A Retrospective Study of the Impact of Pre-operative Stoma Site Marking and Hospital Length of Stay

Purpose:To explore the relationship between preoperative education and stoma siting by a Wound, Ostomy, Continence (WOCN) advanced practice nurse (APRN) and hospital length of stay in patients requiring the formation of an ostomy to divert fecal effluent due to a disease process.

Background:Very little quantitative research is available to provide quantitative support for the routine use of WOCN APRNs and stoma siting to decrease hospital length of stay 

Method:A retrospective, correlational study using a convenience sample of people known to have required surgery which resulted in the formation of an ostomy. The study is a parametric, non probability study using nominal data.  The patient charts from January 1, 2011 to December 31, 2011 are assessed to determine the correlation between patients who received preoperative stoma siting and those who did not and the effect on hospital length of stay. Individual characteristics such as baseline disease process, age, gender, and race are the documented variables.

Results: The cost savings to healthcare facilities as evidenced by a decreased length of stay  validate the expansion of gastrointestinal (GI) support and education by a certified Wound, Ostomy, Continence Nurse  (WOCN)  Advanced Practice Nurse (APRN) . It will serve as a foundation for developing and implementing a nurse driven multidisciplinary approach to improve outcomes and cost efficacy in the  surgical treatment of gastrointestinal diseases such as Crohns, Colitis, diverticulitis and Colon cancer

Conclusion:Pre-operative education and stoma site marking decrease hospital length of stay and provides a quantitative benefit to the hospital to justify routine use of a WOCN certified APRN for pre-operative stoma siting