The Perfect Fit: Moldable Technology in Home Care

Problem:  Patients with new or established ostomies can present some unique challenges to the Home Health Care nurse.  Not only is the nurse expected to be an expert at managing any disease process the patient has presented with, and deliver all required aspects of care, they are charged with demonstrating confident patient teaching and self care ostomy management skills. Patient dexterity and/or vision deficits, learning disabilities and emotional factors can impact how patients learn and perform self ostomy care.  Also irregular stomas challenge the nurse to select a properly fitting ostomy appliance from the agency formulary.

Past Management:  At our agency, a CWON is just a phone call away to assist the nurse while at the patient’s home to select an appliance that addresses leakage issues, contact dermatitis, stoma retraction, and other peristomal complications that impact appliance wear-time. 

Current Management: Many  peristomal complications of our ostomy patients’ are now being managed with a two-piece ostomy system that has moldable skin barriers* including moldable convex skin barriers*. The challenges listed above are successfully addressed by using these products.  To be more adaptable to managing the stomal and peristomal skin complications our agency were faced with, moldable skin barriers* were added.

 

Outcomes: 

The moldable skin barriers* have been recommended for approximately 60% of the agency ostomy population.  Patient satisfaction with ease of use, staff satisfaction for ease of teaching and clinical outcomes of sufficient wear time and decreased peristomal skin irritation have occurred.

Approximately 30% of our patients require convexity.  Of the most recent 12 patients who were switched to the moldable convex skin barriers*, all 12 also experienced outcomes of increased wear time and decreased skin irritation.  Cut-to-fit convex skin barriers* have not been recommended in over a year. 

*SUR-FIT Natura®, Durahesive and ConvaTec Moldable Technology are trademarks of ConvaTec Inc.