Evidence based practice poster board in-service video
Hello welcome to the august presentation of the evidence based practice council’s education for the month this month we’re presenting chlorhexidine umbilical cord care in contrast to the dry care that we have previously practiced here at the facility if you will view the presentation board along with me you will be able to benefit the most from the presentation first
Of all our pico subject for the month included the question in neonates 28 days and under is chlorhexidine more effective than dry care at preventing adverse events in umbilical cord care including on the lightest granulomas erosion lesion bleeding discharge foul odor and overall parent concern as well as we move on to purpose you’ll see that each of these areas
Is important but overall the stress and concern that it causes the parents increases in number of phone calls we receive extra medications and the hospital additional treatments increased risk of morbidity and mortality as well as additional clinic visits on the outpatient side one thing that you’ll notice about the presentation this month is the presentation does
Apply not only to the inpatient setting but the outpatient setting as well both of these clinical areas will be viewing this so you might hear information you’re not used to hearing as the presentation is intended to cover both of the areas the purpose for our video this month is intended to educate nurses to provide evidence-based care that is actually a change
In what our policy procedure has been as well as to prepare the nurses to educate parents better this cord care will be done much more often by parents in the home setting than it will be by nurses any of the clinical settings we used the crucial appraisal skills program to evaluate multiple different clint random controlled clinical trials that had been done as
Well as meta-analysis to confirm which articles supported the evidence to way most adequately whether dry care super hebda dean or some other method of treatment of core care was most effective across the board each study did come back showing that chlorhexidine was more effective than any of the other treatments of all the articles that we reviewed three did come
To the top as being most reliable most valid in their findings and most pertinent to our setting the first one of those was the study effects of topical application of core hexa diene for umbilical cord care compared with conventional dry care on the risks of neonatal sepsis this did prove to be a valid study it was well conducted the results are reliable they do
Meet the standards of high quality nursing research and so therefore their findings showing that blood culture proven sepsis was much lower in the chlorhexidine group than in the dry care group confirmed that this evidence-based practice is important for us to implement the next important article that was researched by the committee was higher rates of cord related
Adverse events in neonatal with dry umbilical care cord care compared to four hexa diene powder it is important to note in years past chlorhexidine swabs were used for cord care but it has been and that because the chlorhexidine slobs do contain alcohol absorption of the chlorhexidine was being found within the blood streams of the anthon so it is important in
This cord care instructions that chlorhexidine powder is what is recommended not swab this study as well did result in high quality nursing research value it was valid to the situation the findings were pertinent for our setting this was a icu i’m sorry a nicu study that looked at the effects of randomly assigned infants to each of the group and did conclude again
That the chlorhexidine group had much lower rates of infection but in addition cord dropped off similar much less bleeding much less discharge there are seven different categories of adverse events that were listed in this study and across the board the core exiting group did better than as far as a number of patients having problems than did riker the last studies
Included here is a meta-analysis of multiple studies that have been done it did find substantially improved mortality rates infant mortality these studies that were evaluated in many of the cases were in third world countries but did show substantial improvements especially in the home birth category for infants that were treated with core hexa diene at time of
Delivery and on a daily basis in each of these studies that was the standard of practice that was recommended one of the studies did recommend that the chlorhexidine powder be applied with each diaper change the rest of the studies did recommend at least daily treatment with the chlorhexidine powder you can view the statistics here for more details on the actual
Success rate we have included some graphics as well so you can see some of the tables as well as the research links are listed at the side in the citations so you can look up the research articles if you care to view more detail the research committee did conclude that these were high quality nursing research and thus decided this is the new standard practice for
Our clinic areas thank you so much for attending the presentation today and we look forward to seeing you next month thank you
Transcribed from video
Chlorhexidine cord care By Dannette Wygal