KNH NEWSLINE ED 2 2021

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NEWSLINE We Listen, We Care

Issue 2.

29/1/2021

Saving Hearts One Beat at a Time Introducing the only Public Cardiac Cath-Lab in Kenya

By Ngure Jacqueline

K

enyatta National Hospital being at the apex of the referral health system in Kenya boasts of many firsts, whether in skill and expertise or facilities and equipment.

That is never in contention. It takes a lot in terms of hard work, discipline, and consistency to attain such worldclass levels of service delivery and takes a lot more to maintain that status.

And such is the outlook exhibited by the great team in the KNH Cardiology department.

Newsline interviewed Mr. Eric Evans Otieno, the Nursing Officer in charge of the Cardiology department, whose mandate at KNH is to provide worldclass cardiovascular services on referral.

It is in this unit where cardiac patients get cardiac investigation services such as ECG (Electrocardiogram) and Echocardiogram and intervention services such as Pacemaker implantation and open-heart surgery.

KNH is the only public hospital with a Cardiac Catheterization laboratory (Cath-lab) in the country and with cardiovascular disease being the number one killer disease, this only means that the department is attending to very high numbers of patients from across the region.

This is further compounded by the fact that services in KNH are highly subsidized and therefore highly affordable.

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ECG is normally the test carried out to detect heart blocks in a cardiac patient, and upon confirmation of their presence, the patient goes ahead to get a Pacemaker, a small device that helps the heartbeat normally, implanted in their heart vessels.

According to Mr. Eric Otieno, the normal heart rate of a healthy person is between 60-100 beats per minute (BPM). If it goes lower than 60BPM, then you will need a pacemaker, he says.

There are various types of Pacemaker, all of which are available in K N H ,

including the single and dual chamber, which pace two chambers of the heart, and the more advanced ones, Cardiac re-synchronized therapy pacing (CRT-P) and Cardiac re-synchronized therapy defibrillator (CRT-D) which pace three heart chambers.

The Pacemaker is prescribed based on the extent of your heart disease, meaning that more advanced pacemakers are an indication of heart failure.

Pacemaker insertion is a simple procedure performed in the cath-lab under x-ray visualization, where the cardiologist will make a small incision along the collar bone and implant the gadget. The device has two wires, each of which is

Mr. Eric Evans Otieno, the Nursing Officer in charge of the Cardiology Department.

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Dr. Bernard Gitura - Specialist Cardiologist leading the Cardiac Cath-Lab Team in Pacemaker insertion procedure. connected to the atrium and ventricle.

It works in a way that can be described as helping or reminding the heart to beat normally.

The good news is that NHIF covers pacemaker procedure costs to a tune of Sh220,000, which caters for the gadget and cath-lab consumables costs.

This has significantly contributed to the increased number of procedures that the cardiology department undertakes.

Last year alone, more than 70 patients benefitted from pacemaker insertions, and many more are set to benefit going forward.

Additionally, the department does not have a patients’ waiting list for the procedures.

Mr. Otieno has nothing but gratitude to the KNH management for the unrelenting support that the cardiology department continues to receive in terms of availability of resources and human capacity, which enables them to continually transform the lives of cardiac patients.

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An on going procedure at the only public Cathlab in Kenya at Kenyatta National Hospital.

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Nutritional resolutions that work Healthy eating & Dieting for the New Year

By Yvonne Gichuru

It’s natural to start the New Year thinking about all of the goals you want to set. Making resolutions for healthy living such as diet and weight loss are always top of the list.

What we eat and drink can affect our bodies’ ability to fight infections as well as help our immune system deal with health problems later in life including obesity, diabetes, heart diseases, and different types of cancer.

H o w e v e r , research shows that many people make resolutions just because it’s New Year’s Eve, but soon give up because they have no real plan of action for achieving them.

Even if you get quick results, you may not experience the life-changing impact you were hoping for. That can be discouraging, so you revert to old habits and g a i n

back the weight.

According to Alice Ngatia, Assistant Chief Nutrition Officer in the medical ward at Kenyatta National Hospital, it is good to know your status first to determine what you want to achieve; whether it’s a long or short term goal.

“Some of these resolutions, however, tend to fail due to ignorance, lack of knowledge especially types of nutritious food to eat and quick expectations of fast results, which if it doesn’t happen, one lacks the motivation to continue,” said Mrs. Ngatia.

She explains that some of the ways one can incorporate exercise into his/her lifestyle including walking pace, using the stairs instead of the elevator, and going for a morning run before starting your normal day.

Ms. Linnette Leyi, an Editorial Officer at KNH kicked off the year with plans to be fitter and healthier.

“I walk from my house to work and vice versa as opposed to using my car,” she claims. She also eats healthy foods and avoids processed meats and fats.

According to the World Health Organization, the exact ingredients of a healthy diet will depend on different factors like how old and how active we are, as well as the kinds of foods that are available in the communities where we live.

Across cultures, there are some common food tips for helping us lead healthier, longer lives.

Our bodies are incredibly complex, and (except for breast milk for babies) no single food contains all the nutrients we need for them to work at their best.

Our diets must therefore contain a wide variety of fresh and nutritious foods to keep us going strong.

Mrs. Ngatia, however, states that some of the healthy eating tips include eating a lot of fresh fruits & Alice Ngatia, Assistant Chief Nutrition Officer in the medical ward at KNH

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vegetables and whole green cereals, reduce salt, sugar, and fat intake, using cooking methods that don’t require you to add fat such as steaming, boiling, baking as well as engaging in physical exercises and eating in moderation.

Sometimes getting started with a new healthy diet and fitness plan is the easy part and many of us hit occasional roadblocks due to busy schedules or loss of motivation.

Those are the times when we feel like we do everything right, but the scale doesn’t seem to budge.

When this happens, don’t give up! Think back as to why you made the goal in the first place, find the inspiration you need to get back on track and be sure to celebrate your small successes.

“To eat is a necessity but to eat intelligently is an art. Eat less, walk more and you’ll live more,” Mrs. Ngatia concluded.

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The KNH Paediatric Diabetes Clinic – The Customised Care for children with Diabetes

By Dr. Prisca Amolo Nzao, Dr. Paul Laigong, and Purity Munene When one mentions diabetes, what comes to mind is that the patient must be an adult. However, the disease affects people of all age groups.

Until 2008, about a hundred children and adolescents with diabetes mellitus were being seen together with adults at the Kenyatta National Hospital Diabetes Clinic, clinic 17.

This created anxiety in some of the children especially when they witnessed some of the complications like limb amputations.

The first paediatric endocrinologist in the country, Dr. Lucy Mungai, together with fellows in paediatric endocrinology started seeing patients at the clinic. One day in a week was assigned to paediatric patients.

The need for a specialist paediatric clinic was ever so necessary.

The Paediatric Diabetes and Endocrine Unit were established in 2009 to provide independent paediatric specialist and multidisciplinary services to these children and adolescents with diabetes and those with other endocrine conditions.

The unit is hosted at the paediatric clinics number 23. The clinic has since grown with the number of children with diabetes, consisting of infants to young adults, currently at about three hundred.

Also, since 2008, the clinic has been a training center for the Paediatric Endocrinology Training Centre for Africa (PETCA) where paediatric endocrinologists from all over Africa have been trained.

It is also a research center for paediatricians, paediatric endocrinologists, nurses, and other health care workers.

The objective of the Paediatric Diabetes and Endocrine Clinic is to provide the highest quality and affordable diabetes care to our patients and their families and to improve their quality of life by empowering them. It is the center of excellence in diabetes care.

The clinic is run by a multidisciplinary team consisting of four paediatric endocrinologists from Kenyatta National Hospital and the University of Nairobi, two nurse diabetes

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Group diabetes education session at the Kenyatta National Hospital Paediatric Diabetes Clinic.

educators, and a nutritionist.

We provide comprehensive care for children with diabetes including assessment and management of diabetes, diabetes education for patients and their families, as well as personalized nutritional assessment.

Our diabetes educators provide group and one-on-one sessions on various aspects of diabetes selfmanagement including home blood glucose monitoring and intensive insulin therapy.

As part of the Diabetes in Schools Training, we also provide education to the children’s school teachers to ensure continued psycho-social support while at school. Psychology service is provided at the psychology unit.

Some of the challenges experienced are lack of adequate staff specially trained diabetes educators and nutritionists.

We currently do not have counselors/psychologists as part of the core team hence patients who require psychosocial support especially adolescents need to be referred to the psychology unit.

We are also not able to conduct a few endocrine tests currently and therefore must refer patients externally for these tests.

Many of our patients are lowincome earners and cannot afford laboratory tests, the ideal analog insulins, and sometimes even food for their children. Some patients

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miss their clinic appointments due to a lack of bus fare.

To mitigate this, we have ensured that the parents have 24-hour telephone access to our paediatric endocrinologists and diabetes educators to ensure continued optimal diabetes care.

We plan to improve the capacity of the clinic in terms of human resources as well as increase the scope of endocrine tests available to ensure affordable comprehensive service delivery.

In future, we would like to expand these services into our satellite clinics to reach out to more needy children with diabetes who reside outside Nairobi.

Our mission is to optimize paediatric diabetes care for even the most financially constrained families to prevent short and long-term complications.

Co-Authors: Dr. Prisca Amolo Nzao, MBChB, MMed (Paed), FESPE, is a boardcertified Consultant Paediatrician and Endocrinologist based at the Kenyatta National Hospital, Nairobi.

Dr. Paul Laigong is a Lecturer at the University of Nairobi and a Consultant Paediatrician and Endocrinologist at the Kenyatta National Hospital, Nairobi.

Purity Munene is a Certified Diabetes Nurse Educator (USA) based at the Kenyatta National Hospital, Nairobi.

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Breath of life: Administration and Safety of Oxygen at KNH-Othaya

By Julius Ita We walk around consuming it, not thinking much about it.

It’s only after the onset of the Covid-19 pandemic that it became clear how important it is to us and more so how expensive it is.

Last year Kenyatta National Hospital Othaya installed a bulk oxygen tank that has the capacity of 3323 liters of liquid oxygen that has greatly aided the hospital in operationalizing its Intensive Care Unit, New Born Unit, and all its theatres.

This has prompted the Bio-Med team in collaboration with the ICU team to sensitize healthcare workers in the hospital on oxygen administration and safety.

“We need to educate our nurses to know what equipment’s to use when it comes to Oxygen administration,’ says Mr. Victor Omollo, a Biomedical Engineer who facilitated the sensitization meeting.

Oxygen can be administered in three ways at the hospital.

1. Portable Oxygen cylinder 2. Oxygen Concentrator 3. Wall Piped Oxygen “The very Oxygen that saves lives can very quickly be lethal if not handled well,’ adds Mr. Omollo.

During the onset of covid 19 in March last year, consumption of

Victor Omollo Biomedical Engineer displaying the safe way to handle an oxygen cylinder to healthcare givers at KNH-othaya.

oxygen per day topped 28 cylinders, which then pushed up the cost of operation, prompting concerns by the management.

Many people see oxygen as just air, but from a medical point of view, it is just as harmful as any other drug.

“It’s not just about conserving the consumption of oxygen. It’s a serious drug and we must use it cautiously to save the cost of operation and more so improve the lives of our patients,” says Mr. Derrick Mutuma, an ICU Nurse.

The management noted a huge knowledge gap when it comes to the personnel administering oxygen, especially the knowledge of when to use oxygen and how much to use.

ICU, which has the highest consumption, saw it fit to do this sensitization to bring all health workers to be at per on matter oxygen administration. ”If you administer oxygen the wrong way to a patient, it can lead to serious damage to body organs especially the lungs and eyes, and in some cases can lead to death,” says Herman Kairu, HoD CCU Unit KnhOthaya.

This is part of the overall training being held at the hospital this year to improve the skill set among the hospital and level service delivery to our patients.

Victor Omollo Biomedical Engineer doing a presentation to his colleagues at KNH-othaya

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Its Mid-Year Performance Appraisal again...

By Julius Ita It’s that time of year again…the dreaded appraisal.

The word alone sends shivers down the spine of many, make employees in various organizations break out in an irrational pool of sweat, and lastminute mad rush from office to office trying to get their reports straight.

But at Kenyatta National HospitalOthaya, it’s a different story as told by the person spearheading the on-going mid-year appraisal process.

“It used to happen a few years back when the appraisal system was introduced in the public institutions.

But gone are the days when this was the case. Kenyatta National Hospital, in general, has grown and it’s a normal exercise taken with a lot of positivity by staff members,” says Ms. Martha Manyalla, HoD HR & Admin.

Performance appraisal is the evaluation of an individual’s performance holistically, carried out twice a year.

At the beginning of every financial year, every worker is expected to commit to what they will achieve within 12 months through an open discussion between the worker and the supervisor.

Once agreed upon you commit by signing the targets.

To an extent, the appraisal process done the wrong way can indeed frustrate and damage staff relations.

“KNH-Othaya has very young professions, mostly having their first job after college, which could be the only reason why they could encounter challenges with the process being it’s their 1st time,” says Ms. Manyalla.

“As a department, we have adopted early staff involvement into the process, through staff sensitization, guidance, and cascading the Hospitals Performance contract signed by our senior director long before the appraisal process starts,” she adds.

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A KNH-Othaya staff member being appraised by Ms Martha Manyalla HOD HR & Admin Appraisals should not be viewed as war, in reality, performance appraisal is an awesome tool for employee’s development opportunities and driving the business forward.

Having turned one year, Ms. Manyalla has big dreams for KNHOthaya as she goes full throttle her 1st Midy e a r

appraisals at KNH Othaya, “We started as a very green hospital with a hand full of staff, and one year on we are over 500 staff. That’s an upward trend which is very positive towards driving the overall hospitals’ Performance contract.” Ms. Manyalla adds.

With Over 15 years of experience in the profession, Ms. Martha has seen it all. The love and passion for her job are still burning strong.

“I love working with people, giving guidance, correcting people where they go wrong, and generally see people thrive in their respective careers,” she says.

Ms. Martha Manyalla HOD HR &Admin KNH -Othaya

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OUR STORY IN PICTURES

KNH CEO Dr. Evanson Kamuri gets tested for blood pressure during the Women’s Golf Tournament celebration held at Royal Nairobi Golf Club.

Health Care Quality team after an exercise in preparation for the hospital internal quality audit which is due next week.

National Government Constituency Development Fund Board Christian Union representatives presenting their donations to the hospital. The donation was received by Mr. Hezekiel Gikambi - M&C Manager.

Part of the KNH staff who successfuly completed the Senior Management Course from Kenya School of Government show case their graduation certificates.

I - Hopee respresentatives Dr. Tony Ndeda and Nancy Kamau handing over donations to Dr. Amina Guleid and Mr. Hezekiel Gikambi

IBER Africa representatives (right) handing over a donation of assorted hospital equipment to Ag. Director Nursing Services Margaret Githire (left).

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Blazing the trail – Kenyatta National Hospital School of Nursing

By Shiphrah Njeri

Mrs. Jane Njambi Chore Principal KNH School of Nursing

Kenyatta National Hospital School of Nursing was established in 1996.

It was, at the time an in-house training for the hospital’s staff. The aim was to build capacity for specialized nurses in the hospital because it had very few trained specialized ones.

The school started with two courses, Perioperative Nursing, and Critical Care Nursing.

Three years later, the school spread its wings, started training students from hospitals nearby including Nairobi, Agha Khan Hospital, Mbagathi hospital, and other public and district hospitals.

This, in effect, marked the beginning of a new journey to becoming a training icon across the region.

At its helm, sits Mrs. Jane Njambi Chore, the institution’s Principal.

Mrs. Chore trained at KMTC Nairobi and briefly worked at the Coast Provincial General Hospital upon graduation in 1987.

She later transferred to KNH in 1988 and worked in the General Surgery department, before being moved to the Critical Care Unit.

She has undertaken a postgraduate course in Medical Education and a Bachelor’s degree in Nursing. Mrs. Chore also has a Master’s degree in Nursing Education from the University of Nairobi.

She is one of the pioneers of the KNH School of Nursing. In

“

“We have students from East and Central Africa which includes Uganda, Tanzania, Rwanda, Zambia, and Namibia,”

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2010 November become the head of the school up to date.

“We have students from East Africa and central Africa which includes Uganda, Tanzania, Rwanda, Zambia, and Namibia,” says Mrs. Chore.

The school has twenty-eight staff members, both teaching and nonteaching staff as well as a total of a hundred and fourteen (114) students.

“Kenyatta National Hospital School of Nursing has a highly skilled vibrant faculty that offers training to students and being in a tertiary hospital, students are exposed to a variety of cases in their respective clinical areas,” adds Mrs. Chore.

She goes on; “They have access to modern medical equipment and highly skilled clinical nurses who help them develop their skills.”

The school is accredited by the Nursing Council of Kenya and the Technical and Vocational Education and Training Authority (TVETA).

It offers six (6) Higher Diploma courses and certificate courses. Higher Diploma courses include Perioperative Nursing, Critical Care Nursing, Nephrology Nursing, Accident and Emergency Nursing, Neonatal Nursing and Oncology Nursing, which was recently started in October 2020 due to the rising cancer cases in Kenya.

Certificate courses, on the other hand, include Stoma and Wound Care Management, Theatre Sterile Assistance course, which takes 3 months to complete.

However, the Covid-19 pandemic brought challenges that led to the closure of schools but Kenyatta National Hospital School of Nursing was able to navigate the challenges by introducing blended learning, which included training students online.

When schools re-opened, all the measures set by the ministry of health were followed.

Hand washing points were set up, social distancing in classes, examination time reduced to 1 hour, and mode of examination changed from essay writing to multiple choices just to ensure the safety of students.

KNH School of Nursing, says Mrs. Chore, is committed to making specialized nursing accessible to all.

The vision is to continue training more nurses, expand and positively impact healthcare in Kenya and beyond.

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Surgipham Limited boost KNH by donating assorted Pharmaceutical products

By Winfred Gumbo Kenyatta National Hospital has received an assortment of pharmaceutical products from Surgipharm Limited.

The donations were received by the Director, Affiliation and Institutional Development; Dr. Tom Menge, who thanked the organization for their kind and generous gesture.

“On behalf of the KNH management, I would like to thank Surgipharm Limited for their kind and generous donations which will go a long way in helping our patients,” said Dr. Menge.

Judy Kobe, Manager, Medical and Surgical Division at Surgipharm Limited, who represented the Managing Director Mr. V.D. Shah on her part said; “We’ve had a long partnership with KNH for more than 13 years. The products we have

donated will assist in ensuring the safety of healthcare workers during this Covid-19 pandemic era. They

OUR VISION A world class patient-centered specialized care hospital OUR MISSION To optimize patient experience through innovative healthcare; facilitate training and research; and participate in national health policy formulation

will help prevent them from infection which may easily be transmitted through the regular needles.”

“You’ve got to get up every morning with determination if you are going to go to bed with satisfaction” – George Lorimer “Go as far as you can see; when you get there, you’ll be able to see further.”

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OUR MOTTO We Listen, We Care

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“I learned this, at least, by my experiment; that if one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours,” - Henry David Thoreau.

To contribute or report on newsworthy items, please contact the Editorial team; Marketing & Communication Department Editorial Team: Dave Opiyo, Hezekiel Gikambi Stories: Jacqueline Ngure, Winfred Gumbo, Dr. Prisca Amolo Nzao, Dr. Paul Laigong, Purity Munene , Julius Ita & Shiphrah Njeri.

Design By: Collins Cheruiyot Photos: Nicholas Wamalwa , Linnette Leyi and Yvonne Gichuru.

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