An evidence-based guideline of using dry care approach for umbilical cord care in newborn

Abstract

As a baby is born, the umbilical cord is cut and clamped, then it dries up and detaches. During the course of cord detachment and before the wound completely heals up, umbilical cord care is essential for preventing any local infection, which may lead to septicemia or infection of other organs.

However, the yellowish and blood-stained discharge from the base of the cord and the appearance of the cord stump often causes anxiety among parents and make them hesitant to provide cord care. Hence, healthcare professionals are responsible for explaining the importance of proper cord care and provide consistent information on the course of cord detachment. This will decrease parental anxiety or the cord-related issues and improve compliance.

Currently, different solutions are being used at different healthcare facilities. This leads to confusion among healthcare professionals and parents. Moreover, as evidenced in many studies, different solutions can affect the umbilical cord detachment time and prolongation of umbilical cord separation time, which can cause immense anxiety among the parents. Hence, a solution that is effective in reducing the umbilical cord separation time can help to alleviate parental anxiety. Dry care, such as using cold boiled water to clean the cord, is suggested to be suitable for umbilical cord care as it shortens the umbilical cord separation time compares to alcohol, which is still being used in many healthcare facilities. Therefore, this proposed innovation attempts to promote dry care as the standard umbilical cord care practice, to shorten the umbilical cord separation time, which in turn, decreases parental anxiety and the workload related to cord care for the healthcare professionals.

The implementation of dry care was explored and it was found that this innovation is cost-effective and has a high transferability and feasibility in the current setting of Hong Kong Maternal and Child Health Clinics. An evidence-based practice guideline was developed and would be launched initially on a trial basis at one of the Maternal and Child Health Clinics after a well-developed communication and implementation plan is established. It is expected to take about 12 months from gaining approval, implementation of the innovation, data collection and to the last stage, program evaluation.