Assessing the knowledge of emergency medical care practitioners in the free state, South Africa, on aspects of pre-hospital management of psychiatric emergencies

Abstract

IntroductionStudies have reported that emergency medical care practitioners (EMCPs) encounter challenges when attending to psychiatric emergencies. The EMC provider's ability to understand, assess and manage psychiatric emergencies has been reported to be poor due to limited knowledge and insufficient training. In South Africa (SA), little is known about the knowledge of EMCPs on pre-hospital management of psychiatric emergencies. The objective of this study was to assess the knowledge of EMCPs working in the Free State province on aspects of pre-hospital management of psychiatric emergencies.MethodsThis descriptive study used a questionnaire survey to obtain data on the knowledge of EMCPs on aspects of pre-hospital management of psychiatric emergencies.ResultsOnly 159 of the initial 192 questionnaires distributed were returned, giving a response rate of 82.8%. The majority (87.4%) of the participants reported inadequate knowledge of pre-hospital management of psychiatric emergencies. More than a third of the participants reported that they are not knowledgeable on how to assess a psychiatric patient (P < 0.01), 64.2% and 73.6% (P < 0.001 in both cases) could not perform mental status examination and lack the knowledge of crisis intervention skills for managing a psychiatric emergencies. The majority (76.7%; P < 0.001) of the participants are not conversant with the Mental Health Care Act 2002 (Act no. 17 of 2002). Finally, participants (94.3% and 86.8%, respectively; P < 0.001) agree that teaching and prior exposure to a psychiatric facility, as in work integrated learning, will empower EMC graduates with skills required to effectively manage psychiatric emergencies.ConclusionEMC practitioners are often the first healthcare professionals arriving at any scene of medical emergencies including psychiatric emergencies. To avoid malpractices, which could be detrimental to patient's health, it is of utmost importance that EMCPs are well trained and equipped to manage any form of medical emergency including those involving psychiatric patients.

Knowledge, Practice, and Associated Factors of Nurses in Pre-Hospital Emergency Care at a Tertiary Care Teaching Hospital

“…41 The participants who took training related to prehospital emergency care were found to be 1.74 times to have good knowledge than those who had not taken the training. This finding was in line with the study done in South Africa, 21,22 in Nepal 26 and Indonesia. 13,23 The possible explanation might be due to that training can enhance an individual's body of knowledge.…”

“…Working in the ICU unit was found to be 3.64 times more likely to have good knowledge as compared with working in the pediatrics unit. This finding was supported by the study conducted in South Africa 22 and Iran. 29 The possible explanation might be because of the prevalence of violence and none violence causality emergency cases occurred more in adults than the pediatric age group.…”

“…The finding was supported by the studies conducted in South Africa. 21,22,29 The possible explanation could be because the more the exposure to a particular works the more the knowledge. 41 The participants who took training related to prehospital emergency care were found to be 1.74 times to have good knowledge than those who had not taken the training.…”

“…19,20 Pre-hospital emergency nursing care is attributed to factors like the working unit, educational level, working experience, and training. 13,[21][22][23] In Ethiopia at the national level, a pre-hospital comprehensive emergency medical system is practically nonexistent, but to centralize the response for emergency calls in Addis Ababa one centralized threedigit number (939) stationed at Addis Ababa Emergency Prevention and Rescue Authority. 24 This call is important to handle emergency patients brought to the hospital from home or on the street or road by ambulance.…”

Human errors and factors that influence patient safety in the pre-hospital emergency care setting: Perspectives of South African emergency care practitioners

“…Findings of this study about the male to female ratio – 2:1 – are consistent with the findings by other studies and confirms that the pre-hospital emergency medical care environment in South Africa is a male-dominated field (Mothibi, Jama & Adefuye 2019 ). This finding suggests that there may be a gender bias in the EMS profession.…”