Ostomy Kits: Addressing the Supply Gap Between Rural Healthcare Facilities and Agencies

Ostomy Kits: Addressing the Supply Gap Between Rural Healthcare Facilities and Agencies

Maggie Lott, FNP, CWON, HealthCare Educators, Nurse Consultant, Fresno, Ca. and Joe Alfaro, Territory Representative, Shield Healthcare, Fresno, Ca.

Problem: For many rural home health patients with new fecal diversions, there is a gap between the hospital/SNF discharge and the arrival of appropriate ostomy supplies in the home.  Factors contributing to this problem include:

• Comorbid conditions including advanced age and obesity
• Lack of access for preoperative marking and postoperative enrollment in sample programs during hospitalizations
• Cost containment by health care organizations

When home health services begin, nurses often encounter frequent appliance changes due to leaking, periostomal skin breakdown and chaos in the home.   Supplies such as skin barrier rings, belts and convex wafers are not standard supplies in the nurse's car box leaving the nurse at a loss to deal effectively with the problems.

Objective: Development of a cost effective pouching system for rural home health patients with fecal diversions that can be adapted and used on any stoma until WOCN can be consulted.

Method:  A partnership was established between the WOCN and territory representative of a national medical supply company to provide “ostomy kits” for the home health agency.  Included in a zippered red bag were

• Two cut to fit appliances (flat and convex)
• 2” skin barrier ring 
• Measuring guide
• Curved scissors
• Liquid deodorant
• Enrollment form for national sample program
• Calendar for local ostomy support group meetings
• Medical/ostomy supply catalogue   

Nursing inservices were held integrating basic ostomy management with the contents of the new kit.  Each nurse was given a bag to keep in her car box.

Results:  The agency reported a cost savings in ostomy supplies and improved satisfaction in ostomy care by nurses and patients.