Nurses’ Knowledge of Respiratory Distress in Children under Five and Implications for Pediatric Emergency Care in Northern Ghana

Abstract

Introduction: Respiratory distress remains a leading cause of under-five morbidity and mortality in Ghana, particularly in Northern regions where health resources are limited. Nurses, as frontline providers, are critical for early detection and intervention in pediatric emergencies. Understanding their knowledge levels in this setting provides important insight for improving child health outcomes. Aim: To assess nurses’ knowledge of respiratory distress in children under five and examine associations with socio-demographic characteristics in selected hospitals in Northern Ghana. Methodology: A descriptive cross-sectional study was conducted among 94 nurses providing direct pediatric care in three hospitals. Data was collected using a structured, piloted self-administered questionnaire assessing knowledge in four domains: emergency signs, classification of airway obstruction, airway management, and oxygen administration. Descriptive statistics summarized responses, while Pearson correlation examined associations between knowledge scores and socio-demographic factors. Results: Knowledge of emergency signs was moderate (mean score: 1.18/3), with 61.7% correctly identifying accessory muscle use as an indicator. Classification of airway obstruction was relatively high (mean correct response rate: 76.4%). However, critical gaps emerged in airway management as only 46.8% knew the correct OPA insertion technique, suctioning knowledge was low (12.8% correct), and oxygen administration knowledge was moderate (mean correct: 47.6%), with notable gaps in age-specific flow rates for older children. Significant association were observed between hospital of practice (r = 0.260, p = 0.012), level of education (r = 0.206, p = 0.047), and knowledge. Conclusion: Nurses demonstrated fair overall knowledge but with serious deficits in suctioning, OPA use, and oxygen flow rates, which could delay lifesaving interventions. Incorporating pediatric respiratory distress modules into nursing curricula, introducing periodic simulation-based training, and ensuring access to WHO ETAT guidelines are recommended to strengthen competencies and improve child survival, contributing to progress on Sustainable Development Goal 3. This study contributes to the limited empirical literature from Northern Ghana by highlighting priority training gaps and providing evidence to inform both institutional capacity-building and national nursing education reforms.