Purpose: Patients having a fecal or urinary diversion are being discharged faster from the hospital. With shorter hospital stays, the patient has minimal time to absorb ostomy teaching in order to be independent in performing basic ostomy care once they are home. Many of these patients may not see a Certified Wound Ostomy Continence Nurse (CWOCN) in the hospital. Most of these patients are referred to a Visiting Nurse Agency that will provide follow-up assessment and teaching until the patient is independent in their ostomy care. However many home care agencies do not have a CWOCN on staff or access to an ostomy out-patient clinic to refer patients with osotmy management problems.

 This poster will describe the use of an assessment tool for the home care nurse to guide them in recognizing stoma and peristomal complications and also for appropriate selection of an ostomy pouching system.

Plan: A one-page assessment tool and algorithm was developed and piloted by a CWOCN (author) in three facilities; two Home Care Agencies and one Hospice Agency. This tool provides items that the nurse will assess in order to identify if there is any stoma or peristomal problems. The algorithm will guideline the nurse in selecting a pouch system if the patient is having problems with pouch wear time and peristomal skin problems. An in-service for the nursing staff was conducted by the CWOCN, who developed the tool, before implementing this assessment tool and is available as a consultant to the agencies.

Outcomes: The home care nurse will become more experienced in performing ostomy assessment and recommending an appropriate ostomy pouch system.

Conclusions: This poster will demonstrate how the Ostomy Assessment tool provided the nursing staff with concise, accurate assessment and interventions guidelines in a timely systemic process to achieve the goal of the patient becoming independent in ostomy care.