Bridging the Knowledge - practice Gap in Emergency Care at the Primary Healthcare Level: Evidence from Ahafo Ano North Municipality, Ghana

Abstract

Emergency care at the primary healthcare level is essential for the timely assessment, stabilisation, and referral of patients with acute illnesses and injuries, particularly in rural settings where access to higher-level facilities may be delayed. This study examined emergency care knowledge, confidence, training exposure, and perceived system barriers among nursing professionals in Ahafo Ano North Municipality, Ghana. A descriptive cross-sectional design was used to collect quantitative data from 224 nurses working in primary healthcare facilities, including health centres and Community-Based Health Planning and Services compounds. Participants were selected through convenience sampling from a municipal nursing population of 246. Data were collected using a structured questionnaire and analysed using IBM SPSS Statistics version 27 and R version 4.3.1. Descriptive statistics and inferential analyses were used to summarise participant characteristics and explore associations among emergency care knowledge, confidence, training exposure, and related factors. The mean age of participants was 31.53 years, indicating a predominantly young nursing workforce. Participants reported moderate-to-high emergency care knowledge, with a mean score of 3.44 and a standard deviation of 0.49. Confidence in managing emergency cases was moderate, with a mean score of 2.86 and a standard deviation of 0.66. Male participants reported significantly higher knowledge scores than female participants, while confidence levels did not differ significantly by gender. Commonly encountered emergencies included trauma-related accidents, obstetric emergencies, paediatric emergencies, and cardiac emergencies. Reported barriers included staff shortages, inadequate emergency equipment, limited training, delayed access to specialist care, communication challenges, and limited management support. The findings suggest that improving emergency care at the primary healthcare level requires structured training, regular drills, adequate staffing, essential equipment, strengthened referral systems, and supportive supervision.