THE ELDORET NATIONAL POLYTCHNIC

INDUTRIAL ATTACHMENT REPORT HELD AT THE NYANG’ANDE SUB

COUNTY HOSPITAL

NAME OF PRESENTER: THERESA AKELO OTIENO

ADMISSION NUMBER: 2021/07732

COURSE: CERTIFICATE IN SOCIAL WORK AND COMMUNITY

DEVELOPMENT

PRESENTED TO: INDUSTRIAL ATTACHMENT COORDINATOR

PURPOSE: IN PARTIAL FULFILMENT FOR THE REQUIREMENT OF THE

AWARD OF CERTIFICATE IN HEALTH RECORDS AND INFORMATION
TECHNOLOGY

SUPERVISOR: MADAM BEATRICE

ATTACHMENT PERIOD: 5TH APRIL - 31ST JULY 2022

DATE OF PRESENTATION: SEPTEMBER, 2022

 DECLARATION

I Theresa Akello Otieno declare that this field and industrial attachment report is my own
work and has not been submitted before for any academic award for either any academic
award for either any academic award either in this or other learning institutions for academic
or any other purpose. The references used in this report are stated in the reference section.

NAME: THERESA AKELLO OTIENO

Signature: Date:
 ACKNOWLEDGEMENT

I take our special thanks to the Almighty God for giving me life and good health throughout
my attachment.

I also thank the entire TENP Administration who played a great role for releasing us to the
field which has contributed to the success of this report.

It’s my gratitude to thank the in charge, Madam Beatrice for allowing me to carry my
practical attachment at Nyang’ande Sub county Hospital under their Supervision. It is also
my privilege to thank the staff at large who made my attachment successful.

It is also our pleasure to give thanks to my dear family for giving me financial and material
support for sustainability. I also thank my colleagues from other institutions who tirelessly
supported me during the attachment.

May God bless you all!

i
 TABLE OF CONTENTS

DECLARATION........................................................................................................................i

ACKNOWLEDGEMENT:........................................................................................................ii

CHAPTER ONE: INTRODUCTION...................................................................................1

1.1 Historical background..........................................................................................................1

1.2 ORGANIZATIONAL STRUCTURE..................................................................................2

1.3 MISSION, VISION AND COREVALUES.........................................................................2

1.3.1 Vision.........................................................................................................................2

1.3.2 Mission.......................................................................................................................3

1.3.3 Values........................................................................................................................3

1.4 OBJECTIVES OF THE ATTACHMENT.......................................................................3

CHAPTER TWO: WORK EXPERIENCE...........................................................................4

2.1 Introduction..........................................................................................................................4

2.2 Outpatient Department.........................................................................................................4

2.2.1 Functions of health records and information department at OPD.............................4

2.2.2 Activities of HRIO at OPD........................................................................................4

2.2.3 Tools..........................................................................................................................4

2.3 Comprehensive Care Centre................................................................................................5

2.3.1 Functions of health records and information department at CCC.............................5

2.3.2 Activities of HRIO at CCC........................................................................................5

2.3.3 Tools used..................................................................................................................6

2.4 Central Records....................................................................................................................6

2.4.1 Function of health records and information department at Central records..............6

2.4.2 Activities of HRIO at Central Records......................................................................6

2.4.3 Tools used..................................................................................................................7

2.5 Maternity Unit......................................................................................................................7

2.5.1 Functions of health records and information department in maternity unit..............7

ii
 2.5.2 Activities of HRIO in maternity unit.........................................................................7

2.5.3 Tools used..................................................................................................................8

2.7 Maternal child health and family planning unit...................................................................8

2.7.1 Functions of Health records and information department in MCH...........................8

2.7.2 Activities of HRIO in MCH.......................................................................................8

2.7.3 Tools used in MCH....................................................................................................9

2.9 Health information system office.........................................................................................9

2.9.1 Functions of health records and information department at HIS office....................9

2.9.2 Activities of HRIO at HIS office...............................................................................9

2.9.3 Tools used................................................................................................................10

2.10 Injection room..................................................................................................................10

2.10.1 Functions of Health records and information department at injection room.........10

2.10.2 Activities of HRIO at injection room....................................................................10

2.10.3 Tools used in injection room.................................................................................11

CHAPTER THREE: CHALLLENGES, ACHIEVEMENTS, RECOMMENDATIONS

AND CONCLUSION...........................................................................................................12

3.1 Challenges..........................................................................................................................12

3.2 Achievements.....................................................................................................................12

3.3 Recommendations..............................................................................................................12

3.4 Conclusions........................................................................................................................13

iii
 CHAPTER ONE: INTRODUCTION

1.1 Historical background

Nyang’ande Sub county Hospital was started in 2007 as a level 3 facility. In 1988, it was run
by the municipal council up to 2013 where it became under Nyang’ande Sub County and it
became effectively managed by the sub county in 2014.

Other units were; Maternity started 2017, the outpatient department that houses MCH/FPs
Laboratory, pharmacy, Comprehensive Care Clinic started in 2009 and clinics were
constructed by MOH in the spirit integrating outpatient department services.

1
1.2 ORGANIZATIONAL STRUCTURE

Hospital manager

Health Records and

Information officer in
charge

Triage
section Injection room Family Maternal Child
and pharmacy planning Health
Department

Health Maternity Comprehensi Outpatient

Information Department ve Care Department
System Centre

1.3 MISSION, VISION AND COREVALUES

1.3.1 Vision

To be a district center of excellence in holistic health care development, medical research and
education.

2
1.3.2 Mission

The mission of Nyang’ande Sub county Hospital is to provide quality, affordable, specialized
and sustainable promotive, preventive, curative and rehabilitative health care services.

1.3.3 Values

These are believes that governs the behavior of a member in committee and staff in meeting
the hospital strategic directions and in dealing with implementation in this strategic plan.

It includes;

 Team work
 Sensitivity to national diversity
 Integrity
 Accountability
 Commitment
1.4 OBJECTIVES OF THE ATTACHMENT

The attachment is aimed at bridging the gap between theory and practice this includes;

 To produce practically oriented graduates that meet the required job related
competencies of my future employer.
 To enable me as a student get hands-on/real life experiences that am expected to work
in when I graduate.
 To provide an opportunity for students to apply the principles and techniques
theoretically learnt into real life problem solving situations.
 To provide an opportunity for students and academic staff to interact with the
stakeholders and potential employers and appreciate field situations that will also
generate information for curricula review and opportunities.
 To enhance and strengthen linkages between Eldoret National Polytechnic and
various stakeholders

3
 CHAPTER TWO: WORK EXPERIENCE

2.1 Introduction

The Hospital has 10 sections that work together in achieving the hospital objectives. They are
listed as follows:

2.2 Outpatient Department

This is the department where clients or patients are provided day health care services.

2.2.1 Functions of health records and information department at OPD

 Registration
 Reception
 Maintaining Security of health records equipment and information
 Confidentiality of patient health information.
 Data management

2.2.2 Activities of HRIO at OPD

 Registering of patients into the EMR system

 Receiving of patients and clients
 Issuing of appointment cards to various departments
 Updating clients who revisit for services into the EMR
 Directing patients or clients to various areas of service

2.2.3 Tools

 Outpatient card MOH 201

 Computer

4
2.3 Comprehensive Care Centre

It is a department that deals with health care services for HIV infected clients.

2.3.1 Functions of health records and information department at CCC

 Clinic preparation
 Appointment management
 Records management
 Maintaining confidentiality of patient’s health information
 Registration
 Data management
 Maintaining security of health records equipment and information

2.3.2 Activities of HRIO at CCC

 Booking and giving appointment to clients for next visit

 Retrieval of client’s files
 Filling back of the retrieved file using alphabetical for T.I, adolescent and pediatrics
 Compiling monthly report
 Updating the DAR register
 Updating of Pre ART and ART register
 Preparation of appointment list
 Recording of viral loads and CD4 results
 Sorting of clients files
 Editing of clients file
 Checking of misfiling
 Directing clients to various service points
 Receiving clients
 Tracing of clients files and other medical documents
 Weeding of inactive/dormant files

5
2.3.3 Tools used

 Computer
 Green Card MOH 257
 Appointment card MOH 258
 Treatment Preparation Register-MOH 361A
 ART Cohort Register –MOH 361B
 PEP register
 Daily activity register for CCC MOH 366
 Calendars
 Diary

2.4 Central Records

It is the main library or filing section for medical records in the hospital.

2.4.1 Function of health records and information department at Central records

 Records management
 Data management
 Maintenance of confidentiality of patient’s information
 Maintaining security of patients records and equipment

2.4.2 Activities of HRIO at Central Records

 Checking and correcting for misfiling

 Sorting of patient files
 Tracing of medical records
 Filing medical files using terminal digit filing system
 Filing disease index cards using alphanumeric filing system
 Weeding of inactive/dormant files
 Editing of case notes before filing
 Retrieving medical records

6
2.4.3 Tools used

 Computer

2.5 Maternity Unit

This unit provides inpatient services to the sick pregnant mothers and newborns. It also
provides delivery care and post-natal health services. It has the following wards namely;

 Antenatal ward (ANW)

 Labor ward (LW)
 Postnatal ward (PNW)

2.5.1 Functions of health records and information department in maternity unit

 Coding and indexing

 Records management
 Data management
 Maintenance of confidentiality of patient’s information
 Maintaining security of patients records and equipment
 Assisting in civil registration of Births and deaths

2.5.2 Activities of HRIO in maternity unit

 Checking and correcting for misfiling

 Sorting of patient files
 Indexing of diseases and injuries using diagnostic index card MOH 268
 Tracing of medical records
 Filing medical files using straight numerical filing system
 Uploading coded files in DHIS
 Weeding of inactive/dormant files
 Editing of case notes before filing
 Retrieving medical records

7
2.5.3 Tools used

 MOH 301-in-patient register

 MOH 333-Maternity register
 MOH 268- Diagnostic index card
 Computers
 Medical files
 Tracer register

2.7 Maternal child health and family planning unit

It is unit that provides preventive health services.

It consists of the following services;

 Immunization
 Antenatal
 Post-natal
 Child welfare clinic
 Family planning and cervical cancer screening
 HIV care services
 Nutrition

2.7.1 Functions of Health records and information department in MCH

 Records management
 Data management
 Maintenance of confidentiality of patient’s information
 Maintaining security of patients records and equipment

2.7.2 Activities of HRIO in MCH

 Ensuring daily summary of all MCH registers

 Compiling monthly reports
 Ensuring MCH care model files are filed

8
2.7.3 Tools used in MCH

 MOH 262- Cervical cancer screening and treatment Register

 MOH 361A- Treatment Preparation Register
 MOH 366- DAR for CCC
 MOH 405- ANC Register
 MOH 510- Immunization Register
 MOH 511- Child Welfare Clinic (CWC) Register
 MOH 512- Daily Activity register for contraceptives
 MOH 216- Mother Child Booklet
 HIV Exposed Infant (HEI) Card
 Green Card – MOH 257
 MOH 702- Immunization and Vitamin A tally sheet
 MOH 704- Child Health Nutrition Information System tally sheet

2.9 Health information system office

This is a section where hospital reports are compiled and disseminated to the next level by
uploading onto DHIS. Hard copies are submitted to the sub sub county health information
office.

2.9.1 Functions of health records and information department at HIS office

a. Data management
b. Maintaining security of health records equipment’s and information
c. Maintaining confidentiality of health information

2.9.2 Activities of HRIO at HIS office

 Collection of patients’ data in all departments

 Collection of DBR from wards
 Uploading data on DHIS
 Downloading monthly reports

9
2.9.3 Tools used

 MOH 717 –Monthly work load

 Computer
 MOH 711-National integrated form for reproductive health, TB, HIV/AIDS and child
nutrition
 MOH 705A-Outpatient summary under 5years
 MOH 705B-Oupatient summary over 5 years
 MOH 731-Comprehensive HIV/AIDS facility reporting form
 Service delivery form-MOH 105
 Malaria commodities form
 Sexual gender-based violence form-MOH 365
 Monthly nutrition summary sheet –MOH 713
 Immunization and vitamin A summary sheet-MOH 710
 Laboratory summary sheet-MOH 706

2.10 Injection room

This is a very important unit in the hospital where emergency cases are handled first.

Most of the patients brought in at casualty are always service immediately.

2.10.1 Functions of Health records and information department at injection room

 Admission
 Registration
 Reception
 Maintaining Security of patient’s health information and health records equipment
 Maintaining confidentiality of patient’s information
 Data management

2.10.2 Activities of HRIO at injection room

 Recording clients’ details in MOH 301 and medical file

 Admission and re-admission of patients in the EMR system

10
  Admission of BID and internal bodies in the system
 Creation of patient file
 Entering of patient’s bio data and updating in the EMR system
 Issuing of both outpatient and inpatient cards to patient
 Receiving of the patient/clients
 Directing of patients/clients to various service points

2.10.3 Tools used in injection room

 Computers
 Medical Files
 MOH 301 inpatient register
2.11.0 Triage section

This a place where the patients temperature, blood pressure and weights are recorded

Tools used
1. Thermogan

2. Weighing scale
3. Blood pressure monitor

11
CHAPTER THREE: CHALLLENGES, ACHIEVEMENTS, RECOMMENDATIONS
AND CONCLUSION

3.1 Challenges

 Inadequate filing space

 Inadequate staffs
 Inadequate computer
 Network failure
 COVID-19 pandemic

3.2 Achievements

 Able to calculate hospital administrative statistics

 Able to manage patient medical records
 Able to manage appointments and prepare clinics
 Able to manage health data
 Able to consider ethical and legal issues pertaining to health records and information
 Able to coordinate and manage health records and information services.

3.3 Recommendations

 The administration should improve on network connection

 The hospital administration should procure more computers
 The sub county government should employ more staffs
 The hospital administration should build secondary filing areas

12
3.4 Conclusions

I concluded that despite the challenges encountered during attachment, I was able to achieve
the objective of gaining skills and knowledge in relation to the health records and information
training. I also gained experience in management and coordination of health records services.
Therefore, I encourage the college to continue sending students for attachment to this
institution since there is good learning atmosphere.

13