Mapping the knowledge and skill gaps in emergency nursing- an assessment of needs in the emergency department at Connaught Hospital, Sierra Leone
Creators: name: Nyhus, Hedda
name: Kamara, Michael
Publisher: name: F1000Research
Year: 2016

description: Emergency Nursing is in its infancy in Sierra Leone and little attention has been given to the development of the profession nationally. The recent Ebola epidemic demonstrated weaknesses in the country's health system when responding to a national emergency, but also highlighted the ability of the Sierra Leonean health workers in tackling the biggest outbreak of it's sort in West Africa. Taking momentum to further strengthen the development of a strong Emergency Nursing profession in the country, the King's Sierra Leone Partnership (KSLP) is advocating for the national implementation of the African Federation Emergency Nursing Curriculum , focusing on the Emergency Department (ED) in the principal adult tertiary hospitals in Sierra Leone, Connaught Hospital based in Freetown, Western Area. As a first step to this development a need assessment was conducted. <br><br>To best understand existing skills and knowledge, as well as  the needs and educational desires of the nurses working in the ED, a four- pronged analysis tool was developed. This included:<br><br>• A 25- question multiple choice questionnaire (MCQ) based on the general and focused topics presented in the AENC1 and the AFEM Handbook Of Acute And Emergency Care2 (AFEM HAMC), building on the Trauma Nursing Core Curriculum course (TNCC) (ENA 2007) and the Certified Emergency Nurse Review Manual and Online Exams.<br><br>• Observations of nursing practice in ED by study team.<br><br>• Focus group discussion based on clinical scenarios presented in the MCQ with nursing groups working in the ED.<br><br>• A 45-question self-assessment survey aiming to identify nursing practices and the nurses wishes for educational interventions and prioritising of these.<br><br>• 42 of 47 nurses working in the ED at Connaught Hospital were recruited to participate. A non- probability, convenience sample was utilised. Senior nursing management did not participate in written evaluation or focus groups. The participants were  informed that participation was voluntary and that there would be no penalty for not participating.<br><br>This assessment outlines the educational desires and knowledge level of the nurses working in the A&amp;E at Connaught Hospital. The nurses that participated showed an overwhelming enthusiasm for additional education, passionate about increasing their knowledge and skills in emergency nursing concepts and practice. It is clear that there is significant commitment to improve the quality of care provided at Connaught Hospital among these nurses. This is a collective strength that should be leveraged.  Taking measurement of the examples and successes of other SSA countries, in particular the results produced in Ghana there is every opportunity for an emergency nursing professional training program to be developed and implemented in Sierra Leone based on the African Curriculum for Emergency Nurses.<br><br>As Sierra Leone was declared Ebola free in December 2015, the country has now moved into the post Ebola reconstructive phase. This study provides important insights on how to take momentum of the skills and knowledge gained during the epidemic and how to use these in motivating nurses toward participating in specialty training. This can contribute towards building a resilient and responsive health system, also providing the opportunity to take into account the priorities and needs provided by the nurses themselves.<br><br><br><br><br><br><br><br><br><br>