Poor records keeping, glaring gaps in the admission process and poor chain of command and communication are some of the reasons that have dogged Kenyatta National Hospital.
A preliminary Inquiry Committee report released on Friday by the Medical Practitioner and Dentists Board shows that there are systemic challenges facing service delivery.
Kenyatta National Hospital has recently been making headlines as a result of systemic challenges.
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In January, there was a national outrage over a Facebook post detailing allegations of sexual abuse of mothers who have delivered at Kenyatta National Hospital.
KNH was in the headlines again in March after a neurosurgeon opened up the head of the wrong patient.
This compelled the board to conduct an inquiry
It found out that Mary Wahome, the nurse who handled the patient needs to be considered by her Regulator, the Nursing Council of Kenya.
Wahome had testified that she had been unwell for several months after being involved in an accident, and had not recovered fully.
However, the competency of the Dr. Hudson Ng’ang’a Kamau, who undertook the surgery of the patient, assisted by Dr. Mose Moraa, could not be questioned.
"The Committee finds that the appropriate Regulator should consider whether the said nurse is fit to practice under such an environment.The said nurse also admitted being aware that the patient was in a confused state but on being requested to deliver one, John Mbugua Nderitu, to the trauma theater she went to Room 2 with a porter and shouted his names and she then prepared and labelled the “responsive patient” before taking him to theater."
The committee said the acts of the nurse also contributed to the unfortunate mishap as the “responsive patient”, who was in a confused state due to head injuries.
The committee also found out that Kenyatta National Hospital had Standard Operating Procedures for the various processes which was never implemented, monitored or evaluated.
Dr. Peter Masinde, the Acting Director of Clinical Services at the at the hospital revealed this.
Masinde admitted that the Medical Advisory Committee of the Hospital existed only on paper.
This contradicted the evidence of Dr. Ben Githae and suspended CEO Ms. Lily Koros.
Dr. Githae had testified that the said Committee existed though it only addressed disciplinary issues whereas Dr. Masinde stated that he may need to go to their archives to get minutes of the said Committee, they ever existed.
KNH also has glaring gaps on the admission process.
It was noted that the neurosurgery patients were spread in different wards within the facility and as a consequence being a potential risk to proper management and follow-up of the patients.
Poor chain of command and communication between the Hospital and the University of Nairobi, School of Medicine was also noted.
Witnesses confirmed that the working relationship of the two institutions was affecting their operations and under the current structure of calls the Residents and University Lecturers appear more prominent.
The Committee reviewed the patients files submitted to the Board and noted that there was poor documentation by different cadres involved in the management of the patient.
Nurses had also improvised identification tags for the patients.
The committee has since ordered Medical Practitioners and Dentists Board to constitute a Professional Conduct Committee within the next three days.
It will undertake an inquiry on the role played by the Hospital and the doctors involved in the treatment and management of the two patients.
The committee will convene its sitting in Nairobi within the next 14 days.
Nursing Council of Kenya will initiate an inquiry on the role played by nurses in the treatment and management of the two patients also within 14 days.
The Clinical Officers Council of Kenya will follow suit.