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The treatment of newborn umbilical cord from birth to discharge into home care.
ŠNAJDROVÁ, Šárka
Recent state: The umbilical cord care is one of the basic operations which are made immediately after the childbirth and during the first weeks in the newborn?s life. It is an everyday routine of midwives, infant nurses and mothers. The umbilical cord care is very important as the cord stump can easily become a gateway for an infection and hereby endanger the newborn?s health and life. Many pages in various publications have been written about the way how to treat the umbilicus. The authors wrote mostly about their own experience and the possibilities which they had in their time. Considering that the procedure changed several times in the past years, there is no unity in the way how to proceed in unison and the newborn?s umbilical cord care is performed differently in diverse hospitals. Repeated education of mothers about correct umbilical cord care in hospital as well as at home is also necessary. World Health Organisation (WHO), The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), European Resuscitation Council (ERC) and in the Czech Republic The Czech Neonatology Organisation (ČSNeoS) deal with the issue of the umbilical cord care. Subject: The aim of the work was to find out the way in which the umbilical cord care in newborns from birth to the discharge to home care is performed in chosen infant wards and the way the mothers are educated about the umbilical cord care in chosen infant wards. Methodology: The practical part of the work was compiled on the basis of qualitative survey with a small set of respondents. The qualitative survey was made in a form of questioning and the technique of depth interview was used for the data collecting. This method was chosen because it helps to keep the content aspect of the interview and at the same time it provides space to the respondents to express their own opinions, feelings and experience about the subject of the interview. It also enables to see how the respondents understand the particular problem. The subsequent coding, categorization and content analysis of interviews was made easier thanks to the uniform composition of questions. Research set: The research set was assembled from three infant nurses/midwives and three mothers in purposely chosen infant wards in Valašské Meziříčí, Benešov and České Budějovice. Three criteria were set for choosing of the infant nurses/midwives. The first criterion was work in an infant ward without technical supervision (valid registration of the nurse in NCONZO), the second one was employment for at least one year in an infant ward and the third one was a visible identification of person. Two criteria were set for choosing of the mothers. The first criterion was mother?s newborn care in the form of rooming-in for at least 48 hours and the second one was that the mother and the newborn will be discharged to home care on the day of interview. Results : From the result of the research it is clear that the way of the newborn umbilical cord care in chosen infant wards differs in the umbilical cord care after the birth as well as in the subsequent care provided in the rooming-in care. The standard of the umbilical cord care in infant wards are set by the consultant and the head doctor of the ward and basically do not change, only in České Budějovice there was one change last year, when they accepted the latest AWHONN recommendation from 2007 which says that the cord stump should be left to fall off spontaneously. It follows that the infant ward in České Budějovice matches the WHO, AWHONN and ČNeoS recommendation the most, the infant ward in Benešov slightly differs in the procedure and the infant ward in Valašské Meziříčí treats the umbilical cord according the old standard of ČNeoS. Conclusion: The output of the work is a standard of nursing care in the newborn umbilical cord care which could serve as a uniform procedure in chosen infant wards.
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