Audit of Bloemfontein Primary Healthcare Clinics' Emergency Preparedness

Abstract

Primary health clinic staff must be prepared to manage medical emergencies until an ambulance arrives. This study aimed to determine how well prepared clinics in Bloemfontein, South Africa, are to manage common emergencies regarding consumables, equipment and medication, secondarily to identify common emergencies. This was an observational descriptive study and included all 16 public primary health clinics in the Bloemfontein sub-district. Data were collected using a walk-through audit tool based on current provincial equipment lists. Mean compliance was 45 per cent (range 32–67%) for consumables, 53 per cent (range 46–63%) for equipment, and 58 per cent (range 36–77%) for medication. None of the clinics achieved a level of above 90 per cent in any of these three categories. Six clinics (38%) scored below 40 per cent for consumables, one (6%) for equipment and two (13%) for medication. Items not found in any of the clinics were paediatric or neonatal Magill forceps, size 6.5 cuffed and 4.5 uncuffed endotracheal tubes, and 14 g intravenous cannulas. Two clinics had an automated external defibrillator. Respiratory (asthma), metabolic (hypo- and hyperglycaemia) and cardio circulatory (hypertension) were the most common emergencies. Almost half of all the clinics scored less than 40 per cent in at least one of the three categories, suggesting a general “poor culture†of maintaining emergency trolleys. The utilisation of an easy-to-use audit tool to monitor the emergency preparedness of clinics appears essential. Identified challenges with such a tool need to be dealt with and clear audit rules must accompany such a tool. Audit results should be used in the performance assessment of responsible managers.