Three destinations, four hospitals, six courses run for over 150 delegates is a numerical summary of the GRASPIT teams work during the 10 days they were in Kenya, but doesn’t really convey the amazing success of this trip.
During previous KOP missions it became apparent that Kenyan hospitals face the same challenges as the UK around the management of ward patients who are at risk of deterioration. Early detection of changes in the patient’s vital signs (pulse, blood pressure, temperature and oxygen levels) provides an opportunity to intervene with simple readily available treatments, such as oxygen and intravenous fluids, which will often stabilise the patients’ condition. In Torbay hospital these principals are encapsulated in a one day Stabilisation of the Sick course delivered to nurses and doctors, both junior and senior. Following a pilot in Mombasa in November 2011 Hazel Robinson (Critical Care Sister and Outreach Lead) and Matt Halkes (Consultant in Anaesthesia and Critical Care) developed GRASPIT (Global Recognition and Assessment of the Sick Patient and Initial Treatment) – a one day course specifically adapted for the Kenyan healthcare environment. Joined by Jim Webster (Charge Nurse Critical Care) and Mike Swart (Consultant in Anaesthesia and Critical Care) the fours strong team delivered the first courses at two hospitals in Mombasa before travelling to the National Nurses Association at Kenyatta Hospital in Nairobi. Two further courses were delivered here, before the team were reunited with their colleagues in Nanyuki for the final two days.
Although confident that our previous experience in Kenya has stood us in good stead when preparing the course content there was naturally some trepidation around how it might be received. We were particularly anxious that we did not attempt to teach concepts that were divorced from the reality of delivering healthcare in the developing world. These anxieties were rapidly allayed with the delegates readily engaging with the teaching and providing very positive feedback. The Kenyan staff particularly enjoyed the role playing scenario based teaching, despite this being a relatively new way of learning for many of them. The transferability of the course hinges on the fact that it utilises core basic knowledge, but promotes the application of this knowledge in a systematic way. As in the UK it was this structured approach that the delegates felt would improve their management of sick patients.
Where next for GRASPIT? In Nairobi the training was attended by members of the Kenyan Resuscitation Council who are keen to accredit the course meaning that it will be recognised as official training for healthcare workers in Kenya. Working with the Council and the hospitals we visited the aim is to develop a Kenyan faculty who will disseminate the course more widely.
Examples of feedback from delegates:
“It was one of the best teaching sessions have ever attended”
“Please ensure you equip more and more medical people with this knowledge and challenges God bless you all You are a wonderful team”
Our thanks to James Maina (Coast Province General Hospital), Donald Chiwai (Mombasa Hospital), Jason Kiruja (Kenyatta Hospital Nairobi) and Ellie Gregory (Nanyuki Hospital) for all their help arranging venues and recruiting delegates. Without their help we would not have achieved half as much. Also thanks to Peggie Christie (Modern Matron ICU) for her support and juggling off duties to enable Hazel and Jim to join the team.