Ostomy-Evidence-Based Interventions

Abstract

There was a clear need for an ostomy care continuum for optimal patient care. This continuum needed to begin preoperatively for the best outcomes. Patients who were unmarked preoperatively for ostomy surgery often had poorly sited stomas, and more pouching difficulties such as decreased weartime, and leaking. Preoperative stoma marking leads to well-placed stomas and effective pouching and improved quality of life. Our objective was for patients to have optimal stomas and improved adaptation to life with an ostomy. There was a need for increased awareness among the surgeons for the importance of preoperative marking and teaching. We wanted to identify patients preoperatively and track them throughout their postoperative phases. Practice changes began with meetings with surgeons to raise awareness of the ostomy nurse's function. The surgeons' secretaries became involved to assure pending ostomy surgery patients were identified for stoma marking. The patient receives the first postoperative lesson after surgery, involving changing the pouch and providing verbal and written instruction. New ostomy patients area seen throughout their hospitalization and electronic discharge instructions are entered by the ostomy nurse. Patients are seen for their first postoperative appointment along with the surgeon. This provides another opportunity for teaching, support and evaluation of the pouching system. Ongoing care is at the ostomy nurses' clinic. We believe that patients' outcomes improve with these interventions during their care continuum. Decreased amount of products and decreased use of pouching accessories reveals effective pouching is being obtained. Patients have improved quality of life with a well-placed stoma; there are fewer problems with achieving ideal weartime. The poster presentation will include digital stoma pictures comparing and contrasting stomas that were marked preoperatively and ones that were not marked.