Training nurses in task-shifting strategies for the management and control of hypertension in Ghana

a mixed-methods study

Joyce Gyamfi, Jacob Plange-Rhule, Juliet Iwelunmor, Debbie Lee, Sarah R. Blackstone, Alicia Mitchell, Michael Ntim, Kingsley Apusiga, Bamidele Tayo, Kwasi Yeboah-Awudzi, Richard Cooper, Gbenga Ogedegbe

Research output: Contribution to journalArticle

Abstract

Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). Methods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. Results: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Conclusions: Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration: Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalBMC Health Services Research
Volume17
Issue number1
DOIs
StatePublished - Feb 2 2017

Fingerprint

Ghana
Nurses
Hypertension
Community Health Nurses
Community Health Centers
District Hospitals
Nurse's Role
Practice Management
Insurance Benefits
Patient Education
Primary Health Care
Public Health
Interviews
Delivery of Health Care

Keywords

  • Ghana
  • Hypertension
  • Nurses
  • Sub-Saharan Africa
  • Task-shifting strategies

ASJC Scopus subject areas

  • Health Policy

Cite this

Training nurses in task-shifting strategies for the management and control of hypertension in Ghana : a mixed-methods study. / Gyamfi, Joyce; Plange-Rhule, Jacob; Iwelunmor, Juliet; Lee, Debbie; Blackstone, Sarah R.; Mitchell, Alicia; Ntim, Michael; Apusiga, Kingsley; Tayo, Bamidele; Yeboah-Awudzi, Kwasi; Cooper, Richard; Ogedegbe, Gbenga.

In: BMC Health Services Research, Vol. 17, No. 1, 02.02.2017, p. 1-9.

Research output: Contribution to journalArticle

Gyamfi, J, Plange-Rhule, J, Iwelunmor, J, Lee, D, Blackstone, SR, Mitchell, A, Ntim, M, Apusiga, K, Tayo, B, Yeboah-Awudzi, K, Cooper, R & Ogedegbe, G 2017, 'Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study', BMC Health Services Research, vol. 17, no. 1, pp. 1-9. https://doi.org/10.1186/s12913-017-2026-5
Gyamfi, Joyce ; Plange-Rhule, Jacob ; Iwelunmor, Juliet ; Lee, Debbie ; Blackstone, Sarah R. ; Mitchell, Alicia ; Ntim, Michael ; Apusiga, Kingsley ; Tayo, Bamidele ; Yeboah-Awudzi, Kwasi ; Cooper, Richard ; Ogedegbe, Gbenga. / Training nurses in task-shifting strategies for the management and control of hypertension in Ghana : a mixed-methods study. In: BMC Health Services Research. 2017 ; Vol. 17, No. 1. pp. 1-9.
@article{5cf887e551db40dfb7ef950763f83188,
title = "Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study",
abstract = "Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). Methods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. Results: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9{\%} of the nurses scored 80{\%} or more on the hypertension knowledge test, whereas this improved significantly to 95.7{\%} post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Conclusions: Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration: Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.",
keywords = "Ghana, Hypertension, Nurses, Sub-Saharan Africa, Task-shifting strategies",
author = "Joyce Gyamfi and Jacob Plange-Rhule and Juliet Iwelunmor and Debbie Lee and Blackstone, {Sarah R.} and Alicia Mitchell and Michael Ntim and Kingsley Apusiga and Bamidele Tayo and Kwasi Yeboah-Awudzi and Richard Cooper and Gbenga Ogedegbe",
year = "2017",
month = "2",
day = "2",
doi = "10.1186/s12913-017-2026-5",
language = "English (US)",
volume = "17",
pages = "1--9",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Training nurses in task-shifting strategies for the management and control of hypertension in Ghana

T2 - a mixed-methods study

AU - Gyamfi, Joyce

AU - Plange-Rhule, Jacob

AU - Iwelunmor, Juliet

AU - Lee, Debbie

AU - Blackstone, Sarah R.

AU - Mitchell, Alicia

AU - Ntim, Michael

AU - Apusiga, Kingsley

AU - Tayo, Bamidele

AU - Yeboah-Awudzi, Kwasi

AU - Cooper, Richard

AU - Ogedegbe, Gbenga

PY - 2017/2/2

Y1 - 2017/2/2

N2 - Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). Methods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. Results: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Conclusions: Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration: Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.

AB - Background: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). Methods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. Results: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Conclusions: Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration: Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.

KW - Ghana

KW - Hypertension

KW - Nurses

KW - Sub-Saharan Africa

KW - Task-shifting strategies

UR - http://www.scopus.com/inward/record.url?scp=85011340644&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011340644&partnerID=8YFLogxK

U2 - 10.1186/s12913-017-2026-5

DO - 10.1186/s12913-017-2026-5

M3 - Article

VL - 17

SP - 1

EP - 9

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

ER -