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Background: The readmission rate for dehydration in postoperative ileostomy patients for colorectal services was above the national average. It was determined that there was no specific standardized pre or postoperative education on dehydration prevention by the surgical team, or wound/ostomy nurses. Additionally, an algorithm was needed to address patient phone calls with symptoms of dehydration.
Implementation: A multidisciplinary team including the colon rectal surgery team, wound/ ostomy nurses, quality improvement manager, dietician and care coordinator determined the need for more focused and standardized dehydration education for patients with a new ileostomy. Multiple implementation strategies were initiated for both patient and staff education. The wound/ ostomy nurses developed standardized patient education on dehydration prevention. This included types and amount of fluids to drink, foods that can thicken stool, consistency of stool, and when the patient should call the physicians or wound/ostomy nurses. The care coordinator followed up after discharge with a phone call within 24 -48 hours after discharge.
Results and conclusions: Early data shows a reduction in readmission rates from 43% to 12.5% within two quarters with initial implementation on more focused education.