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Primary Trauma Course Narrative Report MAMA … · Primary Trauma Course Narrative Report MAMA LUCY...
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Primary Trauma Course Narrative Report MAMA LUCY KIBAKI HOSPITAL NAIROBI KENYA 17 th to 21 st June 2013 Purpose of the visit This was the third course in Kenya under the COSECSA Oxford Orthopaedic Link (COOL) Project. The course had been planned for the Nairobi Surgical Skills Center (NSSC). Unfortunately attempts to confirm the course with the NSSC were unsuccessful. The Primary Trauma Course (PTC) development in Kenya has taken place outside of Nairobi. Trauma in Kenya has no regional, rural or city boundaries. It is everywhere. There are sadly no shortages in venues to deliver this trauma course in Kenya. We thought it was important to bring the PTC course to Kenya’s capital city. Hence a change of venue in Nairobi was found. We were fortunate to find a new venue at Mama Lucy Kibaki Hospital (MLKH) in Kayole suburb of Nairobi. This is a new hospital in Nairobi. MLKH is a 137 bed public hospital located in a highly populated area of Nairobi serving an estimated population of two million people. This is the only public hospital in the area and therefore handles all the trauma. Dr Keiza the senior surgeon in the hospital observed that this training was going to be the first of its kind in the hospital and was timely. Executive summary Mama Lucy Kibaki Hospital was opened in 2011 in view of population growth in the Eastlands region of Nairobi without concurrent growth in health facilities. Mr Zacharia Lihumbazi the human resources manager indicated that the facility handles up to 800 outpatients in a day, 6,000 maternity deliveries and was already not coping well with the high demand. The training was well coordinated by one of the local surgeons Dr Eric Hungu and the nursing officer in charge of medical education at the hospital, Prisca Kemunto. The senior management of the hospital was very supportive of the training and allowed the staff time off despite the heavy workload and staffing shortage. We observed that planning for this course was much easier given the experience the team has gained in organizing PTC courses. The trainers have also acquired more confidence and are much more at ease with handling whatever aspects of the training are assigned.
Transcript of Primary Trauma Course Narrative Report MAMA … · Primary Trauma Course Narrative Report MAMA LUCY...
Primary Trauma Course Narrative Report
MAMA LUCY KIBAKI HOSPITAL NAIROBI KENYA
17th to 21st June 2013
Purpose of the visit This was the third course in Kenya under the COSECSA Oxford Orthopaedic Link (COOL) Project. The course had been planned for the Nairobi Surgical Skills Center (NSSC). Unfortunately attempts to confirm the course with the NSSC were unsuccessful. The Primary Trauma Course (PTC) development in Kenya has taken place outside of Nairobi. Trauma in Kenya has no regional, rural or city boundaries. It is everywhere. There are sadly no shortages in venues to deliver this trauma course in Kenya. We thought it was important to bring the PTC course to Kenya’s capital city. Hence a change of venue in Nairobi was found. We were fortunate to find a new venue at Mama Lucy Kibaki Hospital (MLKH) in Kayole suburb of Nairobi. This is a new hospital in Nairobi. MLKH is a 137 bed public hospital located in a highly populated area of Nairobi serving an estimated population of two million people. This is the only public hospital in the area and therefore handles all the trauma. Dr Keiza the senior surgeon in the hospital observed that this training was going to be the first of its kind in the hospital and was timely. Executive summary Mama Lucy Kibaki Hospital was opened in 2011 in view of population growth in the Eastlands region of Nairobi without concurrent growth in health facilities. Mr Zacharia Lihumbazi the human resources manager indicated that the facility handles up to 800 outpatients in a day, 6,000 maternity deliveries and was already not coping well with the high demand. The training was well coordinated by one of the local surgeons Dr Eric Hungu and the nursing officer in charge of medical education at the hospital, Prisca Kemunto. The senior management of the hospital was very supportive of the training and allowed the staff time off despite the heavy workload and staffing shortage. We observed that planning for this course was much easier given the experience the team has gained in organizing PTC courses. The trainers have also acquired more confidence and are much more at ease with handling whatever aspects of the training are assigned.
Key staff involved in planning and coordinating Visiting team
1. Dr. Mathenge Nduhiu – General Surgeon – Course Director 2. Dr Josephine Ohas- Medical Officer- Instructor 3. Dr. Samwel Ndanya- Orthopaedic Surgeon- Instructor 4. Dr. Erick Chesori- Medical Officer- Instructor 5. George Mochama- Senior Clinical Officer – Instructor 6. Dr. Mike Swart – Critical Care Consultant- UK NHS Observer Instructor
Local team
1. Dr Eric Hungu- General Surgeon 2. Magdalene Waihenya- Nursing Officer 3. Prisca Kemunto – Nursing Officer
Professional aspects of the visit The course was well received by the senior Nursing team at MLKH and we formed the opinion that this group will form the core team driving PTC at this hospital. The nurses were enthusiastic and informed us that they had realized need for trauma care training but had not secured funds for it yet. They were therefore very happy to take up PTC when they learnt of it from the surgeon.
PTC PROGRAMME Mama-‐Lucy 17th to 18th June 2013
DAY 1
Time Duration Topic Instructor
8.30 A.M. 15 Min Introduction & Local Trauma Perspective
Dr. Ndanya, Dr. Caesar
8.45 a.m. 45 Min MCQs Dr. Ohas
9.30 a.m 30 Min ABCDE of Trauma &
Primary Survey
Dr. Ohas
10.00 a.m. 35 Min Airway & Breathing Dr. Mathenge
10.35a.m 15 Min BREAK
10.50 a.m 35 Min Circulation & Shock Dr. Chesori
11.25 a.m. 100 Min Skills Station
(1) Airway
(2) Cervical Spine &
logroll
(3) Chestdrains
Dr. Ndanya, Dr. Mike
Mr. Mochama
Dr. Chesori, Dr. Ohas
13.05p.m 40 Min Lunch Break
13.45p.m 30 Min Secondary Survey Mr. Mochama
14.15p.m 15 Min Demonstration Scenario ALL
14.30p.m 80 Min Scenarios (4 Groups) ALL
15.50p.m 15 Min Break
16.05p.m 25 Min Chest Injuries Dr. Ndanya
16.30p.m 15 Min Overview & Summary Dr. Mathenge
DAY 2
Time Duration Topic Instructor
8.30 a.m. 30 Min Head & Spinal Trauma Dr. Mathenge
9.00 a.m. 30 Min Abdominal & Limb Trauma Mr. Mochama
9.30 a.m. 30 Min Trauma in Children & Pregnancy Dr. Ohas
10.00 a.m. 15 Min T E A B R E A K
10.15 a.m. 30 Min BURNS Dr. Ndanya
10.45 a.m. 100 Min Work Shops (Discussions) –
• Analgesia
• Transportation
• Paediatrics
• Neurological assessment
Dr. Ohas
Mr. Mochama
Dr. Mathenge
Dr. Ndanya and Dr. Chesori
12.25p.m 40 Min L U N C H B R E A K
13.05p.m 30 Min Disaster Management Dr. Chesori
13.35p.m 90Min Scenarios (4 Groups) ALL
15.05p.m 15 Min BREAK
15.20p.m 30 Min MCQs Dr. Mike
15.50p.m 15 Min Summary & Evaluation Dr. Ndanya
16.05p.m 15 Min Certificates & Close Dr. Mathenge
PTC Course Participants 17th to 18th June 2013 (day 1 and 2)
First Name Surname Specialty
MONICA GIKURU NURSING OFFICER
FLORENCE NJERI NDUATI CLINICAL OFFICER PAEDS
EVERLYNE VUGUTSA NURSING OFFICER OPD
ERICK KIBET MUTAI MEDICAL OFFICER INTER
SUSAN NDEGWA NURSING OFFICER
MAGDALENE WAIHENYA NURSING OFFICER
OBED ANGWENYI CLINICAL OFFICER INTERN
JOANE SIGU NURSING OFFICER
JACQUELINE ALUKA CLINICAL OFFICER INTERN
ESTHER MOMANYI NURSING OFFICER
HARRISON GITAU CLINICAL OFFICER INTERN
KEVIN NGURING'A MEDICAL OFFICER INTER
DIANA MWALI NURSING OFFICER
KELVIN MOGAKA CLINICAL OFFICER INTERN
PRISCAH KEMUNTO NURSING OFFICER
SYLVIA MWANZIGHE NURSING OFFICER
ELIZABETH GAKARIA NURSING OFFICER
CAROL MWATHA MEDICAL OFFICER INTER
MARTIN AJUJO MEDICAL OFFICER
From the above the following were selected to attend a PTC instructor’s
course Mama Lucy Kibaki PTC Instructors Course 19th June 2013 (day 3)
FLORENCE NJERI NDUATI CLINICAL OFFICER PAEDS
EVERLYNE VUGUTSA NURSING OFFICER OPD
ERICK KIBET MUTAI MEDICAL OFFICER INTERN
MAGDALENE WAIHENYA NURSING OFFICER
JOANE SIGU NURSING OFFICER
JACQUELINE ALUKA CLINICAL OFFICER INTERN
KEVIN NGURING'A MEDICAL OFFICER INTERN
KELVIN MOGAKA CLINICAL OFFICER INTERN
PRISCAH KEMUNTO NURSING OFFICER
CAROL MWATHA MEDICAL OFFICER INTERN
MARTIN AJUJO MEDICAL OFFICER
1 DAY PTC INSTRUCTORS COURSE PROGRAMME MLKH 19-6-2013
9.00 5 minutes Introduction Mr. Mochama
9.05 15 minutes How adults learn Mr. Mochama
9.20 15 minutes Asking questions Dr. Chesori
9.35 25 minutes Feedback Dr. Ndanya
10.00
20 minutes
20 minutes
How to give presentations
General introduction
Lecture
Dr. Ohas
Dr. Mathenge
10.40 15 minutes BREAK
10.55 20 minutes
15 minutes
15 minutes
Discussion group
Teaching a skill
Scenario
Mr. Mochama
Dr. Chesori
Dr. Ndanya
11.45 60 minutes LUNCH BREAK
12.45 120 minutes WORKSHOPS
Lecture
Discussion group
Teaching a skill
Scenario
ALL
14.45 15 minutes BREAK
15.00 15 minutes Language issues Dr. Ohas
15.15 30 minutes Instructor course evaluation
(evaluation sheet, brainstorming and instructor details form )
Dr. Mathenge
15.45 30 minutes Where to go from here (Discussion group)
Setting up a committee
ALL
16.15 FINISH
Second PTC PROGRAMME Mama-‐Lucy 20th to 21st June 2013
DAY 1
Time Duration Topic Instructor
8.30 A.M. 15 Min Introduction & Local Trauma Perspective
Dr. Ajujo
8.45 a.m. 45 Min MCQs Priscah
9.30 a.m 30 Min ABCDE of Trauma &
Primary Survey
Maggy
10.00 a.m. 35 Min Airway & Breathing Kelvin
10.35a.m 15 Min BREAK
10.50 a.m 35 Min Circulation & Shock Jacky
11.25 a.m. 100 Min Skills Station
(4) Airway
(5) Cervical Spine &
logroll
(6) Chestdrains
Dr. Mwatha, Jacky, Kelvin
Dr. Kibet, Maggy, Priscah
Dr. Kevin, Joane, Florence
13.05p.m 40 Min Lunch Break
13.45p.m 30 Min Secondary Survey Joane
14.15p.m 15 Min Demonstration Scenario ALL
14.30p.m 80 Min Scenarios (4 Groups) ALL
15.50p.m 15 Min Break
16.05p.m 25 Min Chest Injuries Dr. Kibet
16.30p.m 15 Min Overview & Summary Priscah
DAY 2
Time Duration Topic Instructor
8.30 a.m. 30 Min Head & Spinal Trauma Dr. Kevin
9.00 a.m. 30 Min Abdominal & Limb Trauma Esther
9.30 a.m. 30 Min Trauma in Children & Pregnancy Florence
10.00 a.m. 15 Min T E A B R E A K
10.15 a.m. 30 Min BURNS Dr. Ajujo
10.45 a.m. 100 Min Work Shops (Discussions) –
• Analgesia
• Transportation
• Paediatrics
• Neurological assessment
Group 4
Group 2
Group 3
Group 1
12.25p.m 40 Min L U N C H B R E A K
13.05p.m 30 Min Disaster Management Dr. Mwatha
13.35p.m 90Min Scenarios (4 Groups) ALL
15.05p.m 15 Min BREAK
15.20p.m 30 Min MCQs Jacky
15.50p.m 15 Min Summary & Evaluation Dr. Kibet
16.05p.m 15 Min Certificates & Close Dr. Ajujo & Maggy
PTC Course Participants 20th to 21st June 2013 Mama Lucy Kibaki Hospital (day 4 and 5)
First Name Surname Specialty
ELIZABETH MBUTHIA NURSING OFFICER
ZAINABU ADAN NURSING OFFICER
LYDIA MOTURI NURSING OFFICER
MARY MORAA NURSING OFFICER
MARY NZIOKI CLINICAL OFFICER
DAMARIS GATITI CLINICAL OFFICER
STELLA GACHERI CLINICAL OFFICER
MONICA NJERI NURSING OFFICER
EMILLY NYUNJA CLINICAL OFFICER INTERN
CHRISTINE GAKINGI CLINICAL OFFICER INTERN
FIDELMA MAWEU NURSING OFFICER
SAMMY MAIYO CLINICAL OFFICER INTERN
ELIJAH GATERI NURSING OFFICER
ELEVER MBABAZI MEDICAL OFFICER
STEPHEN NDUNGU NURSING OFFICER
SUSAN MUTAHI MEDICAL OFFICER INTERN
SAMSON BWIRE OCCUPATIONAL THERAPIST
JOSEPHINE GITHAIGA MEDICAL OFFICER
HASSAN BACHU MEDICAL OFFICER
ELIZABETH WANGU NURSING OFFICER
Instructors for: 17th to 18th June 2013 Nairobi PTC Course 19th June 2013 Nairobi PTC Instructors Course
and Observers for: 20th to 21st June 2013 Mama Lucy Kibaki PTC Course
1. Dr. Eric Chesori – Medical Officer Kitale District Hospital 2. Mr. George Mochama- Senior Clinical Officer Nanyuki District
Hospital 3. Dr. Samuel Ndanya- Orthopaedic Surgeon Embu Provincial
General Hospital
4. Dr Mathenge Nduhiu- General surgeon Nanyuki District Hospital 5. Dr. Josephine Ohas- Medical Officer Nanyuki District Hospital 6. Dr Mike Swart- Critical Care Consultant- Torbay Hospital UK
Instructors for: 20th to 21st June 2013 Mama Lucy Kibaki PTC Course
1. Prisca Kemunto – Nursing Officer Mama Lucy Kibaki 2. Magdalene Waihenya – Nursing Officer Mama Lucy Kibaki 3. Joane Sigu – Nursing Officer Mama Lucy Kibaki 4. Florence Nduati – Clinical Officer Mama Lucy Kibaki 5. Kelvin Mogaka – Clinical Officer Mama Lucy Kibaki 6. Jacqueline Aluka – Clinical Officer Mama Lucy Kibaki 7. Dr Carol Mwatha - Medical Officer Intern Mama Lucy Kibaki
Hospital 8. Dr. Kevin Nguring’a - Medical Officer Intern Mama Lucy Kibaki
Hospital 9. Dr. Erick Kibet – Medical Officer Intern Mama Lucy Kibaki
Hospital 10. Dr. Martin Ajuju - Medical Officer Mama Lucy Kibaki Hospital
Details of activities On the first day of the course we started at 10 am. We later learnt most of the staff had to attend to some of their departmental activities before coming for the course. Initially the participants were held back but as the day progressed they warmed up to the training and really became involved. Day two started at 9 am but we finished late, as it appeared the instructors tended to require more time to elaborate and make clarifications on many issues. We observed that we needed to have a keener eye on time keeping for future courses. We had hoped to use goat larynx for demonstration of the surgical airway as we did in the Kitale training but the butcheries in the area could not supply the required specimens because the butchers were mainly Muslim and indicated that it was against their religion to cut the animal’s necks as low as we required! The instructor course ran very smoothly and we started and finished on time. The new instructors thus had adequate time to prepare for their course. The new instructors did a splendid job of time keeping and were very organized. We trained 11 instructors after a mix up of two similar first names. Both participants however had performed above average and hence we decided not to turn away any. The team however is lacking in senior support and therefore the visiting instructors needed to help in clarifications and answering some questions.
Subsidiary activities On day 4 we took time to visit Mr Lihumbazi the human resources officer in the hospital who indicated to us that he was going to support continued PTC training to the relevant staff that had not been reached. He promised to use some of their training funding for PTC activities. We also made a courtesy call on the nursing services manager sister Felistus Musyoka. On the evening of the 20th the instructors had dinner at the Safari Park Hotel and enjoyed an interesting cabaret chow hosted by the Safari Cats Group. Media coverage There was no media coverage Evaluation of the success and relevance of the visit
During the course of the training we noted that the institution had been lacking in primary trauma care skills. The nursing team at the emergency department led by sister Magdalene Waihenya had recognized this. The participants all observed that they had gathered confidence in handling trauma patients and they expressed enthusiasm to start applying PTC principles in their work.
We also observed that initially the various cadres in the training appeared not to gel as a team but by the end of the training we felt that they now seemed to communicate much better and work better as teams. We therefore believe we have made a significant difference in the management of trauma patients in this hospital and also recruited trainers who will be involved in further PTC trainings in Kenya
PTC Courses 17th to 21st June 2013 at Mama Lucy Kibaki Hospital
COSECSA Oxford Orthopaedic Link (COOL)
This Primary Trauma Care course is part of a project funded through the Health Partnership Scheme, which is funded by the UK Department for International Development (DFID) for the benefit of the UK and partner country health sectors and managed by the Tropical Health Education Trust (THET). The project is called the COSECSA Oxford Orthopaedic Link (COOL). More information is available at www.ndorms.ox.ac.uk/cool.php.
