CORD CARE

EVALUATION TOOL

NAME:

YEAR & SECTION: SCORE

INSTRUCTION:
1 0 REMARKS
Mark the appropriate column
To promote drying and healing of
the cord. To prevent infection
1. Able to state the objectives of the procedures
To provide comfort. To prevent foul
odor
2. Wash hands Perform steps in hand washing
3. Assemble all equipment needed
4. Expose the umbilical stump
To prevent dripping of solution into
5. Cover genitalia or circumcised area with baby’s layette the genitalia or circumcision stump
to prevent discomfort.
To soften dried blood and promotes
6. Drop 70% Isopropyl/ Refine alcohol to the baby’s umbilical cord
easily removal.
Able to give rationale why 70% Isopropyl alcohol or refined alcohol is
7. To keep the stump dry
use for cord care
Soak sterile cotton pledget or sterile cotton buds with 70% isopropyl
8.
alcohol
Able to give rationale why sterile cotton pledget or sterile cotton buds is
9.
used for cleaning
Clean umbilicus with sterile cotton pledget or sterile cotton buds in
10.
circular motion or rotary motion from inner to outer portion of the cord
Able to give rationale why umbilical stump is cleaned using circular or
11. To prevent infection
rotary motion
Discard used cotton pledget or cotton bud is waste receptacle /kidney
12.
basin
Drop refined or 70% isopropyl alcohol or refined alcohol to the umbilicus
13.
by avoiding dripping of solution to the genitalia or circumcision area
Able to give rationale for covering and avoiding dripping of alcohol to the
14. To prevent irritation
genitalia or circumcised area
15. Dry the umbilical cord by open dressing
Able to give rationale for not covering umbilical stump right after cord
16. Facilitates drying and healing.
care has been performed
17. Remove the cord clamp after 48 hours

18. Able to describe the condition of the umbilical cord after procedure

19. Do aftercare

20. Wash hands

TOTAL

PERFECT SCORE: 20 = 100%

________________________________
CI’s Signature over printed name

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 CORD CARE
EVALUATION TOOL

LEGEND:
1 SKILLED
0 UNSKILLED

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