Eliminating Barriers, Overcoming Distances: Creating a Post Op Ostomy Teaching Program To Serve Patients in Remote Areas

Educating patients and caregivers in skills needed for stoma care is always challenging. In an area of the country where remoteness is a common lifestyle, this can be difficult. Optimizing educational opportunities during the acute post-op period challenges organization and time management skills, especially since many patients are discharged within a few days of surgery. Our multi-disciplinary teaching program includes the WOC nurse, bedside nurses, dietitians, case managers and social workers. Each patient receives a folder with printed information specific to each type of ostomy. There is a step-by-step pictorial guide for pouch changing, a peristomal skin care handout, diet information, how to recognize complications and product catalogs. The teaching plan includes specific interventions and tasks for each day of the hospital stay. Of course, this is continually revised as the patient’s condition changes.

Purpose: As the only WOC nurse in a 250-bed licensed hospital, a daily post op teaching schedule was developed in order to maximize teaching opportunities.

Outcomes: Patients and caregivers have learned the basic skills of ostomy care. Many of the patients return home to remote areas where there is no hospital or health care provider. Mail service to some areas is inconsistent. As a result of our organized patient education program, patients are able to care for themselves and obtain ostomy supplies. Follow up outpatient visits have been minimal and “frantic” phone calls are few. Patients are able to recognize the signs of peristomal skin breakdown and they understand how to use the appropriate products. The bedside nurses are kept aware of the patients progress and at time of discharge are confident that the patients have adequate knowledge of their ostomy care.