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Rolls N, Gotfredsen JL, Vestergaard M, Hansen AS, Koblauch H. Importance of stoma care nurses in preparing patients for stoma surgery and adjustment to life with a stoma. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S32-S41. [PMID: 37682765 DOI: 10.12968/bjon.2023.32.16.s32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
BACKGROUND Stoma surgery is a life-changing event and patients must subsequently make significant adjustments to their lives. AIM The study set out to understand the level of interaction between patients and stoma care nurses (SCNs) in relation to preparing patients for stoma surgery and in adjustment to life with a stoma. METHODS Retrospective, self-reported questionnaires for patients and SCNs. FINDINGS Most patients (98%) with planned stoma surgery had pre-operative consultations with health professionals in contrast to 36% of patients with unplanned surgery, who did not. One third of patients with unplanned surgery did not feel prepared for life with a stoma based on the information provided during their hospital stay. Two thirds of the nurses reported having sufficient time to prepare patients for stoma surgery and to life with a stoma. CONCLUSION SCNs are key in preparing patients for surgery and for life with a stoma. Variations in care were experienced by patients having planned versus unplanned surgeries.
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Affiliation(s)
- Natasha Rolls
- Lead Stoma Care Nurse, University Hospitals Bristol and Weston NHS Foundation Trust
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Qassim T, Saeed MF, Qassim A, Al-Rawi S, Al-Salmi S, Salman MT, Al-Saadi I, Almutawea A, Aljahmi E, Fadhul MK, Juma IM. Intestinal Stomas-Current Practice and Challenges: An Institutional Review. Euroasian J Hepatogastroenterol 2023; 13:115-119. [PMID: 38222947 PMCID: PMC10785138 DOI: 10.5005/jp-journals-10018-1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/20/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction A stoma is an artificial anastomosis of the gastrointestinal tract to the abdominal skin wall to reroute the stream of feces. Fecal diversion, bowel decompression, and anastomosis protection are common indications for stomas. Relative to other surgical operations, stomas have a high morbidity rate, with rates averaging 40% and ranging 14-79%. The most common early complication was peristomal skin irritation. In contrast, parastomal hernias were the most common late complication. Methods This research was performed at King Hamad University Hospital (KHUH) in the Kingdom of Bahrain. Our study included patients who had undergone ileostomies and colostomies. The inclusion criteria included adult patients who are 15 years and older, both emergency and elective cases, and with ASA score of 1-4. The excluded patients were those who had had their stomas performed outside of KHUH and those who were not following up in the hyperbaric department of our hospital. This study was performed using a retrospective study design. The sample size was 98 which included patients with stomas that were following up with the hyperbaric team between January 2018 and February 2021. Results We have broken down the indications for stoma formation. The breakdown of all our documented complications are illustrated in the given figure. Conclusion Within our institutional study, 63.3% of stoma complications consisted of skin problems. This formed the majority of complications. Establishing a stoma care unit would offer continuous support and care to patients and help them in returning to an optimal quality of life. Additionally, this goal can be met through preoperative and postoperative education regarding surgery and stoma formation. This includes preoperative stoma marking and siting, as well as improved recovery through instruction from knowledgeable stoma care specialists regarding hands-on stoma care.Finally, patients can be assisted through specialized stoma clinics. How to cite this article Qassim T, Saeed MF, Qassim A, et al. Intestinal Stomas-Current Practice and Challenges: An Institutional Review. Euroasian J Hepato-Gastroenterol 2023;13(2):115-119.
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Affiliation(s)
| | - Mirza Faraz Saeed
- Department of General Surgery, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain
| | - Aya Qassim
- Royal College of Surgeons in Ireland, Bahrain
| | | | | | | | | | - Abdulaziz Almutawea
- Department of General Surgery, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain
| | - Eman Aljahmi
- Department of General Surgery, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain
| | - Mohamed Khalid Fadhul
- Department of General Surgery, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain
| | - Isam Mazin Juma
- Department of General Surgery, King Hamad University Hospital, Busaiteen, Muharraq, Bahrain
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Xu X, Zhou Y, Huang Y, Le Q, Lin L, Yu Z. Nursing Management of Abdominal Wound Dehiscence of an Infant With Severe Undernutrition and Peristomal Moisture-Associated Dermatitis After Ileostomy Closure: A Case Study. J Wound Ostomy Continence Nurs 2023; 50:331-336. [PMID: 37467414 DOI: 10.1097/won.0000000000000987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Abdominal wound dehiscence (AWD) is a costly postoperative complication; its management is particularly challenging for WOC nurses when it occurs secondary to an ostomy closure. CASE We present a case of AWD secondary to ileostomy closure in Baby Q, a 9-month 19-day-old female infant. A silver wound contact dressing was used on her dehisced wound followed by negative pressure wound therapy and adhesive tape to pull the wound edge together and promote granulation. We used a combination of enteral nutrition, parenteral nutrition, total parenteral nutrition, and total enteral nutrition adjusting the feeding plan stepwise according to her nutritional status. CONCLUSIONS Malnutrition and severe peristomal skin complications may contribute to the risk of AWD in infants undergoing reversal of a temporary ostomy. Assessing and treating nutritional status and peristomal skin is imperative before performing ostomy closure.
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Affiliation(s)
- Xiaofeng Xu
- Xiaofeng Xu, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Yiwen Zhou, MSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Ying Huang, MD, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Qian Le, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Lili Lin, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Zhuowen Yu, RN, MSN, WON, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yiwen Zhou
- Xiaofeng Xu, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Yiwen Zhou, MSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Ying Huang, MD, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Qian Le, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Lili Lin, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Zhuowen Yu, RN, MSN, WON, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Ying Huang
- Xiaofeng Xu, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Yiwen Zhou, MSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Ying Huang, MD, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Qian Le, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Lili Lin, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Zhuowen Yu, RN, MSN, WON, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Qian Le
- Xiaofeng Xu, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Yiwen Zhou, MSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Ying Huang, MD, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Qian Le, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Lili Lin, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Zhuowen Yu, RN, MSN, WON, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lili Lin
- Xiaofeng Xu, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Yiwen Zhou, MSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Ying Huang, MD, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Qian Le, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Lili Lin, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Zhuowen Yu, RN, MSN, WON, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zhuowen Yu
- Xiaofeng Xu, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Yiwen Zhou, MSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Ying Huang, MD, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Qian Le, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Lili Lin, BSN, RN, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Zhuowen Yu, RN, MSN, WON, Department of Gastroenterology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
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Guerra E, Denti FC, Di Pasquale C, Caroppo F, Angileri L, Cioni M, Parodi A, Fortina AB, Ferrucci S, Burlando M. Peristomal Skin Complications: Detailed Analysis of a Web-Based Survey and Predictive Risk Factors. Healthcare (Basel) 2023; 11:1823. [PMID: 37444657 DOI: 10.3390/healthcare11131823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/27/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive measures. This cross-sectional study involved data regarding 232 Italian patients with a stoma. A questionnaire was used to collect patient characteristics, comorbidities, and stoma management data. The most frequent PSCs observed were dermatitis and pruritis/xerosis in approximately 60% of patients. Psoriasis was strongly correlated with dermatitis, while being overweight or obese increased the risk of pruritis/xerosis. Class 2 obesity and atopic dermatitis were associated with an increased risk of infections. Being underweight, completely nonautonomous, and having inflammatory bowel disease were associated with a higher risk of ulcerations, while radiotherapy was a strong risk factor for ulceration. Preventive measures such as using hydrocolloid barriers, TNT gauze cleansing, and low pH detergent were effective in preventing dermatitis. Appropriate stoma care and maintenance, including the use of protective film and careful monitoring of weight and comorbidities, are crucial in minimizing the risk of complications associated with a stoma.
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Affiliation(s)
- Eliana Guerra
- Ambulatorio Riabilitazione Enterostomale, ASST Spedali Civili Brescia, 25123 Brescia, Italy
| | | | - Cristina Di Pasquale
- Stomal Therapy Outpatient Service, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Francesca Caroppo
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
| | - Luisa Angileri
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Cioni
- St Mary's Hospital, Imperial College NHS Trust, London W2 1NY, UK
| | - Aurora Parodi
- Di.S.Sal. Section of Dermatology, IRCCS San Martino Polyclinic Hospital, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
| | - Silvia Ferrucci
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Martina Burlando
- Di.S.Sal. Section of Dermatology, IRCCS San Martino Polyclinic Hospital, Largo Rosanna Benzi 10, 16100 Genoa, Italy
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Scientific and Clinical Abstracts From WOCNext® 2023: Las Vegas, Nevada ♦ June 4-7, 2023. J Wound Ostomy Continence Nurs 2023; 50:S1-S78. [PMID: 37632270 DOI: 10.1097/won.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Vendelbo G, Carlsson E, Tøndel LT, Myller E, Sternhufvud C, Simonsen KS, Munch P, Petersen B. Using peristomal body profile assessment to improve leakage-related quality of life for individuals with an ostomy. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:173-181. [PMID: 36828564 DOI: 10.12968/bjon.2023.32.4.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND Improper fitting between peristomal body profile and ostomy product(s) is one of the main reasons for leakage among individuals with an ostomy. AIM To evaluate clinical usability of the Body Assessment Tool developed by Coloplast that is available free of charge. The aim was also to study how changing to product(s) that were best suited to an individual, guided by peristomal body profile, affected the number of leakages and individuals' quality of life. METHODS The study consisted of questionnaires administered before and after the study, which spanned 4-5 weeks. A total of 22 nurses and 68 individuals with an ostomy participated in four Nordic countries. FINDINGS Of the 22 nurses, 21 recommended use of the tool. A shift to best fitting ostomy product(s) resulted in a significant decrease in the number of leakages (from 5.9 to 1.8 per 7 days) and a substantial improvement in quality of life. CONCLUSION The findings support the use of the Body Assessment Tool in clinical practice and the results showed that optimally fitting ostomy product(s) reduced the number of leakages and increased individuals' quality of life.
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Affiliation(s)
- Grethe Vendelbo
- Stoma Care Nurse, Regionshospitalet Gødstrup, Herning, Denmark
| | - Eva Carlsson
- Stoma Care Nurse, Surgical Department, Sahlgrenska University Hospital, Gothenburg, and Associate Professor, Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | | | - Elena Myller
- Stoma Care Nurse, Turku University Hospital, Turku, Finland
| | | | | | - Philip Munch
- Senior Market Manager, Coloplast Danmark A/S, Denmark
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Virgin-Elliston T, Nonboe P, Boisen EB, Koblauch H. Evaluating the Performance and Perception of a Stoma Bag Full-Circle Filter in People with a Colostomy or an Ileostomy-Two Randomized Crossover Trials. Healthcare (Basel) 2023; 11:healthcare11030369. [PMID: 36766947 PMCID: PMC9914626 DOI: 10.3390/healthcare11030369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Stoma bag filter-related issues, such as ballooning (the bag filling with gas), remain highly prevalent among users. The full-circle filter was purposely designed to reduce ballooning through the inclusion of a unique, full-circle pre-filter. Two similar randomized crossover trials were conducted to compare the performance of the full-circle filter with a dual filter in adults with a colostomy (n = 20) or an ileostomy (n = 20). The frequency of ballooning was significantly lower with the full-circle filter versus the dual filter in participants with a colostomy (p < 0.0007) and in participants with an ileostomy (p < 0.0001). No significant differences were observed in the frequency of other issues (pancaking, odor problems, and ostomy solution discretion) between the filters. On average, participants with an ileostomy wore ostomy solutions with the full-circle filter for 3.3 h longer than ostomy solutions with the dual filter (p < 0.0001); wear-time in users with a colostomy was comparable between the filters. Considering the lack of published research on stoma bag filters and the high prevalence of filter-related issues, these data provide important information for health care practitioners who support people living with a stoma.
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Affiliation(s)
- Tracey Virgin-Elliston
- Department of Colorectal Surgery, Chelsea and Westminster NHS Foundation Trust, London SW10 9NH, UK
| | | | | | - Henrik Koblauch
- Coloplast A/S, Holtedam 1-3, DK-3050 Humlebæk, Denmark
- Correspondence: ; Tel.: +45-4911-2311
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de Fries Jensen L, Rolls N, Russell-Roberts P, Vestergaard M, Jensen ML, Boisen EB. Leakage of stomal effluent outside the baseplate leads to rise in product usage and health professional interactions. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:8-19. [PMID: 36626266 DOI: 10.12968/bjon.2023.32.1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Leakage of stomal effluent outside the baseplate that soils clothes or bedsheets is a common problem for many people with a stoma and significantly impacts their quality of life. AIM To understand behavioural changes for people experiencing faecal leakage outside the baseplate regarding the usage of pouching systems, supporting products and interactions with health professionals. METHODS Retrospective, self-reported questionnaire. FINDINGS Respondents on average experienced 1.1 incidents of faecal leakage outside the baseplate per fortnight. In periods with issues of leakage, 21% of respondents had been in contact with health professionals, 40% increased their use of pouching systems, 25% increased their use of existing supporting products, and 21% included additional supporting products to their change routine. The increased use of healthcare resources was estimated to cost £32.47 in the 3 weeks following a leakage incident. CONCLUSION Incidents of leakage outside the baseplate lead to increased use of healthcare resources.
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Affiliation(s)
| | - Natasha Rolls
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Tonks N, Rolls N, Bain K, Russell-Roberts P, Bain M. Results of an audit of the Peristomal Body Profile Assessment Tool. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S4-S12. [PMID: 36519481 DOI: 10.12968/bjon.2022.31.22.s4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Leakage is the number one concern for people with an ostomy. The 2019 Ostomy Life Study, a global study of more than 5000 ostomates, showed that 92% of people living with a stoma worry about leakage. Getting the right stoma appliance for each patient is key to increasing patient quality of life. AIM The study was designed to assess the use of the Peristomal Body Profile Assessment Tool in helping choose the most appropriate stoma products for a given patient, decreasing incidents of leakage and peristomal skin complications. METHODS A multi-centre (33 sites, 147 patients) low-interventional clinical investigation was conducted in which the use of the Peristomal Body Profile Assessment Tool was evaluated as a tool to reduce incidents of leakage, increase peristomal skin health and increase patient quality of life. A focus group of randomised participating clinicians (n=16) was held to explore the audit results. RESULTS The assessment tool most often took between 2 and 5 minutes to complete. It supported clinicians in selecting the right appliance for each patient, avoiding leakages and preventing associated peristomal skin complications. The assessment tool helped improve the accuracy and quality of documentation in the patients' medical/nursing notes, increasing the quality and continuity of care. Participants reported that using the assessment tool helped reduce care costs by reducing the need for product changes, supporting product usage and return patient visits. CONCLUSION Use of the Peristomal Body Profile Assessment Tool helped clinicians choose the most appropriate stoma appliance the first time, resulting in patients having healthier peristomal skin, fewer leakages, more confidence in their stoma appliance and a higher quality of life.
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Affiliation(s)
- Nicola Tonks
- Lead Stoma Care Nurse, The Shrewsbury & Telford Hospital NHS Trust, Shrewsbury
| | - Natasha Rolls
- Lead Stoma Care Nurse, Bristol Royal Infirmary & Western Hospitals, Bristol
| | - Kimberly Bain
- Senior Partner, BainGroup Consulting, Kingston, Ontario, Canada
| | | | - Mark Bain
- Managing Parner, BainGroup Consulting, Kingston, Ontario, Canada
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McNichol L, Bliss DZ, Gray M. Moisture-Associated Skin Damage: Expanding Practice Based on the Newest ICD-10-CM Codes for Irritant Contact Dermatitis Associated With Digestive Secretions and Fecal or Urinary Effluent From an Abdominal Stoma or Enterocutaneous Fistula. J Wound Ostomy Continence Nurs 2022; 49:235-239. [PMID: 35523238 PMCID: PMC9093722 DOI: 10.1097/won.0000000000000873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Moisture-associated skin damage (MASD) occurs when skin is repeatedly exposed to various sources of bodily secretions or effluents, often leading to irritant contact dermatitis, characterized by inflammation with or without denudation of affected skin. In 2020, the Wound, Ostomy and Continence Nurses Society commissioned an initiative that led to the addition of multiple International Classification of Diseases, Tenth Revision, Clinical Modification codes (ICD-10-CM) for irritant contact dermatitis caused by various forms of MASD for use in the United States. In a recent issue of the Journal of Wound, Ostomy and Continence Nursing, a clinical practice alert identifying the various new codes was published that summarized each of the new codes and provided highlights of the descriptions for each of these codes. This is the second in a series of 2 follow-up articles providing a more detailed description of the MASD conditions to which the newest irritant contact dermatitis ICD-10-CM codes apply. Specifically, this article reviews the clinical manifestations and assessment, pathophysiology, epidemiology, prevention, and management of irritant contact dermatitis associated with digestive secretions from a stoma or fistula, and fecal or urinary effluent from an abdominal stoma or enterocutaneous fistula.
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Affiliation(s)
- Laurie McNichol
- Correspondence: Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, 11 Bluff Ridge Court, Greensboro, NC 27455 ()
| | - Donna Z. Bliss
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, WOC Nurse, Cone Health, Greensboro, North Carolina
- Donna Z. Bliss, PhD, RN, FGSA, FAAN, University of Minnesota School of Nursing, Minneapolis
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Mikel Gray
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, WOC Nurse, Cone Health, Greensboro, North Carolina
- Donna Z. Bliss, PhD, RN, FGSA, FAAN, University of Minnesota School of Nursing, Minneapolis
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
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Colwell JC, Stoia Davis J, Emodi K, Fellows J, Mahoney M, McDade B, Porten S, Raskin E, Sims T, Norman H, Kelly MT, Gray M. Use of a Convex Pouching System in the Postoperative Period: A National Consensus. J Wound Ostomy Continence Nurs 2022; 49:240-246. [PMID: 35523239 PMCID: PMC9093727 DOI: 10.1097/won.0000000000000874] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Convex pouching systems have been available for ostomy patients for decades; however, controversy remains over the use of convexity in the postoperative period. A group of 10 nurses and physicians with expertise caring for patients with an ostomy completed a scoping review identifying research-based evidence and gaps in our knowledge of the safety and effectiveness related to the use of a convex pouching system following ostomy surgery. Results of this scoping review demonstrated the need for a structured consensus to define best practices when selecting a pouching system that provides a secure and reliable seal around the stoma, avoids undermining and leakage of effluent from the pouching system, and contributes to optimal health-related quality of life for patients following ostomy surgery. The expert panel reached consensus on 8 statements for the use of convex products immediately after surgery and throughout the first 6 months after stoma creation, as well as describing goals in choosing the best pouching system for the patient with an ostomy.
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Affiliation(s)
- Janice C. Colwell
- Correspondence: Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, 1335 S. Prairie Ave, Chicago, IL 60605 ()
| | - Janet Stoia Davis
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Krisztina Emodi
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Jane Fellows
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Mary Mahoney
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Bethany McDade
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Sima Porten
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Elizabeth Raskin
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Terran Sims
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Holly Norman
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Matthew T. Kelly
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Mikel Gray
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
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Burgess-Stocks J, Gleba J, Lawrence K, Mueller S. Ostomy and Continent Diversion Patient Bill of Rights: Research Validation of Standards of Care. J Wound Ostomy Continence Nurs 2022; 49:251-260. [PMID: 35523241 PMCID: PMC9093730 DOI: 10.1097/won.0000000000000876] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
An estimated 725,000 to 1 million people are living with an ostomy or continent diversion in the United States, and approximately 100,000 ostomy surgeries are performed each year in the United States. As a result of ostomy surgery, bodily waste is rerouted from its usual path because of malfunctioning parts of the urinary or digestive system. An ostomy can be temporary or permanent. The ostomy community is an underserved population of patients. United Ostomy Associations of America, Inc (UOAA), is a nonprofit organization dedicated to promoting quality of life for people with ostomies and continent diversions through information, support, advocacy, and collaboration. Over the years, UOAA has received hundreds of stories from people who have received inadequate care. In the United States, patients receiving medical care have certain health rights. For ostomy and continent diversion patients, these rights are known as the "You Matter! Know What to Expect and Know Your Rights-Ostomy and Continent Diversion Patient Bill of Rights" (PBOR). These rights define and provide a guide to patients and health care professionals as to what the best practices are when receiving and providing high-quality ostomy care during all phases of the surgical experience. This includes preoperative to postoperative care and throughout the life span when living with an ostomy or continent diversion. In 2020, the National Quality Forum released "The Care We Need: Driving Better Health Outcomes for People and Communities," a National Quality Task Force report that provides a road map where every person in every community can expect to consistently and predictably receive high-quality care by 2030 (thecareweneed.org). One of the core strategic objectives this report stated is to ensure appropriate, safe, and accessible care. Actionable opportunities to drive change include accelerating adoption of leading practices. The adoption of the PBOR best practices will drive the health care quality improvement change needed for the ostomy and continent diversion population. There are concerns in the ostomy and continent diversion communities among patients and health care professionals that the standards of care outlined in the PBOR are not occurring across the United States in all health care settings. There are further concerns stated by health care professionals that the patient-centered recommendations outlined in the PBOR need to be strengthened by being supported with available published health care evidence. The work of this task force was to bring together members of UOAA's Advocacy Committee, members of the Wound, Ostomy, and Continence Nurses Society (WOCN Society) Public Policy and Advocacy Committee, and representatives from surgical organizations and industry to create a systemic change by validating through evidence the Ostomy and Continent Diversion PBOR. Through the work of the task force, each component of the PBOR has been substantiated as evidence-based. Thus, this article validates the PBOR as a guideline for high-quality standards of ostomy care. We show that when patients receive the standards of care as outlined in the PBOR, there is improved quality of care. We can now recognize that until every ostomy or continent diversion patient receives these health care rights, in all health care settings, will they truly be realized and respected as human rights in the United States and thus people living with an ostomy or continent diversion will receive "the care they need."
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Affiliation(s)
- Joanna Burgess-Stocks
- Joanna Burgess-Stocks, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
- Jeanine Gleba, MEd, UOAA Advocacy Manager
- Kathleen Lawrence, MSN, RN, CWOCN, WOCN Society Public Policy and Advocacy Coordinator
- Susan Mueller, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
| | - Jeanine Gleba
- Correspondence: Jeanine Gleba, MEd, United Ostomy Associations of America, Inc, PO Box 525, Kennebunk, ME 04043 ()
| | - Kathleen Lawrence
- Joanna Burgess-Stocks, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
- Jeanine Gleba, MEd, UOAA Advocacy Manager
- Kathleen Lawrence, MSN, RN, CWOCN, WOCN Society Public Policy and Advocacy Coordinator
- Susan Mueller, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
| | - Susan Mueller
- Joanna Burgess-Stocks, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
- Jeanine Gleba, MEd, UOAA Advocacy Manager
- Kathleen Lawrence, MSN, RN, CWOCN, WOCN Society Public Policy and Advocacy Coordinator
- Susan Mueller, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
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13
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Stoia-Davis J, Colwell JC, Emodi K, Fellows J, Mahoney M, McDade B, Porten SP, Raskin ER, Norman HS, Kelly MT, Sims T. Survey Results on Use of a Convex Pouching System in the Postoperative Period. J Wound Ostomy Continence Nurs 2022; 49:247-250. [PMID: 35523240 PMCID: PMC9093726 DOI: 10.1097/won.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to validate time frames for postoperative care following stoma surgery and to determine participants' current practice with convex pouching systems during the postoperative period. DESIGN A Cross-sectional survey. SUBJECTS AND SETTING The sample comprised 332 ostomy care specialists practicing in the United States. Most (n = 220; 66%) had more than 10 years' experience caring for patients with ostomies, 82% (n = 272) were certified WOC or ostomy care nurses (CWOCN and COCN), and 7% (n = 23) were board-certified colorectal surgeons. METHODS A 23-item online questionnaire was created for purposes of the study. Items in the questionnaire queried professional background and experience caring for patients with an ostomy. A single item was used to identify postoperative care periods following ostomy surgery. Additional items queried current practice patterns related to use of convex pouching systems and the timing of their use. Data were collected from January 18 to February 8, 2021. RESULTS Most respondents (n = 270; 90%) agreed with the following postoperative periods after ostomy surgery: immediate postoperative period (days 0-8); postoperative period (days 9-30); and transition phase (days 31-180). Most respondents (n = 274; 95%) indicated they would use a convex pouching system when clinically appropriate during the first 30 days following ostomy surgery and 79% (n = 228) indicated using a convex pouching system regardless of when the surgery was performed. Less than 1% (n = 2) indicated never using convexity within the first 30 days following stoma surgery, and only 3% (n = 8) indicated avoidance of convexity pouching systems in the immediate postoperative period. CONCLUSIONS Findings indicate that use of convexity during the postoperative period is prevalent to provide a secure seal and predictable wear time.
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Affiliation(s)
- Janet Stoia-Davis
- Correspondence: Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, 18038 Twin Lakes Dr, Riverside, CA 92508 ()
| | - Janice C. Colwell
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Krisztina Emodi
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Jane Fellows
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Mary Mahoney
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Bethany McDade
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Sima P. Porten
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Elizabeth R. Raskin
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Holly S. Norman
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Matthew T. Kelly
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Terran Sims
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
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Martins L, Andersen BD, Colwell J, Down G, Forest-Lalande L, Novakova S, Probert R, Hedegaard CJ, Hansen AS. Challenges faced by people with a stoma: peristomal body profile risk factors and leakage. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:376-385. [PMID: 35404660 DOI: 10.12968/bjon.2022.31.7.376] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM The Ostomy Life Study 2019 aimed to obtain a better understanding of the challenges faced by people with stoma. METHODS Online survey with participants from 17 countries. FINDINGS Of the 54 614 individuals invited to take part, 5187 responded; 62% of the respondents avoided physical and social activities because of their stoma and 37% had never consulted their stoma care nurse to have the fit of their stoma product checked. In a subgroup receiving questions on leakage (n=4209), output under the baseplate and leakage onto clothes were experienced within the previous month by 76% and 26% of respondents, respectively. Higher chance of leakage was associated with an irregular stoma shape and peristomal body profile; a stoma level at or below the skin surface; and the presence of creases, folds and other changes in the peristomal area. CONCLUSION Leakage and access to a stoma care nurse to provide the necessary care and guidance remain important concerns for individuals with a stoma.
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Affiliation(s)
- Lina Martins
- Clinical Nurse Specialist, Wound, Ostomy and Continence, London Health Sciences Centre, London, Ontario, Canada
| | | | - Janice Colwell
- Advanced Practice Nurse, Ostomy and Wound Care, University of Chicago Medicine, Chicago, Illinois, USA
| | - Gillian Down
- previously Nurse Consultant Stoma Care, Bristol; North Somerset and South Gloucestershire Clinical Commissioning Group, Bristol, UK
| | | | - Svatava Novakova
- Enterostomal Therapist, Masaryk Hospital, Surgery Department, Ústí nad Labem, Czech Republic
| | - Rosalind Probert
- Clinical Nurse Consultant Stomal Therapy, Wound Management Department, Division of Surgery, Queensland, Australia
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15
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Aibibula M, Burry G, Gagen H, Osborne W, Lewis H, Bramwell C, Pixley H, Cinque G. Gaining consensus: the challenges of living with a stoma and the impact of stoma leakage. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S30-S39. [PMID: 35333550 DOI: 10.12968/bjon.2022.31.6.s30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND People with a stoma face many unique challenges. Leakage is a significant one but is not sufficiently discussed within the wider area of health and social care. AIMS This study aimed to articulate and achieve consensus on the problems experienced by people with a stoma, particularly leakage, in the hope of encouraging conversations among patients, clinicians and policymakers on how to solve them. METHODS Output from a modified Delphi panel, consisting of patient groups, was used to create a set of calls to action, with a particular focus on the issue of leakage. FINDINGS Leakage has a large impact on daily life and can cause both physical and mental health difficulties. Peer support and specialist care can be offer considerable benefits in dealing with these. CONCLUSIONS There are significant unmet needs for equitable access to specialist stoma care and peer support, as well as information provision for non-specialist healthcare providers. The calls to action should be implemented.
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Affiliation(s)
| | - Gill Burry
- Market Access Programme Manager, Payers and Evidence, Coloplast
| | - Hannah Gagen
- Head of Government Affairs and Patient Advocacy, Coloplast
| | | | | | - Caroline Bramwell
- PR and Communications Manager, Ileostomy & Internal Pouch Association UK
| | - Hazel Pixley
- Chief Executive Officer, Urostomy Association UK
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16
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Pittman J, Colwell J, Mulekar MS. Ostomy Complications and Quality of Life of Ostomy Support Belt/Garment Wearers: A Web-Based Survey. J Wound Ostomy Continence Nurs 2022; 49:60-68. [PMID: 35040815 PMCID: PMC8768503 DOI: 10.1097/won.0000000000000843] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to examine ostomy complications and health-related quality of life (QOL) in individuals with an ostomy who wear an ostomy support belt/garment. DESIGN A mixed-methods descriptive study. SUBJECTS AND SETTING Two hundred two community-living adults with an ostomy were recruited using an industry distribution list. The target sample had no geographic restrictions. METHODS Descriptive analysis was conducted for all outcomes. Participants were separated into groups depending on type of ostomy belt or belt/garment worn or none. All categorical data were summarized using percentages and numerical data using mean ± standard deviation. Association between categorical factors was evaluated using a χ2 test and proportions of occurrences from 2 groups were compared using a 2-proportion z-test. The mean outcomes for 2 or more groups were compared using t tests or analysis of variance (ANOVA), respectively. If ANOVA showed difference among groups, post hoc analysis of group means was conducted using Tukey's Honestly Significant Difference (HSD) test. RESULTS Two hundred two respondents completed the survey. Of the 174 participants who responded to the survey question on leakage, 157 (90%) reported experiencing leakage and 135 (77.59%) reported rash or skin irritation. Comparison of whether participants had ever experienced a leakage event was not significantly different across groups (P = .3663). Those who wore an ostomy support belt/garment reported leakage less often (less than once a month) versus respondents who wore other types of belts or no belt (n = 49, 73.13% vs n = 53, 59.55%; P = .0388). Of the 174 participants who responded to the peristomal skin question, 135 (77.59%) participants reported peristomal skin complications. Significantly fewer participants who wore an ostomy support belt/garment reported having peristomal skin irritation compared to those who wore other types of belts or no belt (69.01% vs 84.16%; P = .0080). The mean cumulative total City of Hope Quality of Life (COH QOL) Ostomy score for all participants was 6.45 ± 1.36 out of 10, with the psychosocial domain scoring the lowest at 5.67 ± 1.30 out of 10. No significant differences were observed in mean QOL domain and total scores by those who wore an ostomy support belt/garment, other type of belt/garment, and none. When comparing COH QOL mean scores and leakage frequency of more/less once a month, those who reported leakage more often had significantly worse QOL scores in all 4 domains as well as total scores: physical (P = .0008), psychological (P = .0154), social (P = .0056), spiritual (P = .0376), and total COH QOL score (P = .0018). CONCLUSION This study provides important information related to ostomy complications and QOL associated with wearing an ostomy belt or belt/garment. The use of an ostomy support belt/garment may offer an additional intervention to decrease frequency of leakage and peristomal skin irritation and improve QOL.
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Affiliation(s)
- Joyce Pittman
- Correspondence: Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, 5721 USA Dr N, 2037G, Mobile, AL 36688 ()
| | - Janice Colwell
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Janice Colwell, MS, APRN, CWOCN, FAAN, University of Chicago Medical Center, Chicago, Illinois
- Madhuri S. Mulekar, PhD, University of South Alabama, Mobile
| | - Madhuri S. Mulekar
- Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile
- Janice Colwell, MS, APRN, CWOCN, FAAN, University of Chicago Medical Center, Chicago, Illinois
- Madhuri S. Mulekar, PhD, University of South Alabama, Mobile
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Down G, Vestergaard M, Ajslev TA, Boisen EB, Nielsen LF. Perception of leakage: data from the Ostomy Life Study 2019. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S4-S12. [PMID: 34889680 DOI: 10.12968/bjon.2021.30.22.s4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Leakage is a common problem for people with a stoma. AIM To investigate how people with a stoma and stoma care nurses perceive different patterns of effluent under the baseplate. METHODS The Ostomy Life Study 2019 included a user survey and a nurse survey covering experiences of leakage and the perception of leakage. FINDINGS Most people with a stoma perceived effluent reaching outside the baseplate as leakage (88-90%), whereas effluent close to the stoma only was not perceived as leakage by the majority (81-91%). Effluent covering major parts of the baseplate was perceived as leakage by most respondents with a colostomy or ileostomy (83%), whereas fewer respondents with a urostomy perceived this as leakage (57%). Most of the nurses (70%) did not perceive effluent close to the stoma as leakage. CONCLUSION This study revealed that effluent confined to the area next to the stoma is generally not perceived as leakage.
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Affiliation(s)
- Gillian Down
- previously Nurse Consultant Stoma Care, Bristol; North Somerset and South Gloucestershire Clinical Commissioning Group, UK
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18
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Villa G, Crafa A, Denti F, Grilli M, Passafiume S, Sarritzu G, Spena PR, Maculotti D. SACS Evolution: a peristomal health tool for the prevention of peristomal skin disorders. Minerva Surg 2021; 76:423-428. [PMID: 34814654 DOI: 10.23736/s2724-5691.21.09171-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The ostomy patient's quality of life also depends on their peristomal health and thus first and foremost on keeping healthy peristomal skin. This is by no means an easy task, given that the incidence of peristomal skin disorders can be a factor in up to 80% of cases. Over the past 15 years, several tools have been developed to classify peristomal skin lesions to facilitate the management of the problem. These tools, however, meet the needs of healthcare professionals and those of patients. Hence the decision to work on an advanced version of the SACS©, currently the most widely used tool, with the setting up of the SACS Evolution Consensus Group. METHODS By applying the simplified Delphi method, the SACS Evolution Consensus Group critically re-read what had been garnered from the literature in the light of their personal clinical experience, identified the key issues to be addressed, and processed and refined the relevant statements. This made it possible to achieve the challenging objective of creating a peristomal health tool to help prevent peristomal skin lesions. RESULTS SACS Evolution is, indeed, a promising tool for preventing peristomal lesions. It is structured on two different levels, one for the patient and one for the healthcare professional, each characterized by specific language and based on an innovative concept of healthy peristomal skin, which is essential for those who work on peristomal health. CONCLUSIONS The SACS Evolution Consensus Group thus aims to validate this peristomal health tool and has already started a validation process so that the tool can be used in clinical practice.
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Affiliation(s)
- Giulia Villa
- Center for Nursing Research and Innovation, Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy -
| | - Antonio Crafa
- Ostomates Clinic, Unit of Emergency Medicine, Sacro Cuore di Gesù-Fatebenefratelli Hospital, Benevento, Italy
| | - Francesco Denti
- Clinic for Ostomate Rehabilitation, Department of Surgery and Emergency Traumatology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Matteo Grilli
- Ostomates Clinic, Unit of Surgery, Fermo Hospital, Area Vasta n. 4, Fermo, Italy
| | | | - Giovanni Sarritzu
- Stomatherapy Clinic, Monserrato Hospital, A.O.U. Cagliari, Cagliari, Italy
| | - Pier R Spena
- Federazione Associazioni Incontinenti e Stomizzati, Milan, Italy
| | - Danila Maculotti
- Clinic for Ostomy and Pelvic Floor Rehabilitation, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy
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Ber FL. Novel stoma appliances to minimise complications and improve patient outcomes. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S4-S10. [PMID: 34514827 DOI: 10.12968/bjon.2021.30.16.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Stomas are created for a number of reasons and, if they are formed without the opportunity for preoperative care and consideration, such as siting, stoma care needs can be more complex in the long term. Patient quality of life can be negatively affected by the incidence of stoma related complications, such as leakage or sore skin. A new range of products, Aura Plus, distributed by CliniMed Ltd in the UK, were evaluated on more than 200 patients with a stoma and assessed for comfort, ease of application, security and leakage. Case studies highlight positive patient outcomes following the use of Aura Plus, and demonstrate how Aura Plus can benefit patients experiencing different needs with their stoma care, such as leakage, peristomal skin complications or a parastomal hernia.
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Affiliation(s)
- Fiona Le Ber
- Clinical Nurse Specialist for Bladder and Bowel, Family Nursing & Home Care, Jersey; Queen's Nurse; Acting Vice Chair, Royal College of Nursing Bladder & Bowel Forum
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20
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Heerschap C, Butt B. Algorithmic approaches to ostomy management: An integrative review. Nurs Open 2021; 8:2912-2921. [PMID: 34467661 PMCID: PMC8510707 DOI: 10.1002/nop2.1044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/23/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this review is to describe approaches to ostomy management utilizing algorithmic approaches found within the literature. Design An integrative review approach was used based on a modified Cooper's five‐stage research review framework. Data Sources Systematic searches occurred using the CINAHL and MEDLINE databases searching for peer‐reviewed, English publications. Review Methods There were 640 articles identified through the review process, 608 of which were excluded based on title and abstract review. The remaining 12 articles were assessed in full text after which two studies were removed as duplicates and six studies were excluded based on inclusion/exclusion criteria. Four studies were included in this synthesis. Studies were critically analysed using a critical appraisal tool developed for both qualitative and quantitative study assessments. Results Utilizing inductive content analysis, included literature was presented within two categories: validation of ostomy algorithms and implementation of ostomy algorithms in practice. Four themes emerged from these categories including the following: algorithm validation, identifying underlying causes, focus on accessories and large‐scale implementation. Conclusion No currently available validated algorithms published in full were found during this literature review. Current literature demonstrates the potential benefit for ostomy management algorithms to standardize and improve ostomy patient care. Impact This study sought to determine the availability and supporting research of ostomy management algorithms which may assist in standardizing and improving ostomy care. This review has demonstrated a lack of available ostomy management algorithms. Given the potential benefit of ostomy algorithms identified within the literature, further studies should be completed to develop, validate and test new ostomy management algorithms.
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Affiliation(s)
- Corey Heerschap
- Royal Victoria Regional Health Centre, Barrie, ON, Canada.,School of Nursing, Queens University, Kingston, ON, Canada
| | - Britney Butt
- North York General Hospital, Toronto, ON, Canada
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21
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Ferreira BCS, Martins SS, Cavalcante TB, Junior JFS, Carneiro SCDS. INDICADORES SOCIODEMOGRÁFICOS E DE SANEAMENTO E MORADIA NA QUALIDADE DE VIDA DE PESSOAS COM ESTOMIA. ESTIMA 2021. [DOI: 10.30886/estima.v19.1103_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo:Analisar as relações entre a qualidade de vida (QV) de pessoas com estomia com indicadores sociodemográficos, clínicos, de estilo de vida, de saneamento e moradia. Métodos: Estudo transversal com amostra de 106 indivíduos com estomia entrevistados de maio a dezembro de 2019. Utilizou-se um questionário sociodemográfico e clínico e o City of Hope - Quality of Life - Ostomy Questionnary. Resultados: O bem-estar espiritual (7,71±1,09) foi o domínio com melhor performance. A QV não diferiu entre homens e mulheres (p = 0,372), porém esteve associada à escolaridade (< 0,001) e renda familiar (p = 0,025), ao diabetes (p = 0,008) e etilismo (p = 0,044), às condições da água para consumo (p < 0,001), ao destino do lixo (p = 0,021), em ter energia elétrica (p = 0,034), ao tipo de moradia (p = 0,026) e ao número de cômodos (p = 0,023) e tipo de cobertura da habitação (p = 0,021). Conclusão: Piores indicadores socioeconômicos, de saneamento básico e moradia, parecem impactar negativamente a QV de pessoas com estomias.
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Ferreira BCS, Martins SS, Cavalcante TB, Junior JFS, Carneiro SCDS. SOCIODEMOGRAPHIC AND SANITATION AND HOUSING INDICATORS ON THE QUALITY OF LIFE OF PEOPLE WITH STOMA. ESTIMA 2021. [DOI: 10.30886/estima.v19.1103_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: To analyze the relationships between the quality of life (QOL) of people with stoma with sociodemographic, clinical, lifestyle, sanitation, and housing indicators. Method: Cross-sectional study with a sample of 106 individuals with stoma interviewed from May to December 2019. A sociodemographic and clinical questionnaire and the City of Hope Quality of Life Ostomy Questionnaire were used. Results: Spiritual well-being (7.71 +/-1.09) was the best performing domain. Quality of life did not differ between men and women (p = 0.372), but was associated with education (< 0.001) and family income (p = 0.025), diabetes (p = 0.008) and alcoholism (p = 0.044), drinking water conditions (p < 0.001), garbage disposal (p = 0.021), having electricity (p = 0.034), housing type (p = 0.026), number of rooms (p = 0.023), and housing coverage (p = 0.021). Conclusion: worse socioeconomic, sanitation, and housing indicators appear to negatively impact the QOL of people with stomata.
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Abstract
The Wound, Ostomy, and Continence Nurses (WOCN) Society identified the need to define and promote peristomal skin health. A task force was appointed to complete a scoping literature review, to develop evidence-based statements to guide peristomal skin health best practices. Based on the findings of the scoping review, the Society convened a panel of experts to develop evidence- and consensus-based statements to guide care in promoting peristomal skin health. These consensus statements also underwent content validation using a different panel of clinicians having expertise in peristomal skin health. This article reports on the scoping review and subsequent 6 evidenced-based statements, along with the generation and validation of 19 consensus-based statements, to assist clinical decision-making related to promoting peristomal skin health in adults.
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Chabal LO, Prentice JL, Ayello EA. Practice Implications from the WCET® International Ostomy Guideline 2020. Adv Skin Wound Care 2021; 34:293-300. [PMID: 33979817 DOI: 10.1097/01.asw.0000742888.02025.d6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
GENERAL PURPOSE To introduce the 15 recommendations of the International Ostomy Guideline (IOG) 2020, covering the four key arenas of education, holistic aspects, and pre- and postoperative care; and to summarize key concepts for clinicians to customize for translation into their practice. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will:1. Analyze supporting evidence for the education recommendations in the IOG 2020.2. Identify a benefit of the International Charter of Ostomate Rights.3. Distinguish concepts related to pre- and postoperative ostomy-related care.4. Select a potential barrier to IOG 2020 guideline implementation.
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Voegeli D, Karlsmark T, Eddes EH, Hansen HD, Zeeberg R, Håkan-Bloch J, Hedegaard CJ. Factors influencing the incidence of peristomal skin complications: evidence from a multinational survey on living with a stoma. ACTA ACUST UNITED AC 2020. [DOI: 10.12968/gasn.2020.18.sup4.s31] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Leakage of stomal effluents underneath the baseplate or inappropriate removal of stoma appliances can cause peristomal skin complications (PSCs), which are known to have many negative implications for people with a stoma. While numerous studies have examined the causes of PSCs, less is known about what drives the risk of a PSC developing. To address this gap in knowledge, the largest multinational survey to date was conducted, including 4235 people with a stoma on four continents and in 13 countries. The survey revealed that, besides leakage, other factors, such as age, gender, time since surgery and type of stoma, also drive the risk of PSCs. The survey also revealed that having a PSC resulted in greater use of stoma accessories and more frequent contact with health professionals, increasing overall healthcare costs. Collectively, the survey results reveal a need for more awareness on the risk factors for PSCs, which subsequently could have a positive effect on healthcare spending.
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Affiliation(s)
| | | | | | | | - Rikke Zeeberg
- Senior Insights Manager, Coloplast, Humlebæk, Denmark
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