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Asian Journal of Healthy and Science

p-ISSN: 2980-4302

e-ISSN: 2980-4310

Vol. 2 No. 8 August 2023

EMERGENCY PREPAREDNESS OF NURSES AND MIDWIVES IN

ACCRA, GHANA

Dennisia Kafui Dzakpasu,

Oscar Agyemang Opoku,

Selina Achiaa Owusu

Abdul Wahab Atta Bashiru,

Henry Okudzeto,

Jesse Azebiik Anak

Ghana College of Nurses and Midwives, Ghana

2,4,6

University of Cape Coast, Ghana

Kwame Nkrumah University of Science and Technology, Ghana

Dodowa Health Research Center, Ghana

Email: oscar.opoku@stu.ucc.edu.gh

Abstract

Nurses are often the first responders in hospital emergencies, a greater emphasis on

emergency preparedness in nursing education, as well as ongoing training and

capacity building, is necessary. The study focused on the emergency preparedness of

nurses and midwives at the Police Hospital in Accra of Ghana. It considered the

knowledge of nurses and midwives on emergency and disaster preparedness; the roles

of the nurses and midwives on emergency and disaster preparedness; and relevant

training programmes of the nurses midwives on emergency preparedness and

management. The study employed descriptive survey of the quantitative approach.

Questionnaire was employed for 133 nurses and midwives that were selected with

the aid of simple random sampling technique. The data was analysed using

frequencies, percentages, means and standard deviations with the aid of SPSS

software version 26. About 60% of respondents indicated they have training on

emergency/disaster preparedness in the last 5 years. Close to 74% also revealed that

emergency/disaster planning is a preparedness on what might be needed to be done,

how to be done before and after. Most (64%) of respondents indicated they have

adequate knowledge on safety precaution and management during emergency and

disaster occurrence, however, few respondents (34.6%) indicated that the Police

Hospital have bed capacity, equipment and logistics to cater for patients in the

occurrence of an emergency/disaster. The police hospital has a triage area and has

a chain of command during a large scale emergency event. About 75.2% of

respondent indicated they know how to triage in a large-scale and almost 79.7% of

respondents know how to assess and respond to site safety issues for self, co-workers

and affected people during a large-scale emergency event. About 91.7% agreed that

there is a need for periodic training and lecture for the nurses and midwives whiles

88.7% indicated that emergency and disaster stimulation drills should be conducted

frequently to adequately prepare the nurses and midwives for emergency events. The

nurses and midwives had a moderate degree of perceived knowledge in

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emergency/disaster management. They were well-informed about their roles in

emergency/disaster preparedness. Despite their limited knowledge and skills, the

respondents were enthusiastic about emergency/disaster training and simulations.

Keywords: emergency; preparedness; disaster; knowledge

INTRODUCTION

Every day, disasters strike somewhere in the world, wreaking havoc on

individuals, families, and communities (Ibrahim, 2014). Disasters can completely

transform the landscape of a developing country in a matter of seconds, obliterating

years of progress. Nations with more resources are usually able to reconstruct

infrastructure and the economy more swiftly. No one bargains for disaster yet they

do happen anyways (Feller et al., 2017). A disaster is an event that has the potential

to create widespread damage and disruption, as well as to kill and injure people,

damage and destroy their homes and health systems, and cut off their lifelines (Porter

et al., 2018). Partridge et al., (2011) categorized disasters into natural and manmade,

natural disasters includes earthquakes volcanic eruptions, hurricanes, floods, fire,

and tornadoes, whereas manmade is caused by humans such as war, stampedes, fires,

transport accidents, industrial accidents and conflicts.

No one is immune to tragedy, thus it is critical for countries to figure out the

best ways to strengthen their health systems so that they can save more lives when

disaster strikes. World Disasters Report 2020, reported 308 natural disasters

worldwide in 2019, affecting 97.6 million people. About 97% of all these disasters

were caused by climate and weather changes. (World Disasters Report, 2020).

According to the National Disaster Management Organization (NADMO) and Red

Cross Society, in 2019, the floods affected 26, 083 individuals (4,333 families) in 13

districts (116 communities) in Ghana, destroying 2218 houses and partially

destroying 3743 others, resulting in 21 deaths and 19 injuries (Ghansah et al., 2021).

Catastrophes happen as often as possible all over, of which Ghana is no

exemption. Ghana has had its fair share of catastrophes of varying degrees over the

past twenty years; from the twin- calamity (flooding and Goil fuel station fire) in

Accra, in 2015, the collapse of the Melcom Shopping center in Accra, in 2013, the

Second-hand clothing fire tragedy in Accra, in 2013 and numerous terrible events

(Poku-Boansi et al., 2020). It shows up that Ghana has not learnt her lesson when it

comes to administration, moderation and anticipation of what has gotten to be

perpetual calamities. No country, region, community, or person is safe to the

probable destructions of a disaster (Cresswell, 2014). Calamities all through history

have had critical impacts, such as deaths, serious injuries, extensive treatments,

increased risk of infectious diseases, damage to sanitation facilities, harm to water

bodies, food shortages, and populace developments (Giorgadze et al., 2011). Within

the occasion of a major calamity, healthcare professionals are required to respond,

manage, and prevent further damage. The circumstance, hence, calls for adequate

preparedness towards management and care of emergencies, which would deter the

events of challenges in the process (Shannon, 2015).

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Emergency preparedness is all-inclusive skills, capabilities, knowledge, and

activities that are needed to respond and plan for a for a danger, real or suspected,

chemical, radiological, atomic, natural, or explosives (Amberson et al., 2020).

Emergency Nurses Readiness for Disaster Response (2018) suggested that,

emergency preparedness and intervention, which is synonymous to

Emergency/Disaster Management, is pointed at guaranteeing that the resources

essential for responding efficiently within the occasion of a disaster are set in place

and those delegated with having the obligation to respond, know how to utilize those

resources. The activities commonly, associated with emergency preparedness

incorporate planning, formulating disaster plans, emergency coordination,

communication, development of skills and competencies of personnel, expansion of

hospitals surge capacity, availability and accessibility of equipment, stockpiles of

medical supplies vital for effective response and execution of disaster-related tasks,

as cited by (Veenema et al., 2016). Emergency preparedness is done at all levels and

ought to be thoroughly done. Effective preparedness requires comprehensive

planning and alliance among all stakeholders (Amberson et al., 2020).

Ghana's healthcare system was examined by national authorities. They

discovered numerous inefficiencies in the nation's health-care system's equipment

and supplies, particularly in the field of emergency medical services (Biyab, 2015).

When it comes to the nursing profession's emergency and disaster readiness, there

are more questions than answers. The preparedness of nurses must be assessed in

order to determine their skills in the event of a disaster. This will help to prevent the

loss of lives associated with such calamities. When a disaster strikes near a hospital,

nurses are among the first to respond, with nurses accounting for the largest number

of health-care professionals needed (Keeling, 2021). Nurses played a vital role in the

Hurricane Katrina disaster response in 2005, according to one nurse, however it was

out found that most registered nurses were not confident in their capacity to respond

to big disaster events (Bulson & Bulson, 2011). Knowledge, education, life and

professional experience, and the level of expertise of a registered nurse all play a role

in disaster preparedness (Baack & Alfred, 2013).

As first line responders, nurses should have enough preparedness on knowledge

and skills in caring for the victims (Flaherty, 2013). Labrague et al., (2016) states that

nurses have insufficient knowledge and practices regarding the disaster management

and emergency preparedness which is a weak point for nurses. The lack of knowledge

of nurses on emergency preparedness and intervention can result in excessive loss of

life during both, natural and man-made disasters, which ends up at the emergency

unit of the hospital (Khalil et al., 2019). Most Nursing students graduate with a large

gap in knowledge between what they know and what they need to know to be

prepared for emergencies. Undergraduate nursing students who received emergency

training had greater self-reported levels of abilities and confidence in catastrophe

circumstances, according to a pre-test post-test study (Alim et al., 2015). Increased

emphasis on emergency preparedness competencies among health care providers is

needed to reduce the potentially devastating impact on human life and health during

a disaster, thus the need to assess the current level of emergency preparedness of

nurses and midwives of the Police hospital in caring for victims during emergencies

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in Ghana to provide appropriate education and training on emergency preparedness

in this regard.

RESEARCH METHODS

A descriptive design was employed with a quantitative method for this study.

Researchers using descriptive research techniques are able to acquire information

about respondents and their environments without affecting either group (Omair,

2015). The population considered by this study were about 200 nurses and midwives

working at the Ghana Police Hospital. The study population included professional

nurses and midwives who were working in the hospital. The participants available

during the time of data collection and those willing to participate in all age and gender

groups. Using the Yamane formula, 133 nurses and midwives at the police hospital

were selected for this study. Probability sampling technique (simple random

sampling) was used to draw subjects for the study. The main objective of simple

random sampling is to provides a sample that is representative of a population, each

member of the population is selected independently and has an equal chance or

probability of being included in the study. It also gives room for generalisability and

strengthens external validity (Taherdoost, 2016).

The investigation was conducted at the Police Hospital, located in the heart of

Accra's business district. The Police Hospital is surrounded by the national

headquarters and barracks of the Ghana prisons service to the east, the national

headquarters of the Ghana fire service to the west, the cantonment police station and

barracks to the north, and the Danquah roundabout and Koala shopping mall to the

south.

Designed questionnaire was used to collect information from the participants.

It began with an introductory statement, which specified the purpose of the research,

and assured the respondents of confidentiality of their responses. It was grouped into

two sections thus section A and B. The first section covered the demographic

information whiles the second section, the main questions that is assessing their

knowledge and roles in emergency preparedness. The data collection for this study

was done over a period of two weeks. The issuance of the consent and questionnaires

was between 8am-10am in the mornings and 5pm-7:30pm in the evening. The time

of collection for day shift was between 3:00pm – 4:00pm, and for night shift between

07:00 am– 8:00am in the morning.

Reliability is the extent of accuracy in which the methodology device shows

what it is continuously calculating (Bashir, 2018). The questionnaire was written in

a way that guarantees all participants would be asked the same, transparent

questions. The research team's supervisor and the Police Hospital Ethical Review

Board both looked through the questionnaire before it was distributed. The

researchers' supervisor and an emergency services expert all looked over the

questionnaire before it was finalised. The researchers were the only people who

could be reached for help with using the instrument, increasing its consistency. Burns

& Grove, (2010), on the other hand, say that an instrument is valid if and only if it

accurately represents the theoretical notion under investigation. Preliminary testing

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of the questionnaire and revisions made in light of the literature, the study's aims, the

researcher's clinical expertise, and the advice of a supervisor, an emergency nurse

specialist, and a statistician all contributed to the instrument's reliability and validity.

The data-gathering instruments was pre-tested using 6 nurses and midwives in the

hospital two weeks before the actual data collection takes place. The questionnaire

was then adjusted and questions rephrased where needed, more simple terms was

used when respondents find some words or sentences complex or confusing.

Questionnaires that were not appropriately answered and not fully answered

was rejected only when the respondent was not available to make the necessary

corrections. This ensured the dependability and legitimacy of the findings of this

study. Data collected from the questionnaires was collated and analysed using the

SPSS version 26. Descriptive statistics was used in analyzing the data which includes

simple calculations of central tendency (mean, median and mode), standard

deviation and frequency distributions displayed in tables.

An ethical approval and clearance was obtained from the Ghana Police

hospital's ethical review board. Participants were informed that their participation

was voluntary and that they could withdraw at any time prior to or during the study.

The participants were assured that withdrawing from the study would have no

negative consequences. It was explained to them that the researcher is required to

protect the confidentiality of study participants. All participants were informed of the

research objectives and the character of the study in the cover letter before the

researcher obtained their written consent. However, consent documents were not

required, as the return of the questionnaire indicated that consent was given

voluntarily. As a requirement for research involving human subjects, all data

collection or gathering instruments were constructed and designed without subjecting

or exposing research participants to any type of emotional, psychological, or physical

maltreatment. The Police hospital requested an introduction letter from the Ghana

College of Nurses and Midwives. The Medical director and Director of Nursing

Services of the Police Hospital granted permission. Data collection was restricted to

the researcher, statistician, supervisor, and co-supervisor. After the conclusion of the

study, the raw data and ultimate results would be stored in a locked cabinet for a

period of five years. The anonymity of the questionnaires was maintained by placing

them in sealed envelopes and crates.

RESULT AND DISCUSSION

This chapter presents the results and discussions which are in line with the

objectives of the study. It commences with the description of the socio-demographics

characteristics of the respondents. Finally, the knowledge of nurses and midwives,

their roles during emergencies and the relevant training programs they have in

emergency preparedness at the Police Hospital were examined.

Socio-demographic Characteristics

In this study, the variables that were included under socio-demographics

characteristics are age, gender, educational background and the department that the

respondents work at. The results are presented in Table 1.

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Table 1 indicates that, with reference to age about 68% of the respondents were

between the ages of 20-30, close to 19% the respondents were between the ages of 31-

40, 6% were between the ages of 41-50 and about 75 indicated they were between the

ages of 51-60. This finding reveals that there are more youth in the nursing field.

Also, with regards to sex, it was revealed that almost 81% of the respondents

were females and only 19.5% were males. This is in line with previous assertions that,

there are more females in the nursing field than of males. The nursing discipline has

been a female’s dominant field which is now been arrowed by males gradually

entering. Furthermore, in terms of academic background in nursing, it was revealed

in the study that, majority (51%) of respondents were diploma holder, probably attest

to the fact why most of the respondents were within their early twenties. About a

quarter of the respondents (27%) had degrees whiles only19.5% had their masters,

meanwhile about 3% of the respondents had the PhDs.

Table 1: Respondent’s Socio Demographic Characteristics

characteristics

Frequency (N=133)

Percentage (%)

Sex

Male

19.5

Female

107

80.5

Age

20-30

68.4

31-40

18.8

41-50

6.0

51-60

6.8

Education background

Diploma

51.1

Degree

27.1

Masters

19.5

PhD

2.4

Department

Emergency and OPD

17.3

Executive ward

3.8

Children Ward

20.3

Male Ward

11.3

Female Ward

8.3

Maternity/labor ward

6.0

ICU

6.8

Theater

6.8

Dialysis Unit

1.5

Public Health

10.5

Consulting Room

4.5

Covid/isolation center

3.0

The respondents were mainly from the children’s ward (20%) followed by the

emergency and OPD unit (17.3%). A little over 11% of respondents were from the

male ward with only 8.3% from the female ward. Meanwhile, close to 11% of

respondents were from the public health unit whereas 6.8% or respondent were from

the ICU and same for the theater. Almost 5% of the respondents were from the

consulting rooms and only 3% were from the Covid/Isolation center.

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Knowledge of Nurses and Midwives at the Police Hospital on Emergency and

Disaster Preparedness

Various researchers have explored the knowledge of nurses and midwives on

emergency and disaster preparedness from various settings. On that account, the

study also sought to examine the knowledge of nurses and midwives at the Police

Hospital on emergency and disaster preparedness.

Table 2 illustrates that close to 73% of the respondents have worked as nurses

and midwives for about 1–10 years. It was also revealed that about 17% of

respondents had worked for about 11 – 20 years. Meanwhile about 5% of the

respondents indicated they have worked for 21-30years whereas only 6% had worked

for 31 – 40 years. This attest to the youthful strength of nurses and midwives at the

Police Hospital.

Table 2: Knowledge of Nurses and Midwives at the Police Hospital on

Emergency and Disaster Preparedness

Item

Frequency

Percentage

How many years of professional experience do you have

1-10

72.9

11-20

16.5

21-30

4.5

31-40

6.0

How long have you been at your current unit

1-5

104

78.2

6-10

18.0

11-20

2.3

21-30

1.6

What level of training have you reached in your current unit

Orientation

39.1

Regular refresher course

15.0

Professional courses

35.3

No training

10.5

Have you had any training on education on emergency/disaster

preparedness in the last 5 years

Yes

60.2

39.8

Is emergency/disaster planning, a preparedness on what might be

needed to be done, how to be done, before and after

Yes

73.7

26.3

Is emergency /disaster planning a preparedness on what might be

needed to be done, how to be done, before and after?

Yes

73.7

26.3

Do you have adequate knowledge on safety precaution and

management during emergency and disaster occurrence

Yes

62.4

37.6

Does your hospital have a triage area

Yes

71.4

28.6

Do you have knowledge on the chain of command during a large-scale

emergency event

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Yes

45.1

Most respondents (78.2%) indicated they have been at their current unit

between 1 – 5years. Only 18% of respondents indicated they have been in their

current unit for a period between 6-10 years. The study further revealed that about

39% of respondents indicated that they engage in orientation courses, meanwhile

35.3% of respondents revealed they have attended various professional courses.

Furthermore, some respondents (15%) indicated they engage in regular refresher

courses whereas close to 11% revealed they do not engage in any training.

It was further revealed in the study that only 60% of respondents indicated they

have training on emergency/disaster preparedness in the last 5 years. Close to 74%

also revealed that emergency/disaster planning a preparedness on what might be

needed to be done, how to be done before and after. Most (64%) of respondents

indicated they have adequate knowledge on safety precaution and management

during emergency and disaster occurrence, however, few respondents (34.6%)

indicated that the Police Hospital have bed capacity, equipment and logistics to cater

for patients in the occurrence of an emergency/disaster. It was further revealed that

the police hospital has a triage area (s). Contrary to prior studies, most respondents

indicated that they do not know the chain of command during a large -scale

emergency event.

The Roles of Nurses/midwives at the Police Hospital on Emergency and Disaster

Preparedness.

The study sought to examine the roles nurses and midwives play at the Police

Hospital during emergency and disaster preparedness. Questions were placed on a

yes or no dichotomy for respondent to select from. The results are presented in Table

About 75% of respondent was of the affirmative that they know how to triage

in a large-scale. It was indicated that, almost 74% of respondents know how to assess

and respond to site safety issues for self, co-workers and affected people during a

large-scale emergency event.

Table 3: Roles of Nurses/midwives at the Police Hospital on Emergency and

Disaster Preparedness

Item

Frequency

Percentage

“Do you know how to triage in a large-scale emergency event?”

Yes

100

75.2

24.8

“Do you know how to assess ad respond to safety issues for self,

co-workers and affected people during a large-scale emergency

event”

Yes

79.7

26.3

“Do you know how to perform a rapid physical assessment of

victims of a large-scale emergency event”

Yes

106

79.7

20.3

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“Do you know how to provide health counselling education to

patients regarding the long-term impact of chemical, biological,

radiological, nuclear and explosive agents”

Yes

64.7

35.3

“Can you identify key players in the hospital’s emergency

operations plan”

Yes

69.9

30.1

Do you know the specific roles these key players play during an

emergency situation

Yes

59.4

40.6

Is the role of the nurse/midwife during an emergency event to

use communication devices such as phone, fax, email, personal

digital assistant

Yes

63.2

36.8

Most respondents also indicated that they know how to perform a rapid

physical assessment of victims of a large-scale emergency event. Also, most

respondents (64.7%) of respondents indicated the know how to provide health

counselling education to patients regarding the long-term impact of chemical,

biological, radiological, nuclear and explosive agents, only 35.3% were of the

contrary. About 70% of respondents revealed they cam identify players in the

hospital’s emergency operations plan. Specifically, majority of respondents (59.4%)

know the specific roles these players play during an emergency situation. Even

though some respondents (36.8%) indicated their displeasure on the use of

communication devices such as phone, fax email, personal digital assistant during

emergency and disaster situations, most of the respondents (63.2%) indicated

otherwise.

Relevant Training Programs in Emergency Preparedness by the Nurses and

Midwives at the Police Hospital

Initially respondents’ views on relevant training programs in emergency

preparedness was captured using a five-point Likert scale (1=strongly disagree,

2=disagree, 3= uncertain 4= agree, 5= strongly agree) of which they were asked to

indicate their extent of agreement to the statements or otherwise. Holding on the

views of Creswell & Poth, 2016; Pétrier et al., (2010) and Couto, (2011), who opine

that the extreme points of strongly disagree and strongly agree show mere extent and

as such do not have much bearing on reason, the scale was subsequently collapsed

into 3 points of disagree, uncertain and agree. Therefore, the presentation of the

results involved the percentage in agreement, means and standard deviations in Table

According to Table 4, the majority of respondents agreed (M= 4.65, SD=0.91)

that they the hospital management should be adequately prepared in terms of skilled

personnel, beds, equipment and logistics should an emergency occur. It was generally

agreed that (M=4.62, SD= 0.89), there is a need for a well-structured emergency

operation plan for emergency and disaster events at the facility. Most respondents

agreed (M= 4.63, SD=0.86) that periodic training and lecture are necessary for the

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nurse/midwife to ensure they are adequately prepared for emergencies and disaster

events. Furthermore, majority of respondents (M=4.33, SD=0.95) agreed that

emergency and disaster stimulation drills should be conducted in the hospital very

frequently to adequately prepare the nurses and midwives for emergency events.

Almost 92% of respondents were of the view that it is necessary to know their duty

and role during emergency/disaster response in their facility. In line with this,

majority of the respondents were of the affirmative that, it was necessary to have an

emergency/disaster management committee at the hospital.

Table 4: Training Programs in Emergency Preparedness by Nurses and Midwives

at the Police Hospital.

Item

% in

agreement

Hospital management should be adequately prepared

in terms of skilled personnel, beds, equipment and

logistics should an emergency occur

4.65

0.91

The need for well-structured emergency operations

plans for emergency and disaster events at the facility

4.62

0.89

Periodic training and lecture are necessary for the

nurse/midwife to ensure they are adequately prepared

for emergencies and disaster events

91.7

4.63

0.86

Emergency and disaster stimulation drills should be

conducted in the hospital very frequently to adequately

prepare the nurses and midwives for emergency

events.

88.7

4.33

0.95

Is it necessary to know your duty and role during

emergency/disaster response in the hospital

91.7

4.42

0.90

it is necessary to have an emergency/disaster

management committee at the hospital.

85.7

4.52

0.94

Scale: 1.0-2.49=disagree, 2.5-3.45=uncertain and 3.5-5.0= agree. M- Mean SD –

Standard deviation.

Emergency Preparedness

Various researchers have explored the knowledge of nurses and midwives on

emergency and disaster preparedness from various settings. Most of the respondents

(73%) have worked as nurses and midwives for about 1–10 years. It was also revealed

that about 17% of respondents had worked for about 11 – 20 years. Meanwhile about

5% of the respondents indicated they have worked for 21-30years whereas only 6%

had worked for 31 – 40 years. This attest to the great experiences of nurses and

midwives at the hospital. These findings agreed with Nibbelink & Brewer,( 2018) that

nurses with some number of years’ experience bring a lot of previous patient

experiences to their practice, which influences their intuitiveness and helps them

make better clinical decisions.

It was further revealed in the study that only 60% of respondents indicated they

have had training on emergency/disaster preparedness in the last 5 years which

corroborate Wolf, (2012) study that states that nurses must pursue opportunities to

partake in real disaster events, mock drills, and aspire to gain more knowledge and

professional development specific to emergency/disaster preparedness. Majority of

respondents indicated that the Police Hospital as well as many hospitals in Ghana

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now are not prepared for any emergencies/disasters due to inadequate infrastructure

such bed capacity, equipment and logistics to cater for patients in the occurrence of

an emergency/disaster (Norman et al., 2012).

Most (64%) of respondents indicated they have adequate knowledge on safety

precaution and management during emergency and disaster occurrence which

disagrees to the study by McKibbin et al., (2011) which looked at South Carolina

nurse’s perceptual knowledge of emergency preparedness. The nurses had a low

degree of self-reported awareness of emergency preparedness, and they were most

comfortable with triage and least knowledgeable with clinical decision making during

disasters and emergencies.

The Roles of the Nurses and Midwives in Emergency and Disaster Preparedness.

Baack & Alfred, (2013) opine that nurses should expect to play a larger role in

disasters, such as caring for the sick and injured, infection control, contingency

planning to minimise more damage, triage, mass immunisations, mass evacuations,

and mass casualty treatment, which is supported by the fact that the majority of

respondents indicated that they know how to triage on a large scale, assess and

respond to site safety issues for themselves, co-workers, and affected individuals.

A nurse with extensive disaster preparedness knowledge and awareness of his/

her roles can make a significant contribution to providing healthcare at all levels of

emergency events (Kalanlar, 2021). Therefore, the findings of this study show that

most respondents (64.7%) indicated they know how to provide health counselling

education to patients regarding the long-term impact of chemical, biological,

radiological, nuclear and explosive agents. Other responsibilities of the nurse in

emergency preparedness include maintaining and usage of communication devices

at the scene of an emergency, identifying key players and their functions in the

hospital’s emergency operations plan in assuring quality patient care which

respondents were affirmative they had knowledge of. This is similarly to the study

conducted by Sham et al., (2018) for 27 government clinics in one of Malaysia's

states, with 260 participants selected using a suitable sample method. This study

found that nurses in these community clinics had a moderate impression of

knowledge (65.8%) and skills (75.7%) when it came to disaster preparedness.

Relevant Training Programmes on Emergency Preparedness and Management

Holding on the views of Vieira de Figueiredo & Pereira, (2021) who opine that

the extreme points of strongly disagree and strongly agree show mere extent and as

such do not have much bearing on reason, the scale was subsequently collapsed into

3 points of disagree, uncertain and agree. The majority of respondents agreed (91%)

that the hospital management should be adequately prepared in terms of skilled

personnel, beds, equipment and logistics should an emergency occur and (91%)

indicated the need for a well-structured emergency operation plan for emergency and

disaster events at the facility which agrees with Norman et al., (2012) discussion that

part of establishing an effective hospital emergency management, there is a need to

implement a periodic evaluation of health facilities capability and response when it

comes to emergency and have a functioning well structured emergency operations

plan. Ayuba et al.,(2015) in his study found out that 55% of 120 respondents

indicated that insufficient training, education and simulation of personnel’s on

emergency preparedness were factors affecting emergency preparedness hence the

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need for periodic training and stimulations. This study agrees with the findings of

this research which illustrated that majority of the respondents agreed that periodic

training and lecture are necessary (91.7%), emergency and disaster stimulation drills

should be conducted in the hospital very frequently (88.7%) to adequately prepare

the nurses and midwives for emergency events. Almost 92% of respondents were of

the view that it is necessary to know their duty and role during emergency/disaster

response in their facility. In line with this, majority of the respondents were of the

affirmative that, it was necessary to have an emergency/disaster management

committee at the hospital.

CONCLUSION

The nurses and midwives had a moderate degree of perceived knowledge in

emergency/disaster management, according to the current study. They were well-

informed about their roles in emergency/disaster preparedness. Despite their limited

knowledge and skills, the respondents were enthusiastic about emergency/disaster

training and simulations. The respondents had a positive opinion of their abilities,

but they still need to enhance their abilities because they are still unsure how to

handle and conduct themselves in emergency or disaster events. The hospital

response to emergencies situations calls for improvements in emergency

preparedness and effective operational emergency plant. The hospitals’ inability to

handle large scale emergencies would be compromised by the lack of logistics and

infrastructure and undertrained front liners.

The following suggestions are given based on the findings of this study All

nurses and midwives in both public and private health hospitals should receive proper

training and retraining from the Ministry of health and Ghana Health Service in

order to equip them with knowledge on how to prepare for and handle any

emergency/disaster events.

Stakeholders must recognize the importance of nurses' and midwives'

emergency preparation, the Ministry of health and Ghana Health Service should

make policies to guarantee that nurses and midwives should be appropriately

equipped to offer the services required by the community.

Administrators and Medical Directors of hospitals should sponsor emergency

preparedness education, training as well as conduct periodic simulations and regular

drills for their personnel in order to equip them for any eventualities

It is strongly suggested that the GHS and MOH should develop a template for

hospital operational emergency plans, surge capacity planning, and provide the

necessary funds for personnel training in emergency/disaster risk reduction and

mitigation.

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Dennisia Kafui Dzakpasu, Oscar Agyemang Opoku, Selina Achiaa Owusu

Bashiru Atta Wahab, Henry Okudzeto, Jesse Azebiik Anak (2023)

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