Creating an effective discharge handoff for the ostomy patient

Topic:  Lack of proper hand off and inconsistencies of ostomy care transitioning practices are evident across all health care settings.  Failed handoffs foster maladaptive patient coping strategies, safety concerns, rehospitalization, stomal, and peristomal complications. 

 Purpose: WOC Nurses from hospital, outpatient, and home care arenas developed a work group to identify solutions to transitional gaps in ostomy patient care. 

Objective:  The mission statement included components of communication and documentation to promote ‘best practice’ ostomy care and continuity between care providers and care settings. Process outcome goals included increased quality of life, increased safety, and decreased chance of rehospitalization for patients with ostomies.  A survey was distributed to identify gaps and current practices in care transitions.  A literature search supported these evidence based practices.

Outcome:   Based on affiliate survey results and evidence based literature findings, a group of transitional tools appropriate for all settings were developed.  These included an ostomy supply fact sheet, a best practice discharge statement and a community WOC nurse resource list.  A hand off tool prototype was created which was designed to be individualized at each facility. 

Conclusion:  A multi-tiered action plan was developed starting within the affiliate. Attention focused on increasing awareness and involvement of case managers, discharge planners and home care coordinators was incorporated care settings.  Skilled care facilities were targeted to attend the affiliate’s annual ostomy workshop with the addition of a nursing assistant program.  Physician stakeholders were made aware of the discharge initiative to promote support in discharge plans and follow up.   Outcome data is not available but the development of a community standard is promising.