Research presentation for the first international nursing research conference of the world academy of nursing science september 2009
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This study compares the effects of 70% isopropyl alcohol, plain normal saline solution, and sterile water on newborn umbilical cord separation. The findings indicate that plain normal saline resulted in the shortest separation time (mean of 6.50 days), while 70% isopropyl alcohol showed the longest time (mean of 9.56 days), and no infections were reported in any treatment group. The conclusion advocates against the use of alcohol for umbilical cord care, suggesting it delays healing.
Research presentation for the first international nursing research conference of the world academy of nursing science september 2009
- 1. Effects of 70% Isopropyl Alcohol, Plain NSS & Sterile Water On Umbilical Cord Separation Monina Hernandez Gesmundo, RN,RM,MAN(C) September 19, 2009 The First International Nursing Research Conference of the World Academy of Nursing Science Kobe International Exhibition Hall, Kobe, Japan
- 2. Objective To identify and compare the effects of using 70% Isopropyl Alcohol, Plain Normal Saline Solution & Sterile Water in the care of the newborns umbilical cord
- 3. Design Prospective randomized controlled trial design
- 4. Setting Postpartum ward of a tertiary-level government hospital in the Philippines
- 5. Study Participants Sample size of thirty (n = 30) singleton, full-term newborns roomed-in at the postpartum ward of a tertiary-level government hospital
- 6. Sampling Design Random assignment with ten (10) newborns in each of the 70% Isopropyl Alcohol, Plain NSS and Sterile Water group Twenty-six (26) completed the study with nine (n = 9) in the Sterile Water group (Group A), eight (n = 8) in the Plain NSS group (Group B) and nine (n = 9) in the 70% Isopropyl Alcohol Group (Group C)
- 7. Bioethical Considerations Principle of beneficence Principle of respect for human dignity Informed consent Principle of justice
- 8. Interventions Mothers were taught to clean the newborns umbilical cord according cord care protocol handwashing before cord care clean equipments use respective solutions proper direction of wiping done three times a day cord is exposed to air and allowed to dry
- 9. Interventions Cord care was done daily until the cord fell-off A checklist of signs of infection was accomplished daily both by the investigator and the mother during hospitalization, and by the mother upon discharge Follow-up phone calls and home visit was done by the investigator to ascertain mothers compliance to the cord care protocol and to assess the cord status
- 10. Main Outcome Measures Length of cord separation time Maternal concerns with regard to the state of their newborns cords and cord care treatment Umbilical cord infection Cost of cord care
- 11. Data Presentation Length of Cord Separation Time (days) Grouped Frequency Distribution of Length of Cord Separation Time 油 Length of Cord Separation Time (in days) Sterile Water Plain NSS Isopropyl Alcohol 油 freq 油 % 油 freq 油 % 油 freq 油 % Less than 5 days 1 11.1 1 12.5 0 0 5-15 days 8 88.9 7 87.5 9 100.0 More than 15 days 0 0 0 0 0 0 Total 9 100.0 8 100.0 9 100.0 Mean 7.11 days 6.50 days 9.56 days Median 7.00 days 7.00 days 10.00 days
- 12. Length of Cord Separation Time (days)
- 13. Length of Cord Separation Time Plain Normal Saline Solution had the shortest length of cord separation time with a mean of 6.50 days (S.D. = 1.85 days ), followed by Sterile Water with a mean of 7.11 days ( S.D. = 2.32 days ). 70% Isopropyl Alcohol had the longest length of cord separation time with a mean of 9.56 days ( S.D. = 2.07days ).
- 14. Signs of Cord Complication
- 15. Maternal Concerns 15% of mothers reported signs of complications - redness at the base, reddish or yellowish discharge at the time of cord separation and mild odor. There was no reported sign of bleeding from the cord.
- 16. Percentage of Mothers Who Observed Signs of Cord Complication
- 17. Umbilical Cord Infection None of the newborns developed cord infection based on the assessment of both the investigator and the attending physician.
- 18. Cost of Cord Care
- 19. Cost of Cord Care Comparing the mean price per milliliter of the three solutions - Sterile Water is the cheapest cord care solution at PhP 0.054, followed by PNSS at PhP 0.058. 70% Isopropyl Alcohol is the most expensive at PhP 0.080 per milliliter.
- 20. Results of Statistical Analysis Length of Cord Separation Time One-way Analysis of Variance (ANOVA) showed a statistically significant difference (significance level of p = 0.014, p < 0.05) in the length of cord separation time between the different cord care solutions.
- 21. Where is the difference? Scheffe post hoc test results showed a statistically significant difference(significance level of p = 0.022, p < .05) in the length of cord separation time between Plain Normal Saline Solution and 70% Isopropyl Alcohol .
- 22. Maternal Concerns All mothers (100%) rated their newborns cord status and cord care treatments as walang problema (no perceived problem) despite reports of signs of cord complication .
- 23. Cost of Cord Care There is no statistically significant difference between the cost of Sterile Water, Plain Normal Saline and 70% Isopropyl Alcohol ( p = 0.613, p > 0.05) .
- 24. Conclusion The length of cord separation time is shortest in the Plain Normal Saline Solution Group and longest in the 70% Isopropyl Alcohol Group. Signs of complication were noted in the different cord care treatment groups but none of the newborns developed cord infection.
- 25. Conclusion This study supports literature that suggests cleaning with alcohol delays healing and drying of the umbilical stump (Cabalum, R., 1996; Dore, S. et al, 1998; WHO, 1999; Largo, J.M & Nafarete, M., 2000).
- 26. Conclusion This study does not support the use of 70% Isopropyl Alcohol for newborn cord care.
- 27. Nurses, lead the way! ( End of Presentation)