THE IMPACT OF HEALTH WORKER EDUCATION AND COMPETENCY ON MINIMIZING PATIENT SAFETY INCIDENTS IN NIGERIA

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Patient safety is a vital and non-negotiable aspect of healthcare delivery, playing a crucial role in ensuring patient well-being and improving health outcomes. According to the World Health Organization (WHO, 2021), patient safety initiatives are primarily aimed at minimizing preventable injuries, medical errors, and adverse events within healthcare settings. While the importance of patient safety processes in delivering quality care is widely acknowledged, the systems responsible for executing these processes are often complex and susceptible to errors. Promoting patient safety is not just a strategic necessity but also an ethical responsibility for healthcare systems, directly influencing patient satisfaction, the trust between providers and patients, and the overall efficiency and effectiveness of healthcare delivery (Aiken et al., 2018). This responsibility is particularly significant in the context of Nigeria’s healthcare system, which faces unique challenges. It is therefore essential to critically examine and improve patient safety mechanisms in Nigeria to protect patients from avoidable harm and foster a culture of quality and safety in healthcare provision. According to WHO (2021), patient safety incidents—which refer to unexpected events resulting in patient harm—contribute significantly to global morbidity and mortality rates, especially in low- and middle-income countries. The Nigerian healthcare system is especially vulnerable due to limited resources, inadequate staff training, and inconsistent competency levels among healthcare workers. These issues contribute to a high rate of safety incidents, although enhancing the training and competency of healthcare professionals may help mitigate their adverse impacts (Ogunlesi et al., 2020). Healthcare professionals' training plays a pivotal role in establishing and maintaining safety standards. Training programs that focus on practical skills, effective communication, and cultivating a safety-oriented culture can significantly reduce safety incidents (Aiken et al., 2018). However, many healthcare workers in Nigeria do not have access to comprehensive training programs, limiting their ability to prevent mistakes. Research indicates that insufficient training is strongly linked to an increased likelihood of errors, especially in high-pressure environments such as emergency rooms and intensive care units (Okeke & Iheanacho, 2019). Therefore, gaps in both initial and ongoing training are frequently cited as contributors to safety lapses in the Nigerian healthcare system. Competency among healthcare professionals is equally essential in minimizing safety risks. Ogunlesi et al. (2020) define competency as encompassing technical skills, critical thinking, adaptability, and adherence to ethical standards. Higher competency levels generally result in better risk anticipation and management before harm can occur. Ameh et al. (2017) found through detailed analysis that training based on competencies improves clinical judgment and patient safety outcomes. Unfortunately, standardized competency assessments are often absent in Nigeria, which means that healthcare professionals may not consistently demonstrate the skills necessary for optimal patient risk management. This inconsistency may cause substantial differences in safety outcomes across healthcare facilities in the country. Continuous Professional Development (CPD) is another key mechanism for helping healthcare workers maintain and improve their skills over time. CPD initiatives—such as certifications, workshops, and simulation training—have been shown to enhance knowledge and competence, thereby improving patient safety (Aiken et al., 2018). However, such opportunities are limited in Nigeria, with many healthcare workers facing challenges like high costs, lack of organizational support, and time constraints when trying to participate in CPD programs (Ameh et al., 2017). Without access to ongoing training, health workers may become less competent, increasing the risk of safety incidents. Furthermore, WHO (2021) emphasizes the need to create standardized processes, encourage error reporting, promote learning, and foster teamwork to build a culture of safety within healthcare institutions. In Nigeria, prioritizing structured and standardized training programs is essential for nurturing a patient safety culture among healthcare staff. Institutions that adopt such protocols experience fewer safety incidents because their personnel are more informed and better equipped to adhere to established safety guidelines (Okeke & Iheanacho, 2019). Although training and competency are recognized as critical factors, few studies have explored their direct effects on patient safety incidents in the Nigerian context. This study thus aims to explore how health worker training and competency contribute to reducing patient safety incidents in Nigeria. 1.2 Statement of the Problem Patient safety incidents continue to be a pressing concern for healthcare systems globally, including Nigeria. These incidents—which range from medication errors to procedural mistakes—can significantly affect patient outcomes and elevate healthcare costs (Aiken et al., 2018). Research shows that a considerable proportion of these incidents are preventable and that having well-trained and competent healthcare workers is essential for reducing such risks (WHO, 2021). In Nigeria, however, the ability of health professionals to uphold safety standards is impeded by factors such as resource constraints, poor assessment of competencies, and insufficient training opportunities (Ameh et al., 2017). Inconsistencies in training quality across various healthcare institutions also contribute to unequal competency levels among professionals, thereby increasing the likelihood of avoidable errors and negative outcomes (Okeke & Iheanacho, 2019). WHO (2021) stresses the importance of educating healthcare providers on best practices in patient safety to reduce incidents that compromise care. Yet, Nigeria faces specific challenges, such as limited access to professional development opportunities and a lack of standardized training frameworks (Ogunlesi et al., 2020). These gaps underscore the urgency for well-designed training programs tailored to meet the particular needs of Nigeria’s healthcare workforce and environment. Consequently, this study investigates the role of health worker training and competency in mitigating patient safety incidents in Nigeria. 1.3 Objectives of the Study The general aim of this study is to explore the influence of health worker training and competency on the reduction of patient safety incidents in Nigeria. The specific objectives are to: i. Assess the competency levels among healthcare professionals in Nigeria. ii. Identify training programs that effectively improve patient safety competencies among healthcare workers. iii. Evaluate the challenges healthcare institutions face in executing training initiatives aimed at enhancing patient safety. iv. Offer recommendations to improve training and competency as a strategy for reducing patient safety incidents in Nigeria. 1.4 Research Questions The study is guided by the following research questions: i. What is the level of competency among healthcare professionals in Nigeria? ii. Which training programs effectively improve patient safety competencies among healthcare workers? iii. What challenges do healthcare institutions encounter when implementing training programs to reduce safety incidents? iv. What recommendations can enhance health worker training and competency to mitigate patient safety incidents in Nigeria? 1.5 Significance of the Study The outcomes of this research can serve as a valuable resource for healthcare institutions in identifying best practices for improving patient outcomes. The insights gathered may aid hospital managers and policymakers in establishing standardized training systems that better prepare health professionals to deliver safe and effective care. Moreover, the findings of this study will benefit the academic community by enriching existing literature, increasing available library resources, and offering guidance for future researchers in this field. 1.6 Scope of the Study This study focuses on examining the role of healthcare worker training and competency in minimizing patient safety incidents within Nigeria. It will empirically assess the competency levels of Nigerian healthcare workers, identify effective training programs that improve patient safety, examine the obstacles healthcare institutions face in implementing such programs, and suggest strategies to enhance training and competency. Geographically, the research is limited to General Hospital Gbagada, located in Lagos State, Nigeria. 1.7 Limitations of the Study As with all research efforts, this study faced several minor limitations. Time Constraints: Balancing academic obligations such as attending lectures with the research process posed a time management challenge. Financial Limitations: The researcher incurred substantial expenses during the study, including printing, typesetting, sourcing relevant literature, and data collection. Availability of Materials: Finding appropriate and up-to-date literature proved difficult due to the limited availability of research focused on the specific topic. 1.8 Definition of Terms Health Worker: An individual involved in providing care and medical services either directly (e.g., doctors, nurses) or indirectly (e.g., lab technicians, aides, waste handlers) within the healthcare system (World Health Organization). Training: A structured set of activities designed to improve healthcare workers’ skills, knowledge, and competencies to enable them to deliver safe and effective care. Competency: A blend of skills, knowledge, and professional attitudes that enable healthcare workers to perform tasks effectively, delivering quality care while minimizing patient risk. Patient Safety: The discipline focused on preventing and reducing risks, errors, and harm that occur to patients during the provision of healthcare services