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Management of the Bariatric Patient with an Ostomy
Kathy Camp RN,CWOCN
West Jefferson Medical Center : Marrero, LA
In 2008, the CDC reported a 28.3% obesity rate among the adult population in Louisiana.1 Our facility treats a large bariatric population. Unique physical challenges such as abdominal contours, curves and creases among this population caused us to evaluate our ostomy pouching routines for improved outcomes.
Post-operatively, our patients were placed in a one-piece pouch with a cut to fit skin barrier.* The average wear-time patients reported was three-four days. The heat and humidity typical for this region coupled with the patient’s weight challenges produced less than desirable outcomes. Patients also had difficulty managing the detachable tail closures.
An evaluation of a unique one-piece pouch with a flexible skin barrier, filter, and integrated tail closure was conducted.** We evaluated the use of this pouch among our geriatric population as well. Patients reported this new pouch as having a more flexible skin barrier and being more comfortable than the previous pouch..
Development of an individual plan of care for ostomy patients throughout their hospital stay and beyond, is a high priority. Plans include general interventions such as pre- and post- operative self care teaching, stoma marking, an introduction to ostomy products, and post discharge follow-up2. Not only have we found that the new one-piece pouch has managed post-operative physical challenges, but when given choices, our patients seem to overwhelmingly choose this pouch. Patients report a wear-time of between four to seven days. When asked, most patients commented on the ease of using the integrated velcro-like tail closure, a feeling of security, and experiencing an increase in their quality of life.
Although changing inventory of ostomy products is a difficult challenge for any clinician, our favorable outcomes have proven well worth the effort.
.
1 Obesity and Overweight. 2008.U.S. Department Of Health and Human Services, Centers for Disease Control and Prevention.http://www.cdc.gov/obesity/data/trends.html. Accessed October 19, 2009.
2 Turnbull G. The battle of the bulge and ostomy care. Ostomy Wound Management. 2006; 52 (4). http://www.o-wm.com/article/5521; Accessed October 19, 2009.
*ActiveLifeÒ One-Piece Drainable Pouch
**EsteemÒ One-Piece Drainable Pouch with InvisicloseÒ Tail Closure
Active Life, Esteem and Invisiclose are registered trademarks of ConvaTec Inc.
Kathy Camp RN,CWOCN
In 2008, the CDC reported a 28.3% obesity rate among the adult population in Louisiana.1 Our facility treats a large bariatric population. Unique physical challenges such as abdominal contours, curves and creases among this population caused us to evaluate our ostomy pouching routines for improved outcomes.
Post-operatively, our patients were placed in a one-piece pouch with a cut to fit skin barrier.* The average wear-time patients reported was three-four days. The heat and humidity typical for this region coupled with the patient’s weight challenges produced less than desirable outcomes. Patients also had difficulty managing the detachable tail closures.
An evaluation of a unique one-piece pouch with a flexible skin barrier, filter, and integrated tail closure was conducted.** We evaluated the use of this pouch among our geriatric population as well. Patients reported this new pouch as having a more flexible skin barrier and being more comfortable than the previous pouch..
Development of an individual plan of care for ostomy patients throughout their hospital stay and beyond, is a high priority. Plans include general interventions such as pre- and post- operative self care teaching, stoma marking, an introduction to ostomy products, and post discharge follow-up2. Not only have we found that the new one-piece pouch has managed post-operative physical challenges, but when given choices, our patients seem to overwhelmingly choose this pouch. Patients report a wear-time of between four to seven days. When asked, most patients commented on the ease of using the integrated velcro-like tail closure, a feeling of security, and experiencing an increase in their quality of life.
Although changing inventory of ostomy products is a difficult challenge for any clinician, our favorable outcomes have proven well worth the effort.
.
1 Obesity and Overweight. 2008.
2 Turnbull G. The battle of the bulge and ostomy care. Ostomy Wound Management. 2006; 52 (4). http://www.o-wm.com/article/5521; Accessed October 19, 2009.
*ActiveLifeÒ One-Piece Drainable Pouch
**EsteemÒ One-Piece Drainable Pouch with InvisicloseÒ Tail Closure
Active Life, Esteem and Invisiclose are registered trademarks of ConvaTec Inc.