Assessment of the perception of service recipients about the quality of work in health care professionals in the Children Emergency Room of a Tertiary Hospital in Nigeria

The children emergency room (ER) is regarded as an essential section of hospitals and other healthcare settings where immediate medical and surgical care is given to children in need of urgent care. The conditions of the emergency room and the quality of service by the emergency room staff has been described as a major determinant of the socio-medical outcome of patients and their relatives. This is a hospital based cross-sectional carried out in the Children Emergency Room (CHER) of the Enugu State University Teaching Hospital, Enugu Nigeria. Parents and care-givers that presented with their sick children to the ER department were successively enrolled after obtaining consent. Information on their assessment of certain aspects of the emergency room environment and quality of service received from medical and administrative personnel working in the emergency room was obtained using a 5-point Likert assessment scale. Results were reported using frequencies, percentages and chisquare were applicable. Statistical significance was set at P≤0.05. Over half (59%) of the 83 respondents that presented to the emergency room during the study period were self-referrals and all (95.2%), but four respondents noted a significant improvement in the condition of their sick children following management in the emergency room. In all parameters assessed, most respondents rated the emergency room conditions as moderate in noise level 69 (83.1), crowdedness 65 (78.3), comfort 49 (59.0) and cleanliness 41 (49.4) with an overall point score of 2.97±0.33 out of a possible five. Doctors were on average rated better than nurses and record clerk staff in politeness (P=0.001), patience (P=0.002), efficiency (P=0.002), and adequate explanation of procedures (P=0.001) while nurses were rated better than record staff in explanation of procedures to their patient (P=0.05) but not in politeness (P=0.894), patience (P=0.505) and efficiency (P=0.982). The rating of record clerks was significantly affected by the socio-economic class of respondents (P=0.036) but not by gender (P=0.252) or age of respondents (P=0.123). None of the respondents’ socio-demographic factors significantly determined their rating for the emergency room conditions and the quality of service by doctors or nurses. There is a need for a continued review of emergency room conditions in addition to training and re-training of staff in the children emergency room. This not only helps improve health outcomes but may also significantly reduce the duration of stay in the emergency room that in turn reduces congestion and the burden on the healthcare system.