The Great Partogram Robbery

We thought we’d better provide a hospital update, if only to reassure you that we are doing some work amongst the Michael Bolton tribute parties, clothes shopping and birdwatching.

Things are going well at the obstetric unit; I’ve acclimatized to the mayhem and even managed to reduce it (sort of) by introducing whiteboards outlining the essential details of all the labouring patients. This is designed to improve the organisation of the ward and to make sure everyone is aware of the patients who need particular attention.  I will admit that there was initial resistance, and for the first 2 weeks there was only me and one of the fourteen residents updating it regularly, however it is now up and running successfully!  I even had a resident come up to me after his weekend shift to apologise for sticking paper on the board after the marker pen ran out.  We now have more marker pens, unfortunately they still need to be tied to the wall to stop people ‘borrowing’ them but small steps are being taken in a (generally) forward direction.

In a similar vein, it is amazing what people ‘borrow’ if they find it lying around the ward. My favourite thing to go missing so far has to be a massive (3ft by 5ft!)  laminated partogram (in this case, by ‘left lying around’ I mean ‘stuck so firmly to the wall that its removal has left the wall paintless’).  On a positive note it gave me the opportunity to discuss why the use of a partogram was so important in the morning meetings and we’ve now organised a partogram teaching session, so every cloud…

Another reason for my work-related blog is to post some of my favourite theatre photos, when things are going less-than-swimmingly in the operating theatre, you just need to walk into the recovery area to find instant amusement.  We have ‘The Dangerous Drug Cupboard’, which I think has a much better ring to it than ‘Controlled Drugs Cupboard’.

The Dangerous Drugs Cupboard

There is also the store of endotracheal tubes with the mysterious empty box – if like me you thought there must be something secret and wonderful inside that is kept safe from all the staff, you may be a little disappointed but I was still amused that it was actually an empty box (modelled by Julia one of the UCLA residents who came over for a recent 3-week placement).

Julia - with empty box

Is it really an empty box?

Also, if you are looking for another way to use tape, here’s your answer.  There is no end to the ingenuity; some of you may have noticed the lack of a cord clamp replaced by the sleeve of a disposable glove which works surprisingly well.

Babies

On a more serious note, our projects are going well, and with the collaboration of my Ugandan colleagues I have managed to pilot a cervical cancer screening project for our HIV-positive patients using visual inspection with acetic acid.  I am also starting a quality improvement project aimed at reducing the very high rate of stillbirth here, so I’ll let you know how that goes.  We are also planning to introduce improved infection control measures, focussing on hand hygiene. This has been proven to reduce rates of sepsis in other Ugandan hospitals, and we’re hopeful that similar results can be achieved in Mbarara.