EINC-checklist-SDRM (1).pptx

for assessing pregnant women

1. EINC PREPARED BY: SARAH DIANA ROSE S. MANALILI,RN ADOPTED FROM TEAM EINC, ADPCN

2. In advance prepare a decontamination solution by mixing 1 part % Chlorine bleach to 9 parts water to make 0.5% chlorine at the beginning of each day or wherever solution is very contaminated or cloudy.

3. Legend: Handle- Yellow Cord care – Red Assist – Blue Handle or Cord care – Orange Handle, Cord care and assist - Green

4. Prior to woman’s transfer to delivery room Ensure that the mother is in her position of choice while in labor. Ask the mother if she wishes to eat/drink or void. Communicate with the mother: inform with the progress of labor, give reassurance and encouragement

5. Woman at the delivery room: Preparing for delivery Check temperature in delivery room area to be in 25-28 C and eliminate air draft. Ask woman if she is comfortable in the semi upright position. Ensure woman’s privacy.

6. Remove all jewelry then wash hands thoroughly observing the WHO 1-2-3-4-5 procedure. Prepare a clean, clear newborn resuscitation area. Check the area if clean, functional and with in easy to reach. Arrange materials in linear sequence: Gloves, dry linen, oxytocin injection, cord clamp, cord pr bandage scissor, 2 kidney basins.

7. In a separate sequence, before after the 1 st breastfed. Eye ointment, stetoscope , Vitamin K 0.1 ml , Hepatitis B 0.5 ml, BCG vaccine, thermometer, cotton swab or cotton balls with ROH, dry cotton balls and waste receptacle. Clean the perineum with antiseptic solution Wash hands and put on 2 pairs of sterile gloves aseptically. (If same worker handles perineum and cord.)

8. At the time of delivery Encourage women to push as desired. Drape mother’s abdomen with clean linen in preparation for drying the newborn. Applied perineal support and control delivery of the head.

9. Call out time of birth and delivery of baby. Baby boy out 9:00 am Baby girl out 9:00 am Informed the mother of the outcome.

10. First 30 seconds Dry the baby for at least 30 seconds, starting from the face and head, going down to the trunk and lower extremities while performing a quick check for breathing.

11. 1 – 3 minutes Remove wet cloth. Place the baby in skin-to-skin contact on the mother’s abdomen or chest. Cover the baby with dry cloth and baby’s head with bonnet.

12. Excluded a second baby by palpating the abdomen in preparation for giving oxytocin. Use wet cloth to wipe the soiled gloves. Administer Oxytocin IM within 1 minute of baby’s birth. Dispose wet cloth properly. Remove 1 st set of gloves and decontaminate them properly in 0.5% Chlorine solution for at least 10 mins.

13. Palpate umbilical cord for pulsations. After pulsations stop, clamp the cord using the cord clamp 2 cm from the base. Place the instrument clamp or forcep 5 cm from the base. Cut near the cord clamp.

14. Perform the remaining steps of AMSTL Wait for strong uterine contractions then apply control cord traction and counter traction of the uterus, continuing until the placenta is delivered. Check VS every 15 mins for the 1 st hour then q 30 mins for the next hour and q hourly thereafter. Examine the placenta for completeness and abnormalities.

15. Clen the mother, flush the perineum and apply diaper. Check the baby’s color and breathing, check the mother if comfortable and uterus is contracted. Dispose the placenta in a leak proof container or yellow bag.

16. Decontaminate instruments in 0.5% Chlorine solution before cleaning and 2 nd pair of gloves before disposing for at least 10 mins. Advise mother to maintain skin to skin contact. Baby should be prone on mother’s chest/in between breast with head turned to one side.

17. 15-90 minutes Advise mother to observe for feeding cues and cited examples of feeding cues. Support and instruct mother on positioning and attachment. Wait for full breastfeeding. After a complete breastfeeding: administer eye ointment, inject Vit. K 0.1ml and Hepa Vaccine 0.5ml and perform antroprometric measurements.

18. Advise delayed/optional bathing of the baby. Advise breastfeeding per demand. In the 1 st hour check baby’s breathing, color and check mother’s VS and massaged uterus every 15mins. In the 2 nd hour chek mother baby dyad every 30 mins -1 hour. Complete all RECORDS