Every Patient, Every Time:; The Establishment of Continuity of Care for Ostomy Patients at Columbus Regional Hospital

During the 5 months our hospital was closed related to the flood of 2008 both staff and physicans practiced at surrounding healthcare settings.  Upon our reopening it was qucikly identified that many aspects of care that were "hard wired" before the flood had become unraveled.  One of the aspects of care that was unraveled was the timely, consistent care of the new ostomy patient and existing ostomy patient admitted to acute care with a different primary diagnosis. 

This lack of consistency in care delivery negatively impacted the quality of care provided to ostomy patients and their significant others. Mandatory housewide nursing education was provided prior to the reopening of our facility.  Because of this, it was felt that education itself was not the problem.  The new reopening nursing model brought many changes and nursing was feeling overwhelmed with these changes.

The WOCN wanted to decrease the frustration of the nursing staff but felt that timely, consistent, quality nursing care was the right of every ostomy patient.  With surgeon support,  a standing order set for all ostomy patients was developed.  This order set allows the physician  to identify the specific orders to be implemented for the ostomy patient both  pre and postoperatively.  The order choice selection was  approved housewide by the physicians.  Thus  the WOCN or admitting nurse, when approprite ,can select the orders specific to the existing  ostomy patient's needs.  These orders are then transfered  to the electronic patient record and become a part of the patient's  plan of care.  In addition, the ostomy patient  has two outpatient  standing orders. This provdes for timely  OP followup with the WOCN.

The adoption of this standing order set assures that every  ostomy patient will receive timely, consistent, quality ostomy care every time.