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Intrapartum and
Newborn Care:
A Step-by-Step
Guide
90% episiotomy
rates
NICU admissions
100%
80%
Skin-to-skin Contact
Real Breastfeeding Initiation
ENC
TRAINING
Weekly team
assess and
improve
60%
40%
20%
0%
39753.0
39995.0
40087.0
40210.0
Significant Results at
QMMC
COST
BLADE
P3
NGT
P7
Cotton
P 2.50
Alcohol
P5
Betadine
P5
Distilled Water
P 11.50
IVF (1L)
P 52.50
IV Set
P 14.50
IV Catheter
P 11.50
Suture
P 97
Flet Enema
P 200
Blade for
Shaving
P5
Rubber Bulb
P 36
Lidocane
P 15
TOTAL
P 465.50
6,670 x P465.50 =
P 3,104,885/yr
or
P 258,740.72
per month
Significant Results at
QMMC
M: 0.25 (0.080.77)
Skin-to-Skin
Contact
S: 0.40 (0.20
0.79)
SD: 0.39 (0.24
0.64)
M: 0.00
Appropriate
Initiation
&Duration of
Breastfeeding
Unnecessary
Suctioning
0.10
1.0
S: 0.17 (0.04
0.74)
SD: 0.18 (0.08
0.46)
M: 8.75 (2.60
29.4)
S: 4.49 (2.268.89)
SD: 4.44 (2.72
7.25)
11
Antenatal
Upon
arrival at
Facility
During
Labor
Prior to
Delivery
Perineal
Bulging
Time
Delivery
Mother
Support the perineum with
controlled delivery of the
head
First 30
secs
1 minute
to 3
minutes
Baby
Call out time of birth and
sex
Dry, check breathing
Put in skin-to-skin contact
Give Oxytocin IM
After excluding a 2nd baby
Do controlled traction of
cord with counter-traction
Massage the uterus gently
15-90
minutes
> 6 hours
Optional: Bathing
Linear Arrangement of
Instruments
Immediate and
Thorough
Drying
Early Skin
to Skin
ContactProperly-timed
ClampingNon-
Separation
of Mother
EINC in Cesarean
Section
20
EINC in Meconiumstained
Vigorous Baby
Normal Delivery?
24
Websites
Download the
Essential Newborn Care (ENC)
Training Videos from:
www.doh.gov.ph
://www.wp://www.wpro.who.int/philippines/Pu
bDocs.htm
http://www.wpro.who.int/philippines/Pub
Docs.htm
EINC Implementation
1. Organize a multidisciplinary EINC
Working
Group
Clinical
staf
Physicians - OB, Pedia, Anesthesia, Infection
Control
Nurses, nursing assistants, midwives
Administrative staf
Medical Director
Finance/ Budget Officer
PhilHealth Officer
Medical Social Service
Engineering
CSR
EINC Implementation
2. Conduct a situational analysis of
your
facility
Time and motion studies of deliveries
and immediate newborn care practices
May be done periodically to determine
effectivity of program implementation
3. Conduct saturation training workshops
for all staf
involved
in maternal
and
newborn
care
DR/OR,
NICU, OB
and Pedia
Wards,
ER staff
services utility workers
Institutional/
EINC Implementation
4.
EINC Implementation
6.
EINC Implementation
7.
Help us bring
to your community
III
Immediate
Newborn Care
(The First 90 minutes)
III
III
Care Prior
To Discharge
but after the first
90 minutes
V
V
Additional
Care
I
II
I
Essential
Newborn Care
From 90 min to 6
hours
IV
IV
Care after
Discharge
To 7 days
VI
VI
Enabling
The
Environment
VII
VII
Equipment
And Supplies
Maintenance
Checklist
32
III
Immediate
Newborn Care
(The First 90 minutes)
I
II
I
Essential
Newborn
From 90 min to 6
hours
33
III
III
Care Prior
To Discharge
but after the first
90 minutes
Breastfeeding
Warmth of the Baby
Hygiene
Sleeping
Danger Signs: serious illne
Signs of Jaundice and
Local Infection
Discharge Instructions
IV
IV
Care after
Discharge
To 7 days
Breastfeeding
Warmth of the Baby
Danger Signs
Very severe disease
V
V
Additional
Care
A. Newborn Resuscitation
B. Additional Care of a Small
Baby (or Twin):
Warmth, feeding support,
KMC, discharge planning
C. Dealing with Feeding
Problems:
Mother-infant separation,
manual expression of
breastmilk, cup feeding
VI
VI
Enabling
The
Environment
VII
VII
Equipment
And Supplies
Maintenance
Checklist
www.wpro.who.int/philippines/Pub
Docs.htm
40