Musculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan ...African nations. Improving care at the district hospital level is an important component of the World Health Organization's strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level. The objective of this study was to provide data on the patient population and patterns of musculoskeletal injury caused by RTI at Ugandan district hospitals.
In this cross-sectional study, all patients with musculoskeletal injuries identified on x-ray presenting to three Ugandan district hospitals from October 2013 to January 2014 were interviewed and examined to obtain data on patient demographics and injury context by road user category. This manuscript is a sub-group analysis of RTI victims from a broader dataset of all musculoskeletal injuries.
Vulnerable road users comprised 92 % of musculoskeletal RTI patients, with 49 % (95 % CI 41-57 %) pedestrians, 41 % (95 % CI 33-49 %) motorcyclists, and 2 % (95 % CI 0-4 %) cyclists. Commonly injured subgroups included student pedestrians (33 % (95 % CI 22-44 %) of pedestrians) and motorcyclists with less than a post-secondary education (74 % (95 % CI 63-85 %) of motorcyclists). The morning hours were the most common time of injury for all RTI patients (37 %%; 95 % CI 30-44 %) and motorcyclists (46 %; 95 % CI 34-58 %), while pedestrians were most commonly injured in the evening (32 %; 95 % CI 21-43 %).
By demonstrating commonly injured demographic groups and high frequency times of day for injury, this surveillance study of musculoskeletal RTI suggests targeted avenues for future road safety research in the districts of Uganda. Compared with previous studies from the capital of Uganda, these results suggest that Ugandan district hospitals care for a disproportionate share of vulnerable road users, a discrepancy which may pertain to other sub-Saharan African nations, as well. Strengthening district hospital orthopedic care should be considered a priority of strategies aimed at improving outcomes for these vulnerable groups.
Abstract Blood as a transplant is not free of risks. Clinicians and patients ought to know the parameters of a transfusion informed consent. A mixed methodology to explore patients’ and clinicians’ ...knowledge and opinions of administration and strategies to improve the transfusion informed consent process was conducted. The clinicians’ level of knowledge was limited to provision of information about and the right to consent to a transfusion. They disagreed on administrative issues but had acceptable opinions on improving the process. Patients perceived this process as a way of assurance of blood safety. This process is important and should not be omitted.
Introduction: Clinical use of blood has shown the least developed part in the vein-to-vein transfusion chain. This global study was carried out in order to investigate the level of awareness, ...accessibility and utilization of continuous e-learning and education, and quality of blood use among blood prescribing clinicians and nurses. Approach: Descriptive ex post facto survey design. Methods: A total of 264 purposively selected blood prescribing clinicians and nurses from the four Human Development Index (HDI) groups of countries (low, medium, high, and very high) participated in this study. Three research questions were answered, while seven null hypotheses were tested at 0.05 level of significance. Descriptive statistical tools (frequency counts and percentage) were used to analyze demographic backgrounds; inferential statistics – Pearson product-moment correlation coefficient (PPMCC) and analysis of variance (ANOVA) were used to analyze hypotheses. Results: Quality of clinical blood use was positively and significantly correlated with the level of awareness (r=0.137; p=0.03; df=262) and accessibility (r=0.184; p=0.01; df=262) to e-continuous learning among clinicians/nurses. There was a significant difference in the levels of awareness (F3,260=53.942, p=0.01), accessibility (F3,260=38.582, p=0.01), and utilization (F3,260=24.858,p=0.01) of continuous e-learning and education among clinicians/nurses based on HDI grouping, particularly between very high and low HDI. Furthermore, there was a significant difference in the levels of accessibility (F6,257=6.444, p=0.01) and utilization (F6,257=13.704, p=0.01) of continuous e-learning and education among clinicians based on clinical specialty/department and a significant difference in the quality of clinical blood use based on clinical specialty/department (F6,257=9.677,p=0.01). Conclusion and recommendations: The higher the HDI level the better is the awareness, accessibility, and utilization of continuous education, both through e-learning and conventional in teaching curricula. This has an immediate impact on the quality of clinical care and in particular on supportive hemotherapy and the development of patient blood management systems.
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