Newborn Cord Care Case Study

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The umbilical cord is an essential lifeline between the mother and fetus. The cord contains two arteries and a vein, is connected to the placenta and provides oxygen and nutrient-rich blood to the fetus in-utero. Though parents are informed during discharge on how to perform dry care for the umbilical cord until it falls off approximately within one to two weeks, care for the cord begins in the hospital setting following the delivery. The main implication for umbilical cord care is to prevent infectious conditions of the cord such as: omphalitis which is clinically manifested as inflammation with fever and drainage from the umbilical stump. This infection can turn deadly and lead to sepsis. Traditionally, a number of antiseptic and products …show more content…
We were able to access a copy of the Women & Children’s Policy and Procedure Manual concerning Newborn Cord Care through our clinical instructor who worked on the unit. Saint Peter’s University Hospital’s policy and procedure on Newborn Cord Care was originated in February 1993. Since then, it has been revised a total of five times with the most recent time being December 2014 and it still remains effective as of January 2015. The policy itself is organized into six parts. The first is the policy part, simply stating what’s to be done with the newborn’s umbilical cord to properly care for it. The second is the purpose part, stating the reason as to why this is being done to the cord. The third part is the equipment section, listing all that is necessary to complete the procedure. The fourth is the actual procedure part. This section explains what should be done by the RN immediately following admission. Next, it makes clear of the daily umbilical cord care. The fifth is the documentation section, stating specifically what should be documented regarding the state of the cord. Finally, the references are listed and for this policy, there are two reputable sources that cite an older edition of AWHONN’s guideline as supporting evidence. The policy is also signed …show more content…
Saint Peter’s University Hospital currently uses the topical agent triple dye to care for the newborn’s umbilical cord. The immediate care in the guideline says to clean the umbilical area with tap water and to dry it thoroughly. In the policy, however, triple dye is applied “in a one inch circle around the base of the umbilical cord.” The ongoing care of the cord in both the guideline and policy is very similar. The primary objective is to keep it dry. Both of them recommend exposing the cord to air whenever possible, especially when diapering the baby. Whenever the newborn’s diaper is changed, it should be folded down to avoid contact with the diaper itself and any urine or stool. Whenever it does in fact get wet or moist at all, it should be cleaned with water and dried thoroughly with gauze. Every time the cord is assessed, the nurse should perform hand hygiene and don gloves. The cleanliness of the cord should be maintained with plain tap water. The nurse should continuously observe for signs of infection such as redness, swelling, discharge, and odors. The nurse should also be able to differentiate between what’s normal healing versus what’s not. It is very crucial to educate the infant’s caregiver(s) on the importance of infection prevention, hand hygiene, and how to clean the cord. The nurse should observe how the caregiver(s) perform diaper

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