A Multidisciplinary Approach to Ostomy Education in Home Care

Despite hospital education, most new ostomates arrive home with incomplete knowledge of how to care for their ostomy. New ostomates are complex with a variety of physical and psychosocial issues that need addressing. Situational depression, social anxieties and fears about living with an ostomy are common. Many home care patients are elderly and have other chronic illnesses and disabilities such as low vision or decreased hand dexterity. Physicians typically order nursing alone to teach ostomy care. WOC nurses are employed in just 6% of home care agencies in the U.S.[1] Evidence based practice purports the use of multidisciplinary approaches to patient care.           

In order to improve patient outcomes and satisfaction, a multidisciplinary approach should be used to help ostomy patients reach their maximum level of activities of daily living (ADL) and quality of life.           

The WOC nurse created a team of occupational therapists (OTs) and social workers to collaborate on new ostomy admissions to home care. The OTs and social workers were trained in basic ostomy care and psychosocial issues by the WOC nurse. The WOC nurse continues to teach ostomy management while the occupational therapists reinforces education and collaborates on ostomy change set-ups, emptying techniques, dressing and ADL’s. Adaptive equipment such as gooseneck mirrors are often ordered. The social worker provides short-term counseling and resources.       

Patients demonstrated competence and acceptance in ostomy care sooner with the multidisciplinary approach.  Patients also received the added benefit of problem-solving and education from other complimentary disciplines that facilitated the achievement of an optimum quality of life.

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[1] Based on 2008 WOC Survey results compared to Center for Medicare & Medicaid Services (CMS) data on number of Medicare certified home health agencies in the US: (0.129 / 4,532) ÷ 9,824 = 0.059

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