Exploration of utilization of primary assessment among nurses at the emergency unit of a district hospital in Ghana

Background: Primary assessment is crucial for effective emergency care delivery. In Ghana, emergency care systems face significant challenges compared to developed nations. This study aimed to explore emergency nurses’ knowledge, current practices, and implementation challenges regarding primary assessment frameworks for trauma patients in a specific district hospital in Ghana. Methods: An exploratory qualitative design with semi-structured in-depth interviews was employed. Fifteen emergency nurses from a district hospital in the Volta Region of Ghana participated. Data were analyzed using inductive content analysis. Interviews were conducted until data saturation was reached at 10 participants, though all 15 interviews were completed for comprehensiveness. Results: Three main themes with corresponding subthemes emerged: knowledge of primary assessment, challenges in assessment implementation, and framework utilization experiences. Participants demonstrated fair knowledge of primary assessment principles but limited familiarity with the HIRAID framework, primarily using the ABCDE approach instead. Major challenges included inadequate training, insufficient equipment, and lack of standardized protocols. Despite these challenges, participants recognized the potential value of implementing comprehensive assessment frameworks like HIRAID to enhance emergency care quality. Conclusion: Emergency nurses in this Ghanaian district hospital possess basic knowledge of primary assessment but face significant implementation challenges. Addressing resource limitations and providing specialized training could enhance the quality of emergency care delivery. Hospital management should consider adopting structured frameworks like HIRAID to standardize assessment practices and improve patient outcomes.