Summary of evidence-based review on colostomy care

Summary of evidence-based review on colostomy care

A colostomy is a surgically opening created for connecting intestine to the surface of abdomen. Patients need to comply with a change of the way of defecation and might experience poor body image and low self-esteem. It is essential to provide the best nursing care for the patients.

Objective: This summary is to describe the available evidence about colostomy care.

Method: The evidence-based clinical practice guidelines and systematic reviews on colostomy care were explored using the search terms: “Colostomy, nursing” in Chinese and “Colostomy, care or management”. The computerized searches from 2000-2011 in Cochrane database of systematic reviews, Australian evidence-based health care databases (Joanna Briggs Institute JBI), National guideline clearinghouse and database of Registered Nurses Association of Ontario (RNAO), Best practice and  Nursing reference Center database were performed.

Results: One nursing best practice guideline (RNAO), one JBI evidence summary and one JBI systematic review were retrieved. For promoting patient compliance with colostomy care, nurses should consider patients’ needs and culture background to develop nursing interventions which focus on using all available supportive network, continued comprehensive assessment of stoma and surrounding skin, health education on the artificial anal bag replacement and training for bowel regularity. Most of evidence was level IV and derived from expert opinion, literature review or low-methodological quality studies. Only two randomized controlled experimental studies with small sample sizes (n₁=15, n₂=33) concerned about the fluid regimens for colostomy irrigation.

Conclusions:  The best practice evidence on colostomy care was not formulated yet.  Due to seldom qualified evidence, no more update rigorous recommendations or clinical practice guidelines on colostomy care was found. It was strongly recommended that more high-quality empirical studies with large sample size need to be conducted for providing reliable clinical practice for colostomy care.

Key words  Nursing care; Colostomy; Evidence-based practice