Successful end to 2nd week here at Wakiso

My last day at the health centre was helping out at the busy HIV clinic. Before I got started I hunted out Sister Betty and Sister Robina to give them my report for the time I have been here. I was able to tell them that I had seen some improvements over the last 8 days. The new desk in reception had helped women see who they needed to report to and freed up space for clinical use in the midwives room. There were some new trash cans in all the public places helping to keep the place clean and tidy and this morning I had seen the midwives on duty start their shift with a daily clean of labour room and office. This made such a difference.
I didn't want to sound too critical so gave a list of 5 things I thought the maternity department could start to work on to make difference.

1. Use the 5S document to improve organisation and encourage staff to take responsibility for the overall tidiness of the department.
2. Stop the dangerous use of Sharpe's for ARM. This procedure and Sharpe's weather it be a clean needle or a broken vial puts midwives at risk of a needle stick injury and mothers and babies at risk. 
3. The clinic works on a curative basis, reacting to problems, when midwifery can have greater impact working in a preventative way. Proactive not reactive. eg: Screen for pre-eclampsia, anaemia , infections and IUGR at every opportunity.You have made a good start by performing and recording BP on every A/N visit. Keep it up.  
4. Encourage midwife Regina to disseminate her skills for resuscitation of the newborn.
5. Regarding dangerous practise during the 3rd stage of labour, my 1st concern is that midwives are performing active management without administering an oxytocin. I recommend that the health centre look closely at the way the 3rd stage is managed and perhaps draw up some guidelines. 

Lastly I would like to say a big thank-you to all the staff at Wakiso maternity unit for making me feel welcome. I have learnt a lot from them, I now feel expert in using a pinard and I shall never throw anything away as there is always another use for it. Except empty vials!

cleaned up midwives room