Component Task: Dressing of the Umbilical Cord

This is an aseptic technique performed by the midwife in the dressing of the umbilical cord. This is done after delivery using the recommended/prescribed antiseptic lotion to optimize the health of the baby until the cord drops off and the complete healing of the wound.

Aims

·         Prevent superficial (omphalitis) and systemic infection

·         Help the umbilical cord stamp to fall of the naval quickly

·         Promote healing

·         Create an opportunity for health education to the mother

·         Prevent bleeding from the stump

·         Promote progressive dryness

Requirements

Tray containing the following:

·         Chlorhexidine gel/methylated spirit

·         Sterile cotton wool swab

·         Sterile gallipot

·         Sterile gloves

·         Receiver for used swabs

·         Cord clamp or ligature

·         Baby dress and diaper

·         Cot sheet

·         Wet wipes

Steps

1.        Establish rapport (refer steps)

2.      Explains procedure to client (Refer steps)

3.      Set a tray and assemble all items to be used

4.      Prepare conducive area (close nearby windows and prepare well-padded flat surface)

5.      Maintain infection prevention and control practice throughout the procedure

6.      Put baby on examination table, wrapped up and protected by mother/assistant

7.       Put on plastic apron and perform hand hygiene

8.      Wear sterile examination gloves

9.      Expose cord and inspect of bleeding, swelling and redness of the skin around the cord

10.    Re-ligate/clamp cord if necessary

11.      Hold stem of cord with one cotton wool swab soaked in spirit OR dry cotton wool swab when using chlorhexidine gel

12.    Swab skin 5cm away and around base of cord when using spirit OR apply gel from tip

13.    Swab stem from base upwards using a swab for each stroke till cord is cleaned or ensure gel spreads around the cord

14.    Swab the tip of the cord (with spirit) and leave cord exposed on top of the diaper/napkin in both cases

15.    Remove the gloves and perform hand hygiene

16.    Dress baby (napkin/diaper folded below umbilicus)

17.    Educate mother on how to manage, what to expect and when to seek at the hospital when she sees signs of infection

18.    Give baby to mother and express appreciation for her cooperation

19.    Communicate findings to mother

20.  Disposed off and decontaminate used items

21.    Perform hand hygiene

22.  Record into Maternal and Child Health Record Book (Manual and Electronic)

23.  Record and report findings to the officer in-charge

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