Creating a team of RN ostomy champions

     The wound/ostomy care team in the acute care hospital I work at noted that there was a lack of knowledge among the staff nurses concerning care of patients with new or preexisting ostomies. Peristomal skin should remain healthy and intact as any breaks can result in skin problems and potentially interfere with getting a pouching system to seal (Colwell, 2004). We identified this need for further education due to the increasing number of inpatients who developed peristomal skin problems and sometimes developed infections due to their pouching stystem leaking and contaminating a surgical incision.

     To address the problems noted above, we have begun to offer an ostomy presentation monthly to a small number of nurses. The offerings include visual and hands on learning in how to apply an ostomy appliance. A general surgeon has also committed to speaking at these gatherings. The objectives to be met are as follows: recognize basic differences and characteristics of ileostomies and colostomies, identify normal and abnormal stomal characteristics and when it is necessary to notify the surgeon, use correct terminology in documentation, choose appropriate ostomy supplies and apply them correctly, and to be able to better manage high output and other challenging ostomies. The presentation is titled "Ostomy 101".

     Using a scale from one to five with one being the lowest, we ask the participants to rate their knowledge and ocnfidence in the application of pouching systems before and after the presentation. The scores are showing an increase in knowledge and confidence in applying a pouching system. Most participants also indentified that they received minimal education regarding ostomies in their training at school and in the hospital. In addition to increasing their knowledge and comfort level, we ask that they act as a resource to peers when the wound/ostomy care team is not present.