Implementation of the policy on standard protocol for care of septic and aseptic wounds in selected public health facilities in Ghana: an analytic case study

Abstract

Background It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relations to septic and surgical wounds has been largely attributed to poor adherence to standard policy protocols on wound management by clinical staff especially nurses. Objective Explore the extent to which nursing staff adhere to the policy protocol on management of septic and surgical wounds in selected public health facilities in Ghana. Methodology An analytic cross-sectional study among nursing staff (n=140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to standard policy protocols on septic and surgical wound care. Findings Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound healing (Coef.= -0.49, CI=-0.93 -0.05, p=0.036). Conversely, being a senior nursing officer relative to other professional ranks increases staff likelihood of complying with standard policy protocol for wound care (Coef. 5.27, CI=0.59 9.95, p=0.027) relative to lower rank of nurses. Conclusion There is the need for accelerated in-service training for staff on standard protocols for wound are coupled with supportive supervisions. Staff adherence to standard quality care should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.