cord care

  1. Just doing a little research on cord care and what other hospital and doctors are doing? How soon after clamping do you remove the clamp? Do you still remove it if the cord is moist? And is anyone still doing triple dye? Does anyone have any good reseach info on this? Thanks
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  2. 21 Comments

  3. by   NorthernRN
    Hi...in the unit I used to work in (and this is still policy), the clamp is removed after 24hrs, as long as there are no s/s of infection. If the cord is still moist after 24 hrs, you need to be looking for s/s. You should have significant drying at that point. And triple dye is still used, but this is the only unit where I've seen it still used...most units are using etoh.
  4. by   obnurseinNW
    So what do you do do if there are s/s of infection? Our current practice is with etoh, however, if the cord is still moist prior to discharge we discharge patient with clamp on. We see them a few days later to remove it. One neonatalogist was concerned that leaving the clamp on could increase the risk of infection. I thought I would just check it out to see what others are doing and why! Sometimes we get into the practice of doing things but don't know for sure why!
    Thanks for the info.
  5. by   OBNURSEHEATHER
    I AM AN OB NURSE IN NW OHIO. OUR PRACTICE IS THAT ALL NEWBORNS RECEIVE TRIPLE DYE. IT IS CONSIDERED PART OF OUR SHIFTLY ASSESSMENT TO APPLY ALCOHOL TO THE SITE (3X'S DAILY). WE REMOVE THE CLAMPS ANYTIME AFTER 24 HOURS, ALWAYS BEFORE DISCHARGE. WE ALSO INSTRUCT MOMS TO CONTINUE THE ALCOHOL AT HOME UNTIL THE CORD FALLS OFF.

    HEATHER
    Last edit by OBNURSEHEATHER on Apr 20, '03
  6. by   NorthernRN
    "So what do you do do if there are s/s of infection?" If there are s/s, then Peds is called (we're a teaching hospital and have residents). Typically, if no systemic s/s exist, then the cord is thoroughly cleaned w/ etoh and watched. If systemic s/s are present, then Peds takes over.
  7. by   obnurseinNW
    thanks for the info.
  8. by   jef
    You can also check out a research study which was published in JOGNN in 1998.
    Dore, Coulas & Cowan (1998) Alcohol vs natural drying for newborn cord care. JOGNN 27 (6), 621-627.
    This article also cites other research studies which were done regarding cord care. Also keep an eye out for new skin care guidelines (including cord care) which will be coming from AWHONN sometime in 2001. The guidelines should be helpful in writing and revising policies as they are all research-based. Hope this is helpful!

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  9. by   obnurseinNW
    Thanks I will check out the article. I remember reading it but forgot. Thanks a bunch.
  10. by   lactationrn
    I read an artile that said cord care with alcohol daily causes more problems and may cause the cord to take longer to heal. forgive me as I dont remember wehere I read it, Maybe in the Riprdan/ Aerobach book Breastfeedng and human lactation 1998 ed.
  11. by   kennedyj
    We tell the moms to apply alcohol to the moist chord with each diaper change and cut off the clamp when it is dry. If it is moist after 24 hrs I usually demonstrate to the parents how to use the achohol pad to the chord. Sometimes short chords do not allow the alcoholto dry the base. I have seen very moist chords become dry after about 3 hours by applying alchol a few good times. However you should be cautious to not get it all over the skin(will dry skin too). I take an alcohol pad and wad it up squeezing the alcohol onto the chord.

    Alcohol works well. Triple dye just gets things stained.
    Jared
  12. by   CTRN1
    At our hospital it is part of the newborn MD orders to apply triple dye to all newborns. Also, we no longer apply alcohol to cords, this change came about a year ago. I believe this was based on literature about it causing longer drying times and other problems. Instead we teach moms to wash and dry the cord with plain water until it falls off. In regard to cord clamps, our newborn alarm security system is part of the clamps, thus they are not removed until just prior to discharge. Hope this helps.
  13. by   prmenrs
    Our hospital (a University/teaching hospital) has d/c'd alcohol. We never did use triple dye. We now do just dry cord care. We teach moms to make sure the diaper is below the cord, as well as the s/s of oomphalitis, and the necessity of an ER visit if that happens.
    The new theory [research-based] os that the alcohol kills normal skin flora which actually HELPS the cord dry up and fall off.
  14. by   Q.
    Our facility actually abandoned the practice of swabbing the cord with alcohol after the current literature suggested that cords swabbed with alcohol have no lesser incidence of infection than cords that were not swabbed.

    Also, we remove the clamp per nursing judgement.

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