Transformational Nursing & Midwifery Leadership Success Story Presenter: Christine Sammy, OGW Newborn & Child Health Coordinator Kitui County, Kenya 13th June, 2019 QUALITY INDICA11TORS AND PATIENT S111AT ISIFICATION THE Kamarutake Genereal Hospital

Objectives To inspire nurses to make a commitment to work hard with determination in order to save lives To encourage nurses working in Countries with limited resources to try and overcome challenges by using simple, basic and effective measures to save lives To encourage nurses Globally to be innovative, creative and have positive thinking towards challenges Background

Map of Kenya Kitui County hospital

County Profile Kitui County is one of the 47 Counties situated in Eastern Kenya. It covers 30,496.5 sq. km with a catchment population of 1,131,289 Male – 47.2%, Female – 52.8%, Children under 5 yrs – 16% and WRA – 23% It is sub – divided into 8 Sub-Counties with a total of 287 functional health facilities (public, private and FBOs) Background

Transforming a Nursery Room into an Independent Newborn Unit In early 2010, it was noted that there were many neonatal deaths and the County had no newborn unit; instead, there was a nursery room at the County referral hospital with no staff of its own There was an admission book which captured very scarce information reflecting that mortality rate was always above 50%. Project Description

Transforming a nursery room Cont… Benchmarking was done at Kenyatta National Hospital and Pumwani maternity hospital respectively, then Kitui NBU was innovatively initiated using locally available resources. Over a span of just one year, the NMR in Kitui district hospital’s NBU reduced from above 50% to below 10% Partners and Financing (Names, functions)

Kitui District Hospital NBU Data

Contributing Leadership Factors to Successful transformation Commitment to excellence starts with the leader, so as a leader one must be committed to her passion and focus and have the type of commitment that turns into perseverance. Challenges should not be an obstacle to achieve your set goals. Being influential, the leader was able to convince the hospital administration to expand the unit from one room to three rooms. More staff were also allocated to the unit.   Sustainability

Contributing Leadership Factors Cont… It was through effective leadership skills of creating stability and driving change that we were able to build and maintain Kitui NBU. The team leader empowered the staff who became an effective and strong team driving them to continuous improvement The commitment to continuous change adjustment and improvement from the leader and the staff led to the success of the unit. Partners and Financing (Names, functions)

Basic & Effective Interventions Applied Infection Prevention & Control Mentorship on newborn resuscitation and monitoring labour using a partograph Critical care of the newborn especially premature babies Monthly neonatal/infant mortality meetings Team work and support from hospital administration and partners Documentation Sustainability

Ward Round – Initially babies were on the floor; to reach them one had to squat/kneel down!

Major ward round – By 2011,babies raised from the floor (IPC Observed)

IPC – Before 2010 there was no IPC area. Late 2010, IPC area in place

IPC & Learning for student nurses allocated in NBU was poor initially Early 2010 Late 2010

Phototherapy Treatment – Kitui hospital 2010 (normal white light) 2011 (UV light)

Fixing Intravenous Line /Resuscitation Area! 2010 2011

Christine updating staff on newborn resuscitation at Kitui County Hospital

Kangaroo Mother Care at Kitui NBU after transforming the Unit Kangaroo Mother Care at Kitui NBU after transforming the Unit. Mothers in NBU attire

Achievements as a Nurse Midwife Leader 2010 District Nurse of the Year 2010 Provincial Nurse of the Year 2013 International Neonatal Nursing Excellence Award Winner 2013 Presidential Award Winner (National Honours Award – OGW 2013 Staff of the Year – Kitui County hospital 2011, 2012 & 2013 NBU was the leading department in the hospital in outstanding service delivery, innovation and organization under my stewardship Sustainability

Christine Sammy – 2013 International Neonatal Nursing Excellence Award Winner Project Description

Documentary on Strength of a Woman – Nursing and Midwifery Leadership Video: Christine maweu sammy strength of a woman Background