KENYA MEDICAL TRAINING COLLEGE (NAIROBI CAMPUS)

DEPARTMENT OF MEDICAL ENGINEERING

A RESEARCH ON LOW OXYGEN PRODUCTION IN KENYATTA NATIONAL
HOSPITAL.

PRESENTED BY: DOREEN NKATHA

D/MET/17001/026.

A RESEARCH PROPOSAL SUBMITTED TO THE DEPRTMENT OF MEDICAL

ENGINEERING IN PARTIAL FULFILLMENT OF AWARD IN DIPLOMA COURSE.

2018

1
DECLARATION
I DOREEN NKATHA declare that this proposal is my original work and has not been presented
in any other institution for an award in diploma.
NAME: DOREEN NKATHA
D/MET/17001/026
SIGNATURE:
DATE:

2
CERTIFICATION
This proposal has been submitted under my approval as the college supervisor.
NAME:
SIGNATURE:
DATE:

3
DEDICATION
I dedicate my work to my beloved family, friends, lectures and mentors for their moral and
financial support.

4
ACKNOWLEDGEMENT
I thank God for His grace upon me and guiding me through the study. Special thanks to my
lovely dad and mum for continuous encouragement and the confidence in me. Not forgetting
wonderful lectures Madam Joyce and jocabeth for guiding me, my classmates for providing a
friendly environment and the HOD medical engineering Mr. Isaac Cheptiony.

5
LIST OF ABBREVIATION
PPM- Planned Preventive maintenance
KNH- Kenyatta National Hospital
BME- Bio Medical Engineer
WHO-World Health Organization
HOD- Head Of Department

6
TABLE OF CONTENTS
DECLARATION........................................................................................................................... 2
CERTIFICATION ........................................................................................................................ 3
DEDICATION............................................................................................................................... 4
ACKNOWLEDGEMENT ............................................................................................................ 5
LIST OF ABBREVIATION......................................................................................................... 6
TABLE OF CONTENTS ............................................................................................................. 7
ABSTRACT ................................................................................................................................... 9
CHAPTER ONE ......................................................................................................................... 10
INTRODUCTION. ................................................................................................................... 10
1.1BACKGROUND INFORMATION. ................................................................................... 10
1.2 PROBLEM STATEMENT ................................................................................................. 10
1.3 JUSTIFICATION OF THE STUDY .................................................................................. 11
1.4 SIGNIFICANCE OF THE STUDY.................................................................................... 11
1.5 RESEARCH QUESTIONS ................................................................................................ 11
1.6 OBJECTIVES ..................................................................................................................... 11
1.6.1 MAIN OBJECTIVE......................................................................................................... 11
1.6.2 SPECIFIC OBJECTIVES ................................................................................................ 12
1.7 SCOPE OF THE STUDY ................................................................................................... 12
1.8 LIMITATION OF THE STUDY ........................................................................................ 12
1.9 DELIMITATION OF THE STUDY .................................................................................. 12
1.10 ASSUMPTIONS ............................................................................................................... 12
CHAPTER TWO ........................................................................................................................ 13
2.0 LITERATURE REVIEW ................................................................................................... 13
2.1.1 WORKING PRINCIPLE. ............................................................................................ 13
2.2PROCESS DESCRIPTION ................................................................................................. 13
2.3 CAUSES OF LOW OXYGEN OUTUT FROM THE GENERATOR. ............................. 14
2.3.1 OLD AGE ASSOCITED WITH OLD TECHNOLOGY. ........................................... 14
2.3.2 POOR MAINTENANCE............................................................................................. 14
CHAPTER THREE .................................................................................................................... 15
3.0 RESEARCH DESIGN AND METHODOLOGY .............................................................. 15
3.1 STUDY AREA. .................................................................................................................. 15
3.2 STUDY DESIGN................................................................................................................ 15

7
 3.3 STUDY POPULATION ..................................................................................................... 15
3.3.1 INCLUSIVE CRITERIA ............................................................................................. 15
3.3.2 EXCLUSIVE CRITERIA ............................................................................................ 15
3.4 SAMPLE SIZE DETERMINATION ................................................................................. 15
3.4.1 SAMPLE SIZE ............................................................................................................ 15
3.4.2 SAMPLING PROCEDURE ........................................................................................ 16
3.5DATA COLLECTION TOOLS .......................................................................................... 16
3.6 DATA COLLECTION PROCEDURE............................................................................... 16
3.7 DATA ANALYSIS AND PRESENTATION .................................................................... 16
3.8ETHICAL CONSIDERATIONS ......................................................................................... 16
REFERRENCES. ........................................................................................................................ 17
APPENDIXES ............................................................................................................................. 18
APPENDIX 1 QUESTIONAIRE ............................................................................................. 18
APPENDIX 11 .......................................................................................................................... 20
BUDGET .................................................................................................................................. 20
APPENDIX 111 ........................................................................................................................ 21
WORKPLAN ............................................................................................................................ 21

8
ABSTRACT
This study will look at effectiveness of oxygen generator employing cryogenic air separation
technology in KNH. It will also provide some of the causes of low oxygen outputs from the
generator. It will consider the percentage purity, technology applied, reliability, maintenance and
staff knowledge on handling. It is intended to provide valuable information that can be used by
the management to improve technology for oxygen generation. Literature review will be
obtained from internet, books, newspapers and documented journals. During the research,
findings will be documented by means of questionnaires, interviews and observations. It will be
presented in charts.

9
CHAPTER ONE

INTRODUCTION.

1.1BACKGROUND INFORMATION.
Oxygen generating plant is a system designed to generate oxygen. They typically use air as
feedstock and separate oxygen from other components. (www.wikipedia.com)

Oxygen is among the major supplies of any hospital since it was also declared a medicine.
Oxygen therapy is used in treatment of hypoxia. This is a condition associated with birth
asphyxia, sepsis and low birth weights in neonates and asthma, pneumonia, heart failure, trauma
and anesthesia in adults.as a result adequate oxygen is required for any healthcare facility. (WHO
2007)

Air separation is made possible by the fact that different constituent gases have different boiling
points and by manipulation of immediate surrounding in terms of temperature and pressure air
can be separated into the constituents. Liquid oxygen is obtained through a process known as
cryogenic separation of air. The process includes: filtration, compression, purification, heat
exchange and distillation. (www.linde-engineering.com).

Oxygen plant was first developed by Carl von Linde in 1895 with an output of three litres of
liquid oxygen per day. The world first oxygen air separation plant begun operation in 1902. With
time it has been progressively developed due to oxygen increased demand for medicinal
purposes. (www.linde engineering.com).

Similarly, in Kenya there is a continuous growth in oxygen production. In 2011, the plant was
installed in KNH following a proposal by the then minister of health. (www.standardmediacoke)

1.2 PROBLEM STATEMENT

Globally unavailability of oxygen has been a challenge particularly in middle and low income
countries. (WHO2007)

10
Similarly, in KNH, the generator plant is designed to give an output of 2500 litres per day but
only gives 500litres per day. This mean the output is around 20% of the designed output. As a
result extra financial budget is spent to purchase oxygen. Records show that 2015\2016 the
hospital management spent 110.8M to counter the deficiency. (www.nation.co.ke).

It was also noted that the firm did not train KNH staff to build capacity internally in order to
ensure continuity of the plant expiry of the service contract. This lead to foregoing hence less
oxygen. (www.businessdailyafrica.com).

1.3 JUSTIFICATION OF THE STUDY

Oxygen is a major supply to any hospital since it is used for treatment. Following proper
production in terms of quality and quantity from atmospheric air would reduce costs involved.
Effective generation ensure high purity, high volumes and right pressure for oxygen therapy.
This proves the need to study on the causes and possible solutions to the low outputs.

1.4 SIGNIFICANCE OF THE STUDY.

The study will help in improvement of the plant through proper maintenance and technology
applied in production to minimize financial budgets set aside for purchases.

It will also contribute to already existing knowledge in this area.

1.5 RESEARCH QUESTIONS

1. What are the causes of low oxygen outputs from the generator?
2. What are the effects of low oxygen outputs?
3. What are some of the possible solutions to the low outputs?

1.6 OBJECTIVES

1.6.1 MAIN OBJECTIVE

To determine causes of low oxygen generation.

11
1.6.2 SPECIFIC OBJECTIVES

1. To determine the causes of low oxygen yielding

2. To determine the effects of low oxygen outputs
3. To determine some of the possible solutions to low oxygen production.

1.7 SCOPE OF THE STUDY

The study will be carried out by determining the volumes of oxygen obtained from generation.

1.8 LIMITATION OF THE STUDY

Respondents may be unwilling to give adequate information

Inadequate references of the study.

1.9 DELIMITATION OF THE STUDY

KNH is nearby hence enabling frequent visits to the area of study.

1.10 ASSUMPTIONS

The information from the respondents will be honest and free from bias.

12
 CHAPTER TWO

2.0 LITERATURE REVIEW

Atmospheric air comprises 21% oxygen78%nitrogen and 1% other gases (argon, carbon dioxide,
and krypton). Oxygen is obtained through air separation made possible by difference in boiling
points. (Smith 2001)

Normally, cryogenic production is the most effective method of producing oxygen for medical
use since it produces high purity above 99.5%, high flow volumes and high pressure for
distribution within the hospital. (Smith 2001)

Cryogenic oxygen generation is the oldest method of producing oxygen and nitrogen, developed
by Carl von Linde in 1895. (www.linde-engineering.com)

2.1.1 WORKING PRINCIPLE.

Cryogenic air separation works on the principle that different constituent gases have different
boiling points and by manipulation of immediate surrounding in terms of temperature and
pressure air can be separated into its components. Air is cooled to liquid form and fractional
distillation carried out at extremely low temperatures. Oxygen boils of at -183`celcius and
nitrogen at -196`celcius. Thus oxygen distills off first and is obtained. (Smith 2001)

2.2PROCESS DESCRIPTION

Air is filtered during intake to remove impurities such as dust particles. The air is then
compressed to provide energy for refrigeration, air is then further purified by cooling below -60`
C to remove water vapour, carbon dioxide and hydrocarbons. Purified air is then passed through
heat exchange where air is cooled to nearly liquefaction temperature. Further compression is
carried out and the liquid air is finally distilled where oxygen boils at -183` C. (www.linde-
ngineering.com)

13
2.3 CAUSES OF LOW OXYGEN OUTUT FROM THE GENERATOR.

2.3.1 OLD AGE ASSOCITED WITH OLD TECHNOLOGY.

Old age could be the cause of low output from the generator. This is because the effectiveness of
the generator may have reduced with time as well as low technology employed.

This can be improved by upgrading the generator system. This is by improving the existing
system and employing more advanced technology.

2.3.2 POOR MAINTENANCE

Inadequate knowledge and skills, lack of regular maintenance schedules including PPM,
servicing and cleaning could be the cause of low effectiveness of the generator.

This can be improved by regular checks, planned preventive maintenance and frequent servicing
by trained personnel.

Other possible causes of low oxygen outputs may include unreliability due to ineffective backup
systems and unsuitable design considerations.

14
 CHAPTER THREE

3.0 RESEARCH DESIGN AND METHODOLOGY

3.1 STUDY AREA.

The study will be carried out at KNH. The hospital is located in Nairobi, 3.5 kilometers
away from city’s Business District along hospital road off Ngong road. It has bed
capacity of 1800 persons and has been in existence since 1901.

3.2 STUDY DESIGN

The study will be descriptive as the process of collecting data to answer questions
concerning the status of the determination of low oxygen outputs from the generator.

3.3 STUDY POPULATION

The study will mainly target biomedical engineers at KNH who mainly deal with oxygen
generators. The study population will be 10.

3.3.1 INCLUSIVE CRITERIA

The study will include all biomedical engineers working at the generator station since
it’s expected they have adequate understanding on the subject.

3.3.2 EXCLUSIVE CRITERIA

Biomedical engineers absent during the study will be excluded.

3.4 SAMPLE SIZE DETERMINATION

The sample size will be determined from the target population of 10 biomedical engineers.
The researcher will deliberately choose who to include in the study based on their ability to
provide necessary data

3.4.1 SAMPLE SIZE

Slovin`s formula

15
n=N\ (1+N (P2))

Where: n=sample size precision is obtained by for example confidence level of 95% expected.

N=study population p=100-95/100 =0.05

P=precision n=10/(1+10(0.05)2) = 10

3.4.2 SAMPLING PROCEDURE

Sampling is a process of selecting a number of individuals for a study to represent the larger
group from which they are selected. Simple random sampling method will be used as each
member has equal chances of being chosen.

3.5DATA COLLECTION TOOLS

The data collection will be done through questionnaires, interviews and observation. The
materials required for data collection include: questionnaire papers, pen, pencil, rubber and
notebook.

3.6 DATA COLLECTION PROCEDURE

For questionnaires, close-ended questions will be provided and observe while making notes to
enable data collection. Questions for face to face interviews will be prepared and questionnaires
given directly to respondents.

3.7 DATA ANALYSIS AND PRESENTATION

Data will be collected, analyzed manually using calculators and presented using tables and pie
charts.

3.8ETHICAL CONSIDERATIONS

The data will be confidential and used for learning purposes only.

16
REFERRENCES.

1. Smith A.R and Jklosek, (2001), A review of air separation technologies and their
integration with energy conversion processes. Fuel processing technology 70.
2. WHO2007 Kenya essential medicine.
3. www.linde-engineering.com
4. www.nationco.ke
5. www.knh.or.ke
6. www.businessdailyafrica.com

17
APPENDIXES

APPENDIX 1 QUESTIONAIRE
a) Do not write your name.
b) Please fill in the questionnaire on the basis of facts.
c) Please mark in the checkbox provided to indicate the correct answer.(only one answer)
1. What is your level of education?
a) primary
b) Secondary
c) College
d) University
2. What is your profession?
a) Biomedical engineer
b) Others
3. How frequently do you carry out daily maintenance?
a) Every day
b) After two days
c) Weekly
d) Monthly
4. How frequently do you carry out PPM?
a) According to instructions manual
b) Half yearly
c) Yearly
5. Who does daily maintenance and servicing e.g. cleaning?
a) Biomedical engineers
b) Other casual workers
6. What is the major cause of low oxygen output?
a) Old technology
b) Poor maintenance
c) Inappropriate design

18
7. How do you ensure the generator does not fail often?
a) Intermittent operation
b) Constant inspection
c) Switching the generator off
8. How long have you experienced low oxygen output from the generator?
a) 1 year
b) 2 years
c) 3 or more years
9. What are the challenges encountered during maintenance?
a) Lack of tools
b) Lack of adequate knowledge and skills.
10. What percentage output based on the generator design is obtained?
a) 20%
b) 30%
c) 50%
d) Above 50%

19
APPENDIX 11

BUDGET
ITEM NUMBER OF COST PER ITEM TOTAL COST
ITEMS
Ballpoint pen 3 25 75
Notebook 1 90 90
Pencil 3 10 30
Eraser 1 10 10
Internet browsing - - 500
Printing and binding - - 900
Miscellaneous - - 1000
2605

20
APPENDIX 111

WORKPLAN
OCTOBER NOVEMBER DECEMBER JANUARY
Week 1,2 Week3,4 Week1,2 Week3,4 Week1,2 Week 3,4 Week 1
Chapter 1 Chapter 2 Chapter 2 Chapter 3 Chapter3 references

21