MAKUENI COUNTY REFERAL HOSPITAL (MCRH)

Services Offered

The range of services provided at the department has expanded over time, currently these include:

1. Child psychiatry services: This is a service offered to all children from 1-12 years who have neuro-developmental and other childhood psychiatric psychosocial disorders.  The clinic runs every Monday from 8.00am (except on public holidays) at the department premises.
2. Adolescent (Youth) Friendly Psychiatric and psychosocial services – These services are provided at the Youth Centre on the ground floor of the Hospital Tower Block on all working days (Monday to Friday) from 8.00am.  The services are free of charge.
3. Psychosocial and occupational therapy services
   1. Psychotherapy clinic – conducted on Tuesday mornings from 8.00am
   2. HIV counseling and testing (with or without giving a certificate) on every day of the week from Monday to Friday.
   3. Sexual and Gender Based Violence psychological and social services provided from Monday to Friday.
   4. Individual and family therapy – provided from Monday to Friday
   5. Group therapy session – These are held on a schedule
   6. Social services – provided by a medical social worker within the department from Monday to Friday
   7. Rehabilitative occupational therapy – provided on Mondays and Wednesdays during the clinic days.
4. General Psychiatry services: Offered on Wednesdays from 8.00am within the department’s premises.
5. Clinical psychology and counseling psychology student on attachments
6. Liaison psychiatry and psychological services: Our clinicians are consulted to provide psychiatric and psychological services in other parts of the Hospital.

Main Events

World Mental Health Day – Commemorated on 10^th October of every year

Days of Activism against Gender Based Violence – marked from 25 November to 10 December.

RATIONALE

To support the Medical Superintendent in achieving world class patient centered specialized healthcare by enhancing high standards of practice in specialized patient centered nursing services.

SERVICES OFFERED

The division of nursing ensures high standards of nursing practice in the following activities:

1. Nursing administration and management of nursing services
2. Coordination and supervision of medical nursing services, surgical nursing services, specialized nursing services and nursing school.
3. Recruitment and deployment and preceptor ship of new nurses
4. Build nursing staff capacity and skill development
5. Coordinate and collaborate healthcare services
6. Advocate for timely clinical interventions and safe care
7. Assets management within units/wards/clinics /theaters..
8. Develop and control the nursing budget
9. Participate in hospital budget projections and cost management
10. Facilitate and coordinate nursing research and innovation
11. Train nursing students and other allied professionals in the clinical areas
12. Determine and maintain high standards nursing practice
13. Maintain discipline, professionalism and nursing ethics
14. Guide top management on nursing matters
15. Participate in National policy development and other activities
16. Offer counseling services to patients and family
17. Endo-tracheal and oral pharyngeal suction services
18. Artificial feeding services
19. Skilled wound management
20. Activities of daily living for the incapacitated patients
21. Monitor patients response to treatment and disease
22. Prevent/ identify clinical complications & intervene accordingly
23. Identify & report medical errors for follow up and action
24. Administer therapeutic medicine
25. Provide pre, Intra and post-operative care to all surgical patients.
26. Recruit and train post graduate student nurses on specialized courses i.e.
    1. Emergency nursing
    2. Critical care nursing
    3. Nephrology nursing
    4. Neonatal nursing services
    5. Peri-operative nursing

MAIN EVENTS

1. NNAK events
   1. International nurses week
   2. Community service responsibility (visit destitute homes)
2. Participate in hospital free medical camps and outreach services.
3. Participate in nursing conferences e.g. NNAK, Individual nursing chapters (8)
4. Nursing symposium annually.

NURSING LEADERSHIP

Nursing division is divided into 3 arms for effective management. Each arm is further divided into departments for ease in supervision and nursing service coordination.

Out of the 17 hospital departments, nursing is structured into 10 departments by combining some, which are small. Chaplaincy is also structured under nursing leadership.

Surgical nursing division has 6 departments and 30 units while medical nursing division has 4 departments and 35 units. Nursing establishment is upto 1800 in number.

As a department we envisage the provision of patient centered specialized nutrition services in disease prevention and care.

Vision

To be a world class provider of patient-centered specialized nutrition services.

Mission

To optimize patient experience through innovative preventive and curative nutrition services; facilitate training and research, and participate in national nutrition health policy.

Nutrition mandate:

1. Providing nutrition support to both in and out patients referred for specialized care.
2. Facilitating in nutrition training and research
3. Participating in national nutrition health planning and policy

Services offered

1. Inpatient

Nutrition assessment & diagnosis; nutrition counseling & education; planning of therapeutic diets (both Enteral & Parenteral) in respect to the presenting medical or surgical condition.

2. Outpatients
   1. Dietary Advisory Clinic– It is an adult nutrition clinic that offers nutrition services to patients with Diabetes, Renal, Hypertension, cancer, asthma, TB, HIV as well as those who require weight management regimen.
   2. Maternal and Child Health Nutrition Clinic – Growth monitoring, vitamin A supplementation/ Ready to Use Therapeutic Feeds(RUTF), nutrition counseling and education

To book appointments please contact the nutrition department using the contacts below.

Main Events

1. Maternal Infant and Young Child Nutrition (MIYCN) Training
2. World breastfeeding week
3. Community Outreaches
4. Team Building
5. TOTs training in Nutrition Management of diseases

Quality objectives

1. To reduce maternal mortality in the hospital from 640/100,000 to 620,000 live births by 30^thJune, 2022.
2. To reduce turnaround time in caesarean section from 4.1 to 3.5 hours by 30^thJune, 2022.
3. To reduce turnaround time in Manual Vacuum Aspiration from 1.1 hours to 1.0 hours by 30^thJune, 2022.
4. To reduce ANC patients turnaround time from 2.5hrs to 2.0hrs by 30^thJune, 2022.
5. To increase proportion of patients scheduled for elective gynecological operations from 87% to 90% by 30^thJune, 2022.
6. To reduce turnaround time for treatment of cervical dysplasia from 10 to 8 days by 30^thJune, 2022.
7. To improve customer satisfaction index from 73% to 76 % by 30^thJune, 2022.
8. To reduce Mother to Child Transmission (MTCT) rate of HIV from 1.2% to 0.8% by 30^thJune, 2022.

Services offered

1. Antenatal clinic, maternity postnatal
2. Caesarean delivery
3. MVA
4. 1D
5. Fertility clinic
6. Emergency gynae
7. Gynae clinic elective surgery 1B
8. Cervical cancer screening and treatment dysplasia
9. Clinic 18
10. Family planning
11. Gender based violence
12. VVF clinic

Main events

1. Outreaches
2. Screening of breast and cervical cancer
3. Laparoscopy camp
4. Breast and cervical cancer screening camp
5. VVF camp

Radiographs, scans and images are important pieces of information that helps doctors diagnose medical problems ranging from a broken finger to cancerous growths. Senior Consultant Radiologists use advanced technology to take images of what is going on inside your body and share this information with your other doctors to complete the picture of your medical condition.

MCRH provides all types of imaging one might need to help diagnose their condition. We assign Senior Consultant Radiologists to read the images; they are experienced in the specific part of the body being scanned.

MCRH is focused on two things, when it comes to Radiology and Imaging-getting the best images possible to allow your team of doctors to help you, and ensure your comfort and confidence during your tests. The procedures provided can be paid either by cash or NHIF.

Sections and Services offered include:

1. General X-ray

The under listed examinations are performed by highly qualified Radiology staff and reported by Consultant Radiologists. The images can be provided in hard copy or on Compact discs (CD). These examinations include;

1. Chest
2. Spine
3. Abdomen
4. Billiary System
5. Urinary System
6. Angiography
7. GI System
8. Hand
9. Wrist
10. Shoulders
11. Humerus
12. Clavical
13. Foot
14. Ankle
15. Leg
16. Knee
17. Femur
18. Hip
19. Pelvic
20. Scapula
21. Skull

Special X-Ray (screening procedures)

These are special exams performed by fluoroscopic procedures. They are done by a Radiologist assisted by Radiographers. These are done by utilization of digital x-ray machines which provide high quality images that use sensitive detector and utilizes little dose to show the image through an instant image view on a computer screen and later printed for reporting by a Consultant Radiologist. They include;

1. Barium meal
2. Barium swallow
3. Barium meal and follow through
4. MCU (Micturating cysto-urethrogram)
5. IVU (Intravenous urogram) 
6. Pyelogram
7. Sialogram
8. Sonogram
9. Fistulogram
10. colostogram

CT (Computerized Tomography)

The unit has state-of-the-art machines that are 32, 64, and 128 slice machines that have a workstation where reports are done by a Consultant Radiologist. The machines are able to detect early diagnosis of the clients sent to the Department. The services provided can be paid either by cash or NHIF. The examinations done include;

1. Head /Brain
2. Neck
3. Abdomen
4. Chest
5. Spine
6. Neck
7. Extremities
8. Pelvic
9. Angiography
10. PNS (Postnasal Space)
11. Pelvimetry
12. CT IVU (Intravenous urogram) 
13. CT guided Biopsies
14. CT guided Aspirations and Drainages

Ultra Sound

It is a unit that operates 24hours. The staff in this unit provide instant reports. The examinations done are:- 

1. Renal
2. Abdominal
3. Pelvic
4. Obstetric
5. Amniocentesis
6. Doppler- Regional
7. Bilateral Doppler
8. Endo-rectal/ End-original
9. Thyroid/Testicular
10. Prostate
11. Cranial
12. Breast
13. Abdominal/Pelvic.

Mammography

It is state-of-the-art digital machine that provides high quality images that are 2D, 3D and Tomosynthesis. 

The world is currently dealing with one of its worst pandemic in history. Towards the end of 2019, Wuhan, a city in the Hubei Province of People’s Republic of China reported a cluster of pneumonia cases. It rapidly spread, resulting in an outbreak and epidemic throughout China, followed by worldwide pandemic. The cause was later identified to be a corona virus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). WHO designated the disease as Coronavirus disease 2019 (COVID-19)

 The first covid-19 case in Makueni County was reported on 31^st June 2020 and as of 21^st September 2021, 2141 Cases had been confirmed, of these cases 269 have been admitted and managed at the Makueni county referral hospital CTU. Before reporting of the index case in our county, a COVID 19 isolation and treatment unit (CTU) had already been established as directed by the Ministry of Health Kenya. This isolation unit has a bed capacity of 12 patients all with access to Oxygen supply. The unit has three well demarcated zone: Red zone where patients are managed from, yellow zone; where donning and doffing is done and a Green zone; which include staff lounge, nursing station, doctors room and is where the PHEOC is located.

Public Health Emergency Operations Center(PHEOC) was established early this year with support from Global Implementation Solutions (GIS) and the Kenya National PHEOC. Its core functions include coordinate incident information, plan for emergency response, mobilization of resources and prevent future public health emergencies.