The WOCN Society 40th Annual Conference (June 21-25th, 2008)
2261
An Ostomy Skin Evaluation tool: How a tool can help patients with peristomal skin problems
Kathy Tavernelli, RN, BSN, CWOCN, Cleveland Clinic Home Care, Supervisor of Specialty Services, 6801 Brecksville Road, Indpependence, OH 44121 and Susan Reif, BSN, RN, CWOCN, Cleveland Clinic Home Care, Wound and Ostomy Care Nurse, 6801 Brecksville Raod, Independence, OH 44131.
Peristomal skin disorders are a common problem for stoma patients [1], and can have a negative impact on quality of life (QoL). However, in the Ostomy Skin Study [1], only 38% of patients identified with a peristomal skin disorder recognized it as such, and <20% had sought medical care. Until now, there has been no standard way of assessing or describing peristomal skin disorders. The Ostomy Skin Tool, which was developed by a global group of expert stoma-care nurses in collaboration with Coloplast, is a novel, standardized tool for assessing peristomal skin through objective observations. It consists of two components: (1) to score the condition of the peristomal skin and (2) and a diagnostic guide to help determine for the cause of the problem.
The Ostomy Skin Tool allows the user to score the peristomal skin in three areas – Discoloration, Erosion and Tissue Overgrowth – to produce a single composite value (the DET score). Within each area assessed, the Tool takes into account the size of the area affected and severity of the problem. The diagnostic guide helps identify the possible mcause of any peristomal skin disorder. Observations are matched with standard descriptions, which are categorized according to likely cause. A final conclusion can then be made and appropriate treatment initiated. The use of a standardized tool to evaluate peristomal skin has the potential to improve everyday care. The Ostomy Skin Tool provides a common language to describe both the severity and cause of peristomal skin conditions. This enables evaluation and monitoring over time of a patient’s peristomal skin by different healthcare professionals in different clinical settings and locations.
The Ostomy Skin Tool allows the user to score the peristomal skin in three areas – Discoloration, Erosion and Tissue Overgrowth – to produce a single composite value (the DET score). Within each area assessed, the Tool takes into account the size of the area affected and severity of the problem. The diagnostic guide helps identify the possible mcause of any peristomal skin disorder. Observations are matched with standard descriptions, which are categorized according to likely cause. A final conclusion can then be made and appropriate treatment initiated. The use of a standardized tool to evaluate peristomal skin has the potential to improve everyday care. The Ostomy Skin Tool provides a common language to describe both the severity and cause of peristomal skin conditions. This enables evaluation and monitoring over time of a patient’s peristomal skin by different healthcare professionals in different clinical settings and locations.
[1] Herlufsen P, Olsen AG, Carlsen B et al. OstomySkinStudy: a study of peristomal skin disorders in patients with permanent stomas. B J Nursing 2006;15:854–62.
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