In early February 2022, CDR Ken Radford, PhD, CRNA, NC, USN, and LCDR Quinn Leeper, DNP, CRNA, NC, USN, completed a training mission to provide a Trauma Nurse Course to Ghana Armed Forces nurses and medics as part of the African Peacekeeping Rapid Response Partnership (APRRP) program. CDR Radford currently serves on the TSNRP Advisory Council, is the assistant specialty leader for Navy Nursing Research, and is the director of the Nurse Anesthesia Program in the Daniel K. Inouye Graduate School of Nursing at the Uniformed Services University (USU) in Bethesda, MD. LCDR Leeper currently serves as the assistant site director and director for scholarly activity for the Nurse Anesthesia Program – San Diego detachment.
The Trauma Nurse Course for the Ghana Armed Forces was held at the 37 Military Hospital in Accra, Ghana, the capital and largest city. The 37 Military Hospital provides numerous services and specialty care to the Ghana Armed Forces and their families, like DoD hospitals. We toured several hospital departments, including the intensive care unit, pediatrics, and main operating rooms. We were also able to meet the faculty and support staff for the Nurse Anesthesia Program, one of 8 programs in Ghana that provides advanced education for nurses in the care and delivery of anesthesia. Nurse anesthetists in Ghana work with physician anesthesiologists in mostly independent practice.
African Peacekeeping Rapid Response Partnership
The APRRP program, founded in 2015, is funded by the U.S. State Department and administered by the U.S. Department of Defense (DoD). The DoD placed this program under the Center of Global Health Engagement (CHGE) direction at the Uniformed Services University (USU). The CGHE actively seeks USU faculty to teach various courses that prepare host African nations to deploy for United Nations (U.N.) peacekeeping missions. The APRRP provides various courses from logistics to medical operations. Under medical, the faculty of APRRP provides training in Trauma Nursing, Critical Care, Tactical Combat Casualty Care (TCCC), and others.
APRRP provided training and planning assistance to several African nations, including Uganda, Rwanda, and Ghana. Unfortunately, the global COVID-19 pandemic created a significant impact on the training calendar during 2020 and part of 2021 due to international travel restrictions and testing. However, APRRP successfully resumed training in late 2021. The next and final country APRRP will support is Senegal, with training missions planned throughout 2022.
The Republic of Ghana in West Africa borders the Gulf of Guinea and the Atlantic Ocean to the south. It is the second-most populous country in West Africa with 31 million people and gained independence in 1957 from British colonization. Since then, Ghana remains a key strategic U.S. ally and a stable, peaceful democratic nation.
The preparation for APRRP courses occurs months ahead of time. APRRP sends advance teams to conduct site surveys in host nations and meet with local command leadership to determine training needs and evaluate facility availability. Local armed forces must supply support personnel, facilities, and a desire/capability to lead training programs following APRRP support.
Facilities for the Trauma Nurse Course in Ghana were exceptional.
Course faculty provided the lectures in a dedicated space with hotspot internet capabilities, laptops, and slide presentations projection on a wall. There was also a dedicated room for hands-on skills demonstration. APRRP purchased and shipped numerous supplies to support skills learning including airways, hemorrhage, intravenous access, splints, cervical collars, chest trauma task trainers. In addition, the APRRP program provided a full-size simulation mannequin to the Ghana Armed Forces. The simulation and host-nation course coordinator controlled the simulator via laptop to provide vital signs and other capabilities such as surgical cricothyrotomy, vascular access, and tourniquet application.
Remote Mentoring & Teaching Teamwork
The Trauma Nurse Course occurs in two phases: Phase 1 = USU-led course and Phase 2 = Ghana Armed Forces-led course. Phase 1 occurred in December 2021, where CDR Radford, along with COL (ret) Paul Lewis, PhD, FNP, Maj Michelle Woodie, DNP, FNP, NC, USAF, and course coordinator Maria Docal, MPH, RN provided training to 15 Ghana Armed Forces nurses and medics. After this course, the U.S. faculty selected six Ghanaian faculty candidates to teach the same course material in February 2022 during Phase 2. CDR Radford mentored these six Ghana Armed Forces faculty over five weeks remotely as they reviewed material, prepared lectures, and designed simulation events in preparation for Phase 2. The six Ghana Armed Forces faculty candidates taught the Trauma Nurse Course material to an additional 15 nurses and medics preparing to deploy. In addition, CDR Radford and LCDR Leeper served as mentors and subject matter experts during Phase 2 for the faculty candidates and assisted with content and skills demonstrations when needed.
The Trauma Nurse Course consisted of various topics taught over five days including blood management, vascular access, airway management, shock, disaster management, triage, hemorrhage control, neurologic injuries, burn management, blast injuries, chest trauma, special populations, traumatic fractures/splinting, and more. Most lectures are immediately followed by hands-on skills training where instructors provide additional knowledge and opportunities for students to demonstrate their skill performance.
The students enjoyed the skills stations because they could interact with the instructors more closely, ask questions, and learn new skills. TSNRP donated 30 Battlefield and Disaster Nursing Pocket Guides that CDR Radford distributed to the Ghana students. The students readily used the pocket guides to supplement their assigned readings and skills stations. Finally, the Phase 1 and 2 courses each concluded with a mass-casualty culmination event. Students used the knowledge and skills gained throughout the course to triage and manage the nursing care for a series of traumatic injuries.
Overall, the Trauma Nurse Courses in Ghana were a success. We shared knowledge and skills with U.N. partners, and more importantly, personal friendships were developed and strengthened. We will never forget the cultural exchanges over breaks, lunches, and weekend excursions led by our Ghanaian hosts. Ghana is a beautiful nation of incredibly welcoming people who always greeted us with unforgettable smiles. We want to offer a special thanks to USU, APRRP, TSNRP, Maria Docal, and our various Ghana host-nation support staff and faculty for an incredible experience and opportunity to participate in this military training course.
Disclaimer: The opinions and assertions expressed herein are those of the authors and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences or the Department of Defense.