JMIR Publications

ABSTRACT

Background:

The Primary Trauma Care (PTC) course was originally developed to instruct healthcare workers in the management of the severely injured patients in low and middle income countries with limited medical resources. The PTC has now been taught for more than 25 years. Many studies have demonstrated that the two-day Primary Trauma Care (PTC) workshop is a useful and informative to front-line health staff and has helped improve knowledge and confidence in trauma management but there is little evidence showing that it leads to changes in clinical practice. The Kirkpatrick (KM) and Knowledge Attitude Practice (KAP) models are effective methods to evaluate this approach. Our study aimed to combine 2 models to evaluate the impact of the PTC program for healthcare staff in two Vietnamese hospitals.

Objective:

to investigate how the “2 day PTC course” impacts on the level of clinical practice in healthcare staff in the emergency departments of two Vietnamese provincial hospitals.

Methods:

We conducted the PTC course over 2 days in the emergency departments (ED) of Thanh Hoa and Ninh Binh hospitals in February and March 2022 respectively. This study was a prospective pre- and post- intervention design. We used validated instruments to assess the participants’ satisfaction, knowledge, and skills before, immediately after the training course and at 6 months after course delivery. Chi-square and T-test were used were used to find percentages and the mean score of pre-test and post-test for subjects.

Results:

There were 80 healthcare staff who attended in the course. At level 1 (satisfaction) of KM, nearly 100 % participants were satisfied with the course. At level 2 (knowledge), the scores on multiple-choice question (MCQ) and confidence matrix (CM) improved significantly from 60% to 77% and 59% to 71% respectively (P < .01), and these improvements were seen in both subgroups (nurses and doctors). The focus of Level 3 was on practice and saw a significant incremental change with scenarios checklist (SC) points increasing from 5.9  1.9 to 9.0  0.9 and bedside clinical checklist (BCC) points increasing from 5  1.5 to 8.3  0.8 (P < .01). At 6-months follow up, MCQ, CM and SC all remained unchanged except MCQ score in the nurse subgroup (P < .01).

Conclusions:

The PTC course undertaken in 2 local hospitals of Vietnam was successful in improving 3 levels of KM for ED healthcare staff. This improvement was maintained for at least 6 months post course. The PTC courses are effective in providing improvement and sustainment in 3 Levels for low- and middle-income countries like Vietnam. Clinical Trial: The trial is registered in ANZCTR with trial ID is ACTRN12621000371897.