CERTIFICATE IN HEALTH RECORDS AND INFORMATION TECHNOLOGY CLASS OF

SEPTEMBER 2021

ATTACHMNENT REPORT DONE AT UASIN GISHU COUNTY HOSPITAL

FROM 9TH MARCH -9TH APRIL2023

REPORT COMPILED BY SYDNEY CHEROP

CHRIT/S-0107/IC/21

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 TABLE OF CONTENTS
i. INTRODUCTION
ii. HOSPITAL HISTORICAL BACKROUND
iii. VISION
iv. MISION
v. DECLARATION
vi. DEDICATION
vii. ACKNOWLEGEMENT
viii. ABBREVIATION
ix. DISEASE BURDEN
x. TOP 10 CAUSES OF INPATIENT MORBIDITY
xi. TOP 10 CAUSES OF MORTALITY UNDER 5
xii. TOP 10 CAUSES OF MORTALITY OVER 5
xiii. HOSPITAL LOCATION
xiv. CLIMATE
xv. SOCIAL ECONOMIC STATUS
xvi. COLLECTING AND REPORTING TOOLS
xvii. RIGHTS OF THE CLIENTS
xviii. HEALTH RECORDS DEPARTMENT
xix. DHIS 2
xx. CHALLENGES FACING HEALTH RECORDS DEPARTMENT
xxi. RECOMMENDATION
xxii. CONCLUSION

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 INTRODUCTION
This is a field attachment carried out at Uasingishu county Hospital from 9th MARCH TO 9th
APRIL 2023

`HOSPITAL HISTORICAL BACKGROUND

The hospital started as a dispensary in 1924.It was then elevated to a health Centre in
1935.Its then became a sub-district hospital in 1941.It had a one 30 bed ward and the first
health officer was posted to the institution. It became a district hospital in 1960.By 1984 the
hospital had a bed capacity of 166.In the same year, a major expansion program me was
started by the government to upgrade the hospital from a district level to a provincial general
hospital. In 1985 the government increased the hospital with Nyayo wards with bed capacity
of 144. In 1987, new kitchen and laundry were completed. An eye-unit comprising an
outpatient, theatre and a 22 bed was completed in 1991.Plan contributed about 50% of the
total cost of the project.

In 1993, a psychiatric unit with 20 beds was completed. In the same year 1993 a 84 cots
children’s ward was completed and equipped fully in partnership with plan international
Uasingishu. At the end of 1995, a maternity unit of 148 beds and 40 cots with an operation
theatre was completed and it was occupied on 22nd FEB 1996.This project was funded by
plan international Uasingishu at an approximate cost of KSH 54 million. Also equipped the
unit fully. Current bed state 525,cots 82,ICU beds 6,HDU 3.

VISION

To be the best provincial hospital records department in Kenya in terms of client’s

satisfaction, complete and timely reports.

MISION

To provide curative, rehabilitative health care through proper documentation and safe
custody of hospital statistics and patient information for continued treatment, planning and
research.

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 DECLARATION.

I solemnly declare that the information in this report is true to my knowledge and belief

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DEDICATION

I dedicate this report to my lecturer MR. STEVE MWANGI for the good guidelines he gave me on how
to tackle the field attachment

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ACKNOWLEDGEMENT
First and foremost, I would like to thank my parents for financial support they provided for me. I greatly
thank the HRIO head of department Miss MISS LILIAN for securing her time and guiding me on the
working areas. I would like to thank the entire hospital workers for accepting and guiding me.

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ABBREVIATIONS
SVD-Spontaneous Vertex Delivery
MCH-Maternal Child Health
CCC- Comprehensive Care Clinic
VL- Viral Load
DVT-Deep Vein Thrombosis
PROM-Premature Rapture of Membrane
CS-Cesarean Section
CCF-Congestive Cardiac Failure
PTB-Pulmonary Tuberculosis
DCM-Dilated Cardiomyopathy
DM-Diabetes Mellitus
RVD-Retroviral Diseases
OPP-Organophosphate Poisoning
CAP-Community Acquired Pneumonia
NNJ-Neonatal Jaundice
RDS-Respiratory Disease Syndrome
CRF-Chronic Renal Failure
NNS-Neonatal Sepsis
PUD-Peptic Ulcer disease
CPA-Cardio Pulmonary Arrest
RTA-Road Traffic Accident
DISEASE BURDEN
1. PNEUMONIA
2. HYPERTENSION
3. MENINGITIS
4. ANAEMIA
5. DIABETES
6. RETROVIRAL DISEASE
7. ROAD TRAFFIC ACCIDENT

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TOP 10 CAUSES OF INPATIENT MORBIDITY
1. Pneumonia
2. Retroviral Disease
3. Anemia
4. Hypertension
5. Head injury
6. Cancer
7. CCF
8. Hernia
9. PTB
10. Diabetes

11.

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TOP 10 CAUSES OF MORTALITY UNDER 5
1. Prematurity
2. Pneumonia
3. Birth Asphyxia
4. Neonatal Sepsis
5. Low Birth Weight
6. Severe Dehydration
7. Anemia
8. RDS
9. Malaria
10. Neonatal Tetanus

TOP 10 CAUSES OF MORTALITY OVER 5

1. Pneumonia
2. Hypertension
3. RVD
4. Diabetes
5. RTA
6. Anemia
7. Meningitis
8. CCF
9. Severe Dehydration
10. PTB

HOSPITAL LOCATION
The hospital is located in Uasingishu county, Eldoret.
CLIMATIC CONDITION
The rainfall pattern in Uasingishu district is bimodal with 2 rainy seasons. Rainfall plays a
leading influence on the use of land with the long rainy season occurring between March and
June while the short rains are expected from October through December. Unreliability both in
amount and expected time of arrival have however made reliance on agriculture unsafe not only
in terms of land use based on the right type of crop for expected rainfall total, but also in that,
poor harvest and low yields are common features of farming.
SOCIO ECONOMIC STATUS
Majority of the people are in rural areas. This makes up 86% while the rest 14% of the
population live in two urban centers namely Uasingishu and Eldoret town. The vast majority of
the economically active population are farmers who are engaged in cash crops and subsistence

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farming. Civil servants also concentrate in two urban centers. The district is fairly served with
road transport network that is cut across by a national trunk road network which opens to the rest
of the country. Road network is quite intensive as it penetrates all economic productive areas
though impassable during rainy season because most of the roads are gravel and have
degenerated into earth road with time. Despite all these there are however no dramatic
fluctuation in the availability of food.

COLLECTING AND REPORTING TOOLS

MOH 301- Inpatient Admission Register
MOH 333- Maternity Register
MOH 361A- Pre-Art Register
MOH 328- Daily Bed Return
MOH 701A- Outpatient Tally Sheet-Under 5 years
MOH 268- Diagnostic Index Card
MOH 366- Daily Activity Register for CCC
MOH 718- Inpatient Morbidity and Mortality Summary Sheet
MOH 257- Comprehensive Care Clinic Patient Card
MOH 258- CCC Appointment Card

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RIGHTS OF THE CLIENTS
1. To express their opinions
2. To have satisfactory services
3. To be listened to
4. To be answered correctly and appropriately
5. To be received positively
6. Right to be directed
7. Right to have proper treatment

HEALTH RECORDS DEPARTMENTS

 Central Records
 Comprehensive Care Clinic
 Casualty
 Maternity unit
 Psychiatric
 Outpatient Department
 Laboratory
 Dental department
 Eye department
 X-ray department
 Skin department
FUNCTIONS OF THE DEPARTMENTS
1. CENTRAL RECORDS
It’s where files of the patients are kept for future reference apart from files from CCC and
MCH.

FUNCTIONS
 Assist in confidentiality of the patients’ files
 Coding and Indexing
 Admission of the patients
 Issuing of the death permit
 Booking of the clinic
 Receiving of the patients for clinic
 Calculation of the statistics
 Indexing of the birth notifications
 Weeding of files

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TOOLS USED IN CENTRAL RECORDS
 Electronic Medical Records (EMR)
 Patients’ files
 ICD Books (volume 1, volume 2 and volume 3)
 Registers
 Birth Notifications
 Death

2. COMPREHENSIVE CARE CLINIC (CCC)

This is a department that provides HIV care services to infected and affected clients.
FUNCTIONS
o Management of patient’s reports.
o Management of data.
o Clinic preparation.
o Maintain confidentiality of the patient information.
o Maintain security of health records and information equipment.
o Schedule files.
o Tracing of files.
o Filing.
o Preparing appointments lists.
o Registration of clients.
o Compile monthly reports.
TOOLS
MOH 361A-Pre Art Register
MOH 361B-Art Register
MOH 366-Daily Activity Register
MOH 257-Bluecards
MOH 258-Appointments
MOH 711-National Integrated Forms for Reproductive Health, HIV/AIDS, Malaria, TB,
Child Nutrition.
MOH 731-Comprehensive HIV/AIDS Facility Reporting Form.
3 .MATERNITY
It deals with pregnant women, complications and delivery.
FUNCTIONS
 Admission.
 Management of records.
 Management of data.
 Compiling of inpatient morbidity and mortality reports.

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  Sorting of files
 Collection of files from wards.

TOOLS
MOH 333-Maternity Register.
MOH 301-Inpatient Register
MOH 718-Inpatient Morbidity and mortality summary sheet
MOH 268-Diagnostic Index Card
MOH 328-Daily Bed Return
Files
Computer

4. CONSULTANT CLINIC
It provides health care services to clients.

FUNCTIONS
 Clinic preparation.
 Sorting files.
 Issuing appointment dates.
 Prepare appointment lists.
 Tracing files.
 Register clients.
TOOLS USED

 Computer
 Files

5. PSYCHIATRIC
It deals with clients who have mental illness.
FUNCTIONS
 Clinic preparation
 Filing.
 Manage data.
 Maintain security of health records and information equipment.

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TOOLS USED
MOH 614-Involuntary Type of Admission
MOH 613-Voluntary Type of Admission
MOH 268-Diagnostic Index Card
MOH 637-Voluntary Admission Register Under the Apparent Age of 16 years.
ICD books (volume 1, volume 2 and volume 3).
MOH 718- Inpatient Morbidity and Mortality Summary Sheet.

6. DATA CENTRE
This is a section where hospital report are saved, compiled and disseminated to the next
level by uploading into KHIS. Thereafter, hard copies are submitted to the sub county
health information office.
FUNCTIONS
 Management of data.
 Maintain security of health records and information equipment’s.
 Maintain confidentiality.
 Collection of daily bed return.
 Upload data into KHIS.
 Collect patient’s data in all departments.

TOOLS USED
MOH 328-Daily Surveillance Form
MOH 713-Monthly Nutrition Summary Sheet
MOH 504-Monthly Surveillance Form
MOH 505-Weekly Epidemic Monitoring Form
MOH 718-Inpatient Morbidity and Mortality Summary Sheet
MOH 706-Laboratory Summary Sheet
Computer.

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 7. OUT-PATIENT DEPARTMENT
Deal with clients who require daily care services

FUNCTIONS
 Reception
 Registration
 Issuing receipts

TOOLS USED
Computer

MOH 201-Outpatient Cards

DHIS 2
District health information system 2, Data is collected from the facility, then organized, analysed
presented, interpreted and Data is then sent to the next level

WHAT I LIKE
 The management of the facility.
 Supervision of the staffs by the in-charge.
 Friendly and supportive staffs

CHALLENGES FACING HEALTH RECORDS DEPARTMENTS

 Shortage of staffs in all cadres, nurses.
 Inadequate equipment; inpatient files.
 Inadequate laboratory services.
 Congested outpatient departments.
 Congested health records offices.
 Insufficient funding

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RECOMMENDATIONS
 Construction of more outpatient department
 Increasing the number of staffs
 Ensuring there is enough equipment.
 Expanding the health record offices.

CONCLUSION
I hereby conclude that, during my practical i acquired the recommended skills, knowledge and
attitudes towards the course i am pursuing.
THANKYOU

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