Background The use of Electronic Health Records (EHRs) to improve healthcare delivery and patient outcomes is rapidly gaining grounds in low- and middle- income countries. However, registered general nurses who constitute the majority of end-users often face unresolved challenges in their use. In Ghana, though the Lightwave Health Information Management System (LHIMS) has been rolled out, the experiences of nurses with regards to its use remain underexplored. Aim To explore the experience and perceived barriers encountered by registered general nurses in the use of EHRs in providing nursing care in a district hospital in Northern Ghana. Methods The study employed a qualitative descriptive design. A purposive sampling technique supported by solicitation was used to recruit 21 registered general nurses with at least one year of working experience in direct patient care. Face-to-face semi-structured individual interviews were conducted using an interview guide. The interviews were audio-recorded and transcribed verbatim. Data were analyzed using Atlas.ti in line with Braun and Clarke's thematic analysis framework. Findings Four main overarching themes emerged: (1) Infrastructure, resource, and technical constraints, detailing unreliable power and internet connectivity, inadequate and outdated hardware, and system downtimes with usability flaws; (2) Human capacity and training gaps, highlighting inadequate initial orientation, absence of refresher training, and variable digital literacy; (3) Workflow, workload pressures, and ethical concerns, encompassing double documentation, reduced nurse-patient interaction, and fears about data confidentiality; and (4) Organizational support, motivation, and perceived benefits, reflecting the admittance of nurses of improved data storage and accessibility and boosting of professional pride despite the lack of full managerial support. Conclusion Nurses recognized the potential of the use of EHRs in the setting, but were grossly restricted by infrastructural deficits, insufficient training, system interface and usability issues, and poor organizational support. Addressing these barriers through sustained investment in alternate power supply and hardware, continuous competency-based training, user-centered system redesign, and clear policy directives holds promise for optimizing EHR use and realizing its full benefits for patient care outcomes.
Background Safe discharge is an important component of continuity of care in patients with acute coronary syndrome (ACS). This study aimed to determine the level of safe discharge and its associated factors among these patients. Materials and methods This descriptive-analytical study was conducted among 192 patients with ACS admitted to hospitals affiliated with Urmia University of Medical Sciences from February 2025 to June 2025. Participants were selected using consecutive sampling. Data were collected using demographic characteristics form and the SMART Safe Discharge Protocol Checklist. Results The mean age of the patients was 57.05 ± 11.76 years, and 103 (53.6%) were female. The overall mean safe discharge score was 28.68 ± 11.75, indicating a moderate level of safe discharge. The highest and lowest mean scores were observed in the “Talk with Me” (10.32 ± 5.82) and “Symptoms” (2.41 ± 1.48) dimensions, respectively. In the multiple regression model, age (β = −0.402, P < 0.001), university education (β = 0.402, P < 0.001), hospital type (β = 0.123, P = 0.021), presence of comorbidities (β = 0.224, P = 0.007), and history of hypertension (β = 0.193, P = 0.006) were significant predictors of safe discharge. The model explained 66.3% of the variance in safe discharge (R2 = 0.663; adjusted R2 = 0.626). Conclusion The level of safe discharge was moderate. Therefore, structured and patient-centered discharge programs, particularly those emphasizing education about warning signs, are necessary. Limitations The study was limited by its cross-sectional design, single-university setting, and lack of post-discharge follow-up.
Background Adverse neonatal outcomes remain a major public health concern in most low-and middle-income countries (LMICs). However, there is limited evidence on the prevalence and associated factors of adverse neonatal outcomes in Afghanistan. Therefore, this study aims to determine the prevalence and associated factors of adverse neonatal outcomes among deliveries conducted at a tertiary hospital in Afghanistan. Methods A hospital-based cross-sectional study was conducted among 1374 mother‑neonate dyads in Afghanistan from July 1, 2025, to December 30, 2025. Data were extracted from delivery registry records. Bivariate and multivariable logistic regression analyses were used to identify factors independently associated with the outcome. Adjusted odds ratios (AOR) with 95% confidence intervals (CIs) were calculated, and statistical significance was considered at p < 0.05. Results The prevalence of adverse neonatal outcomes was 23.4%. Factors significantly associated with greater odds of adverse neonatal outcomes were C-section deliveries (AOR = 1.42), multiple pregnancies (AOR = 5.47), male neonate (AOR = 1.49), gestational hypertensive disorders (AOR = 2.20), preterm premature rupture of membranes (AOR = 68.42), abnormal amniotic fluid volume (AOR = 1.85), and congenital anomalies (AOR = 7.45). On the other hand, antenatal care utilization was associated with lower odds of adverse neonatal outcomes (AOR = 0.44). Conclusion Adverse neonatal outcomes were unacceptably high in this study. Clinical and health system-related factors contribute to adverse neonatal outcomes in Afghanistan. Strengthening access to quality antenatal care, improving early detection and management of hypertensive disorders and prelabor rupture of membranes, enhancing referral systems, and expanding essential newborn care services are critical to reducing neonatal morbidity and mortality in this study.
Background Quality nursing care is vital for patient safety and outcomes, yet concerns in Ghana's Bono Region highlight the need to explore patients' experiences in public hospitals. Purpose To explore patients' perceptions of quality nursing care in the Bono Region of Ghana. Materials and methods A qualitative, explorative, descriptive, and contextual research design was employed. Semi-structured, face-to-face interviews were conducted with 18 purposively selected patients who had received nursing care in three purposively selected public hospitals in the Sunyani Municipality of the Bono Region. The data were analysed using content analysis, as described by Neuendorf. Results Four key themes emerged: 1) Perceptions of characteristics of quality nursing care: Patients described quality nursing care as holistic and compassionate care that upholds the best standards of practice and patient rights, fosters positive nurse–patient relationships, and is delivered by competent nurses. 2) Barriers to quality nursing care: Key barriers included shortages of equipment and medications, lack of food and potable water, poor sanitation, and overcrowded wards. 3) Outcomes of poor-quality nursing care: poor-quality nursing care contributed to adverse patient outcomes, including hospital-acquired infections, readmissions, and increased healthcare costs. 4) Recommendations to ensure quality nursing care: Patients suggested several recommendations for improving quality nursing care, including enhancing nursing care delivery, improving patient satisfaction, increasing nurses' accessibility, and improving patient outcomes. Conclusion The findings underscore the need for patient-centred, holistic nursing care supported by adequate resources, ongoing professional development, and positive nurse–patient relationships to improve care quality in public hospitals.
