Response of Healthcare Workers to COVID-19 Protocols after the Index Case at 37 Military Hospital, Ghana.

The diagnosis and management of COVID-19 are much dependent on the adherence to standardized protocols. Healthcare workers play a crucial role in the case management of COVID-19 in many institutions. Globally, the disease burden is increasing, and the mortality has reached over 2 041 426 compared with 323 000 in May 2020. In West Africa, the pandemic has shown a slow but steady rise in many countries. Existing protocols and their utilization are best assessed after the occurrence of the index case. General aim. The study assessed the health worker's response to COVID-19 protocols at three designated areas of the in-hospital management care triaging, holding area, and treatment centers. Method. A qualitative design was used to assess the response of healthcare workers with regards to early case detection, infection prevention, risk communication to clients and compliance to protocols. The study conducted observational visits and purposively selected healthcare workers comprising of clinicians, nurses, emergency medical technicians, and laboratory technicians who perform routine duties at the triaging, holding, and treatment centers. A total of 41 observations were made over two weeks. Results. Participants comprised 23 males and 18 females. At all observed units, the case definition was being used to screen attendants presenting, and appropriate categorization of patients was ensured. The use of temperature in screening for COVID-19 at the units was generally adhered to. Only 50% of participants used the prescribed PPEs. The physical distancing between healthcare workers and client and between clients and caregivers were not enforced; however, hand hygiene was practiced. Disinfection of working surfaces and equipment with 0.5% chlorine or 70% alcohol-based rubs were used most of the time. It was observed however that no psychological counselling was given to suspected cases or their relatives. Conclusion. Healthcare workers showed discordant response to different parts of the protocols for COVID-19 especially appropriate distancing. There was an enhanced awareness among healthcare workers and improvement in infection prevention protocols. The study also observed that as the risk of infection increased from triaging to holding area and to treatment centers, the response of healthcare workers to COVID-19 protocols also improved. Risk communication is an essential part of the COVID-19 management strategy. At the treatment centers, healthcare workers adhered to this protocol, whereas it was a major gap at the triaging and holding areas.

An audit of MRI machines and services in Ghana.

INTRODUCTION: Magnetic resonance imaging (MRI) is a useful medical imaging modality for the diagnosis and management of patients. However, the huge costs associated with establishing and operating MRI means it may not be readily accessible and affordable for hospitals in developing countries. Little is currently known about the availability of MRI machines in Ghana. Such information may assist in informing future health service development within the country. This study reports on the findings and implications of an audit of MRI machines in Ghana. METHODS: A quantitative descriptive cross-sectional survey was conducted involving all MRI machines in Ghana. Data obtained was analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Independent-samples t-test was conducted to compare the mean cost of MRI examinations between privately-owned and state-owned MRI machines in Ghana. RESULTS: 18 MRI machines, spread across five regions, are available in Ghana. 15 (83.3%) of the MRI machines are located in the Greater-Accra and Ashanti regions. MRI examinations are more expensive in privately-owned machines compared to state-owned machines (p < 0.05). Four state-owned machines have been non-operational for between three-six years resulting in a revenue loss of GHC 36 million (US$7.2 million). CONCLUSION: There are few MRI machines in Ghana and the majority are concentrated in the two largest regions. The increase in MRI machines over the past decade can be attributed to private investment in the sector. IMPLICATIONS FOR PRACTICE: This study will inform the Ghana Health Service and other healthcare policy makers in Ghana to increase investment in MRI machines to ensure equitable regional distribution of MRI machines so that patients across Ghana would have access to the diagnostic benefits associated with MRI machines.

Patients' knowledge, perception, and experience during magnetic resonance imaging in Ghana: A single centre study.

INTRODUCTION: The Magnetic Resonance Imaging (MRI) environment has the potency of inducing anxiety, panic attacks, and claustrophobia in patients with some patients describing it as being placed in a long confining tube. Therefore, having patients that are well-informed concerning the diagnostic tests they are about to undergo can contribute to these patients experiencing reduced anxiety, greater satisfaction, and participation in their care which is key in gaining patients' cooperation and compliance during imaging procedures such as MRI. This study purposed to assess patients' knowledge, perception and experience when undergoing MRI examination. METHODS: A prospective quantitative approach was adopted for the study and was conducted in a leading teaching hospital in the Greater Accra region of Ghana. The study involved patients who were referred to undergo MRI examination from June to December 2019. Primary data was collected using closed-ended questionnaires as the research tool. The researchers self-administered and explained the details of the questionnaire thoroughly to all the patients. RESULTS: Two hundred and four (51%) out of the 400 respondents were males as compared with 196 (49%) females. The most common age group was 41-60 years with a total number of 156 (39%) participants. 120 (30%) indicated they were schooled on MRI by family and friends, 88 (22%) by their referring clinicians, and 65 (16%) indicated other health personnel as their source of knowledge. 228 (57%) indicated that MRI is not safe for pregnant women, 130 (32.5%) indicated it was whilst 42 (10.5%) were not sure. 208 (52%) of the respondents believed MRI can cause cancer, 140 (35%) responded that it does not whilst 52 (13%) were not sure. Also, 312 (78%) indicated that their doctors did not inform them about the use of the contrast medium. CONCLUSION: The study revealed that majority of the respondents were schooled on MRI by family and friends instead of their referring clinicians. Most of these family and friends may not necessarily be qualified health personnel which accounted for more than half of the respondents having a misconception that MRI causes cancer similar to other ionizing imaging modalities. The study further revealed that some referring clinicians did not educate their patients on requested MRI examinations causing radiology staff to spend more time educating them resulting in a decrease in productivity. IMPLICATIONS FOR PRACTICE: The study will bring to bear the gaps in patient's knowledge concerning MRI which will help referring clinicians and radiology staff adopt strategies to ensure that patients are well educated on MRI examinations they have been referred to undertake. This will in effect reduce the time spent by radiology staff in educating and gaining patients' compliance during such examinations resulting in a decrease in waiting and scanning time leading to an overall increase in workflow.

The effect of recall on estimation of incidence rates for injury in Ghana.

BACKGROUND: Injury is a major public health problem in many developing countries. Due to limitations of vital registry and health service data, surveys are an important tool to obtain information about injury in these countries. The value of such surveys can be limited by incomplete recall. The most appropriate recall period to use in surveys on injury in developing countries has not been well addressed. METHODS: A household survey of injury in Ghana was conducted. Estimated annual non-fatal injury incidence rates were calculated for 12 recall periods (1-12 months prior to the interview, with each successively longer period including the preceding shorter periods). RESULTS: There was a notable decline in the estimated rate from 27.6 per 100 per year for a one-month recall period to 7.6 per 100 per year for a 12-month recall period (72% decline). The extent of this decline was not influenced by age, gender, rural versus urban location, nor by type of respondent (in-person versus proxy). Rate of decline was influenced by severity of injury. Injuries resulting in <7 days of disability showed an 86% decline in estimated rates from a one-month to a 12-month recall period, whereas injuries resulting in > or =30 days of disability showed minimal decline. CONCLUSIONS: In this setting, longer recall periods significantly underestimate the injury rate compared to shorter recall periods. Shorter recall periods (1-3 months) should be used when calculating the overall non-fatal injury incidence rate. However, longer recall periods (12 months) may be safely used to obtain information on the more severe, but less frequent, injuries.