Impact of the WHO/ICRC Basic Emergency Care (BEC) course on nurses’ knowledge, confidence, and competence in Primary Health Care facilities in Gauteng, South Africa

Introduction

Primary health care (PHC) nurses handle preventative care and emergencies, despite the latter not being their focus. Upskilling in basic emergency care is essential as PHC facilities serve as the first point of care. The World Health Organization and International Committee of the Red Cross developed a Basic Emergency Care (BEC) course, but its suitability for Gauteng PHC nursing staff remains unknown. This study assessed the BEC course's impact on nurses' knowledge, confidence, and competence in emergency care at selected Gauteng PHC facilities.

Methods

A pre-post intervention design was used with purposive sampling of eighty-six nurses who completed the BEC course from three emergency departments. Data collection occurred April-June 2024. Knowledge, confidence and competence were assessed using pre- and post-course surveys and knowledge tests, plus a final evaluation with 6 open-ended questions. Data analysis included descriptive statistics, correlational analyses, and inferential methods to determine statistical significance of observed variations.

Results

The study included N = 86 nurses across various categories. Knowledge scores significantly increased from 55.1% pre-test to 78.8% post-test. Self-perceived competence and confidence improved from 2.72 to 3.54 post-course. ANOVA revealed significant relationships between nurse categories and scores in pre-tests (p = 0.004) and post-tests (p < 0.001). Post-test confidence also varied significantly between categories (p = 0.046). Content analysis of open-ended responses identified four themes: "Correcting wrongs", "Extremely congested course", "Contextual relevance" and "Skills update."

Discussion

The results highlight significant knowledge gains for all nurses who received BEC training. However, differences in performance between nurse categories suggest a need for further exploration and consideration of how to accommodate different categories of nurses. While nurses found the course highly useful and relevant, content loading and course duration should be considered.