# Knowledge, attitudes, and practices of healthcare providers in pre-hospital care in Nepal

## TL;DR

This study examines the knowledge, attitudes, and practices of healthcare providers in Nepal regarding pre-hospital care, revealing a gap between knowledge and actual practice.

## Contribution

The study provides new insights into the KAP of healthcare providers in Nepal, highlighting the need for targeted training to improve pre-hospital care practices.

## Key findings

- 62% of providers had good knowledge, 66% had positive attitudes, but only 25% demonstrated good practice.
- Males, doctors, and private hospital providers scored higher in knowledge and practice.
- A moderate correlation was found between knowledge, attitude, and practice (rs = 0.420–0.562).

## Abstract

Pre-hospital emergency care is crucial for improving patient outcomes, especially in low- and middle-income countries (LMICs) where trauma is a leading cause of death. In Nepal, inadequate pre-hospital care contributes to approximately 16,600 preventable deaths annually. This study assessed the knowledge, attitudes, and practices (KAP) of healthcare providers in pre-hospital care to identify factors influencing their preparedness.

A quantitative, descriptive cross-sectional design was employed, utilizing a 35-item questionnaire based on a 5-point Likert scale. Data were collected via an online survey (Google Forms) from 517 healthcare providers (doctors, nurses, and paramedics) across 16 hubs and 76 satellite hospitals in Nepal’s seven provinces based on a systematic randomization technique. Data were described with median and interquartile range. Nonparametric analysis, rank Spearman’s rank correlation, and ordinal regression were used to analyze the data.

The study revealed that 62% of providers had good knowledge, 66% exhibited positive attitudes, but only 25% demonstrated good practice. Significant variations were observed by gender, profession, and workplace, with males, doctors, and private hospital providers scoring higher in knowledge and practice. Moderate correlations were found between knowledge, attitude, and practice (rs = 0.420–0.562, p < 0.001). Ordinal logistic regression indicated significant associations between demographic factors and KAP levels.

Despite good knowledge and positive attitudes, only 25% demonstrated good practice, indicating practical implementation of pre-hospital care remains suboptimal. Targeted training programs, simulation-based learning, and continuous professional development will be needed to bridge the gap between knowledge and practice.