Human resources staffing and training

In most developing countries, little consideration has been given to optimizing the training of medical and nursing staff for the care of injured patients. This applies to both urban and rural environments. For example, hospitals in rural areas along major roads in Ghana receive large numbers of casualties, yet are often staffed by general practitioners (GPs) and nurses with no specific training in trauma care. Moreover, 30% of the GPs in these hospitals have not had a surgery rotation during their training as house officers (internship) (10). Inexpensive but effective solutions to such problems might include: (i) country-wide plans to encourage those staff with more experience in trauma care to go to such hospitals; and (ii) provision of continuing education courses on trauma care for GPs and nurses in high-volume trauma hospitals. Pilot programmes for such training have demonstrated improvements in trauma care in a variety of environments, including Ghana and Trinidad (10—14).

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