospital visits. Academic and clinical gerontology experts could collaborate and help improve gerontology knowledge of health workers through workshops and conferences. Improving knowledge of health workers in gerontology may be a positive step towards meeting healthcare expectations of older Ghanaians.

A Qualitative Study to Explore the Experiences of Older People Utilising Outpatient Healthcare Services from a Teaching Hospital in Ghana.

BACKGROUND: Empirical evidence suggests that when older people are provided with quality and affordable healthcare services, their health status can be improved. However, in low- and middle-income countries, healthcare services may not be fully resourced, leading to difficulties for older people utilising those services. There is a paucity of research studies regarding the experiences of older persons accessing healthcare services in sub-Saharan Africa including Ghana. AIM: The purpose of this study was to explore and describe the experiences of older people utilising outpatient healthcare services from a Teaching hospital in Ghana. METHODS: This study adopted a descriptive qualitative approach to describe the experiences of older persons utilising outpatient healthcare services. Participants included a total of twelve older people between the ages of 60 and 80 years who utilised outpatient healthcare services at the hospital. A semistructured interview guide was used to conduct interviews with participants, and their views were analysed into descriptive themes. RESULTS: The results in this study showed that the participants experienced the following in utilising outpatient healthcare services: long waiting hours in accessing outpatient healthcare, poor attitudes from health staff, lack of drugs from the healthcare facility, inadequate information from health staff in the healthcare facility, lack of specialist care at the healthcare facility, and high confidence and trust in the efficacy of the orthodox healthcare. CONCLUSION: The findings from this qualitative study demonstrated that the participants encountered some challenges in accessing outpatient healthcare services. There is the need for government and other stakeholders to address the challenges encountered by older people in accessing healthcare in order to facilitate the utilisation of healthcare among older persons for better health outcomes.

Exploring the reasons why women prefer to give birth at home in rural northern Ghana: a qualitative study.

BACKGROUND: Skilled birth care during childbirth is reported in the literature as one critical strategy for reducing maternal morbidity and mortality. Despite the importance of birth care provided by skilled birth attendants, women in rural areas of northern Ghana still give birth utilising the birth services provided by Traditional Birth Attendants. The aim of this study,therefore, was to explore and describe the reasons why a small group of rural women chose homebirth in rural northern Ghana. METHODS: A qualitative approach was adopted to explore the reasons why women prefer to deliver at home in rural areas of northern Ghana. Individual interviews were used to obtain a full description of factors and experiences of women associated with home births in rural areas in Ghana. The research population consisted of 10 women who utilised birth care services provided by Traditional Birth Attendants in a rural community of northern Ghana. Data collected from the interviews were transcribed verbatim and analysed to identify themes. RESULTS: This study, which was conducted among a small group of women, yielded interesting results on why these women still give birth at home in rural northern Ghana. It was found out that perceived poor quality of care and conduct of skilled birth attendants; the perception that women received better care from Traditional Birth Attendants; financial constraints and lack of access to healthcare facilities in the rural areas by these women accounted for majority of the reasons why women in rural northern Ghana still give birth at home. CONCLUSION: The study highlighted some barriers experienced by participants to the utilisation of birth care services provided by skilled birth attendants in rural northern Ghana. Management of healthcare facilities should facilitate the implementation of supportive supervision in the maternity units to improve the quality of care and attitude delivered by skilled birth attendants in maternity care in rural communities.

Women's knowledge and its associated factors regarding optimum utilisation of antenatal care in rural Ghana: A cross-sectional study.

INTRODUCTION: Improving maternal health is a global public health challenge especially in sub-Saharan Africa. The optimum utilisation of antenatal care (ANC) by pregnant women is known to improve maternal health outcomes. Maternal morbidity and mortality rates in Ghana remain unacceptably high, particularly in rural settings where skilled delivery care often times is disproportionally low. This study assessed factors associated with optimum utilisation of antenatal care in rural Ghana. METHODS: A cross-sectional design was applied to collect data among eligible participants between October 2018 and January 2019. A total of 322 women who gave birth and attended the postnatal clinic were recruited for the study. Consecutive sampling was employed in recruiting participants. The associations between the dependent variables (ANC service utilisation and knowledge of ANC) and independent variables (socio-demographic characteristics) were examined using ordinary least squares logistic regression at 95% confidence interval in STATA version 14.0. RESULTS: Of the 322 participants, 69.0% reported utilising at least four or more times ANC services. Determinants of women attending ANC for four or more times was significantly associated with age [OR = 4.36 (95%CI: 2.16-8.80), p<0.001], educational level [OR = 10.18 (95%CI: 3.86-26.87), p<0.001], and insured with National Health Insurance Scheme [OR = 3.42 (95%CI: 1.72-6.82), p<0.001]. Not married [OR = 0.65 (0.39-1.09), p = 0.011] or divorced [OR = 0.33 (95%CI: 0.13-0.83), p = 0.019] was negatively associated with utilisation of four or more ANC services. The majority (79.0%) of the participants had a good level of knowledge regarding antenatal care. CONCLUSION: Although the majority of women in this study had good knowledge of ANC services, a significant number of them did not complete the recommended number of ANC visits for at least four times during a normal pregnancy. Awareness and further education to reproductive-age women on the significant role adequate ANC attendance plays in advancing health and well-being require further investments, particularly among rural women in Ghana.

Cultural beliefs and practices of women influencing home births in rural Northern Ghana.

Background: One of the maternal health care strategies identified by the World Health Organization as being crucial for saving lives of pregnant women, which also serves as an indicator for progress in reducing maternal mortality, is the provision and utilization of skilled birth care. Despite the importance of skilled birth care in preventing maternal morbidity and mortality, many women continue to give birth at home without the assistance of skilled birth attendants in rural communities of Ghana. Purpose: The purpose of this study was to explore the cultural beliefs that potentially influenced the choice of home births among rural women in Ghana. Methods: A qualitative approach was utilized to conduct this study. Twenty participants who delivered at home were purposefully selected and interviewed individually. Semistructured interviews were used to explore the cultural belief patterns that potentially influenced the choice of home births among women in rural Ghana. Thematic analysis approach was used to analyze the data. Results: Four major themes emerging from the data analysis which influenced rural women's decision to give birth at home are namely: opportunity to access psychological support through family members, opportunity to access culturally acceptable food, opportunity to adopt a birthing position of choice, and opportunity for safe and culturally accepted disposal of placenta. Conclusion: This study concluded that the cultural beliefs held by these women greatly affected their decision to deliver at home. Hence, there is a need for health care managers to facilitate collaborative practices between the skilled birth attendants and traditional birth attendants. This is because this approach could enhance the integration of the cultural beliefs and practices of women in the orthodox health care delivery system to facilitate the utilization of skilled birth care.

A qualitative study on rural women's experiences relating to the utilisation of birth care provided by skilled birth attendants in the rural areas of Bongo District in the Upper East Region of Ghana.

BACKGROUND: Increasing skilled attendance during childbirth is well established in literature to play a significant role in averting the many preventable maternal deaths that occur in developing countries such as Ghana. Inadequate utilisation of skilled birth care services in Ghana is believed to be a major hindrance to efforts aimed at improving the health of women, especially during delivery. The purpose of this study was to explore and describe the experiences of rural women regarding the utilisation of skilled birth care provided in the rural areas of Northern Ghana. METHODS: The study adopted a qualitative, exploratory, descriptive research approach, whereby individual interviews, observations and field notes were used to obtain a thick description of women's experiences regarding the utilisation of skilled birth care services in the rural areas in Ghana. A purposive sampling approach was used to select 20 women who utilised skilled birth care in the rural areas of Bongo District of Ghana. Data collected from the interviews were transcribed verbatim and analysed to identify themes. RESULTS: The study identified three themes: The women had negative interactions with skilled birth attendants during delivery; women lacked confidence in skilled birth attendants' abilities; skilled birth attendants disrespected the traditional beliefs of the women. CONCLUSION: Most of the participants had negative experiences regarding the utilisation of skilled birth care. There is thus a need to develop strategies that could help address the above concerns of women to facilitate utilisation of skilled birth services in the rural areas in Ghana where there is low utilisation of skilled birth care.

Contributing factors to unsafe abortion practices among women of reproductive age at selected district hospitals in the Ashanti region of Ghana.

BACKGROUND: Despite the existence of an abortion law and a safe abortion policy in Ghana, the Ghana Statistical Service found that 15% of all women in the reproductive age group (15-49 years) have practiced unsafe abortions. The objective of this study was to explore factors that contribute to the high incidence of unsafe abortion practices in the Ashanti Region of Ghana. METHODS: A qualitative descriptive study design was used to assess factors that contribute to unsafe abortion practices. Purposive sampling technique was employed in selecting participants. Data were collected through key informant interviews and focus group discussions. One hundred and eleven participants were involved in the study. Data analysis was carried out through qualitative content analysis. RESULTS: Seven thematic categories were elicited from data collected. The categories are: a) Lack of knowledge of safe abortion services; b) Socio-economic conditions as a perceived influence for unsafe abortion practices; c) Safe abortion as a perceived religious and cultural taboo in Ghana; d) Stigma of unplanned pregnancy; e) A desire to bear children only after marriage; f) Avoiding parental/guardian disappointment and resentment; g) A desire to pursue education. CONCLUSIONS: Evidence available in this study suggests that several factors are responsible for unsafe abortion practices in Ghana. Lack of knowledge on safe abortion services, poor socio-economic conditions, cultural and religious beliefs, a stigma of unplanned pregnancy, a desire to bear children only after marriage, attempts to avoid parental/guardian disappointment and resentment, and a desire to pursue education were cited by participants as situations that contributed to unsafe abortion practices. Measures such as Aunty Jane, Ms. Rose and Women Help Women programmes can be publicised to reduce maternal morbidity and mortality that occur as a result of unsafe abortions in Ghana. Improvement in family planning education in educational institutions needs to be considered in order to reduce the rate of unwanted pregnancies among young women in school.

Risk Factors Associated with Neonatal Sepsis: A Case Study at a Specialist Hospital in Ghana.

Worldwide, neonatal sepsis accounts for an estimated 26% of under-five deaths, with sub-Saharan Africa having the highest mortality rates. Though worldwide neonatal deaths have decreased by over 3.6 million per year since 2000, neonatal sepsis remains a notable hindrance to the progress in the decline of cause-specific mortality rates especially in sub-Saharan Africa. This study aimed at examining the risk factors of neonatal sepsis at the Trauma and Specialist Hospital, Winneba. The study was an unmatched case control retrospective study. Cases were neonates who had sepsis with their index mothers and controls were neonates who did not have sepsis with their index mothers. Neonatal and maternal medical records were retrieved from January to December 2017. Data abstraction lasted for one month and 2650 folders for the neonates and their index mothers were retrieved. Nine hundred (900) neonatal folders were considered valid for the study and likewise for the maternal folders. One hundred and three (103) folders were considered cases while 797 were considered as controls. Data were entered using the Statistical Package for Social Sciences Version 22. Logistic regression was used to determine the risk of neonatal sepsis. Maternal factors that predicted the occurrence of sepsis among neonates were parity (p<0.027), mode of delivery (p<0.001), bleeding disorder (p<0.001), and PROM (p<0.001). Neonatal risk factors which predicted the occurrence of sepsis were APGAR score in the first and fifth minute (p<0.001), resuscitation at birth (p<0.004), duration of stay in the facility (p<0.001), and neonatal age on admission (p<0.001). The study found both maternal and neonatal factors to have a strong association with the risk of developing neonatal sepsis. Encouraging maternal antenatal care utilization would help identify the risk factors during prenatal and postnatal care and appropriate interventions implemented to reduce the likelihood of the neonate developing sepsis.

Clinical placement experiences by undergraduate nursing students in selected teaching hospitals in Ghana.

BACKGROUND: In meeting the global standard of patient safety, quality care and nursing leadership, countries are urged by the World Health Organisation to have a greater proportion of nurses educated to degree level or higher. However, some researchers have found that there are very little differences in competencies of diploma registered nurses and first degree nurses in some countries. University education in nursing remains problematic and there are many disparities in the programmes currently being offered in different parts of the world. Though teaching hospitals in Ghana are expected to assist in the training of undergraduate nursing students, there is limited scientific evidence on experiences of undergraduate nursing students in these teaching hospital environments. The purpose of this study was to explore the experiences of undergraduate nursing students in selected teaching hospitals in Ghana. METHODS: A qualitative explorative descriptive design was used in conducting the study. Purposive sampling technique was utilised in collecting data from thirty-five undergraduate nursing students placed in two teaching hospitals in Ghana. Data were collected through a semi-structured interview guide and analysed manually by the research team. A thematic content analysis was used in analysing data. RESULTS: Four main categories of themes were extracted from data. These themes were: 1. Feeling isolated in clinical placement. 2. Inadequate application of the nursing process. 3. Encounter with complex medical devices and complex conditions. 4. Inadequate application of physical examination by nurses. CONCLUSION: There were both positive and negative experiences by undergraduate nursing students in teaching hospitals in Ghana. The opportunity to see various clinical cases and also use complex medical devices were positive experiences for students. However, the undergraduate nursing students also experienced challenges of isolation in placement, inadequate application of the nursing process, and inadequate application of physical assessment by nurses. Undergraduate nursing students require varying levels of support, supervisory commitments and logistics provisions to learn skills such as physical examination and nursing process during placement.

Factors Influencing Information and Communication Technology Knowledge and Use Among Nurse Managers in Selected Hospitals in the Volta Region of Ghana.

This study adopted a cross-sectional design to examine the factors that influence the use of information and communication technology among 108 nurse managers in selected hospitals in the Volta Region of Ghana. A self-administered questionnaire was used to gather data. A χ test of association identified sex (P < .0001), age (P < .0001), years of work experience (P < .0001), rank of the respondents (P < .0001), computer training (P < .0001), computer ownership (P < .0001), and previous use of computers before appointment as a unit manager (P < .0001) as the factors that significantly influenced the use of information and communication technology among nurse managers.

Challenges of being a hospital nurse manager in the Volta region of Ghana: a qualitative study.

AIM: To explore the challenges facing hospital nurse managers (HNMs) in selected hospitals in the Volta region of Ghana. METHOD: The study, which had an exploratory qualitative design, involved the recruitment of 12 HNMs from six public hospitals in the Volta region of Ghana. Purposive sampling was used and data were collected through semi-structured interviews. The conventional content analysis approach was adopted for data analysis. FINDINGS: The study revealed several managerial challenges of being HNMs in performing their roles. These include: a lack of managerial preparedness, clear job descriptions and support; interference by other managers; and inadequate nursing staff and material resources. All these compromised the quality of nursing care. Participants found their role tedious and stressful, but also regard it as an opportunity to learn new ideas. CONCLUSION: HNMs face several challenges that negatively affect their performance. There is a need for succession planning, career development and mentoring programmes to strengthen HNMs' leadership and management skills to help them provide high-quality nursing care.