Preoperative Ostomy Preparation for ALL Patients and Families

Introduction

Pre-operative stoma site marking reduces the incidence of post-operative ostomy complications (Park et al, 1999) and is recommended by the American Society of Colorectal Surgeons and the Wound, Ostomy, Continence Nurses Society (2007). Haugen, Bliss and Savik (2006) reported that pre-operative education by Enterostomal Therapy Nurses was associated with higher quality of life scores. Chauduri et al (2005) concluded that patients who had pre-operative teaching required less time to learn how to manage the ostomy pouch, had shorter lengths of stay and fewer readmissions to hospital. An Enterostomal Therapy Nursing (ETN) team within an academic health centre provides pre-operative preparation Monday to Friday during the day.  However, not all patients and families requiring ostomy surgery during the nights and on weekends were receiving and therefore, benefiting from pre-operative ostomy preparation. This gap represented 10% or forty-five patients per year which needed to be closed.

Method

This presentation will discuss:

• the goal of the Ostomy Best Practice Team “to ensure that 100% of patients and their families undergoing surgery for possible or elective ostomy surgery will receive pre-operative ostomy education and stoma site marking”.
• the objectives in establishing a pre-operative ostomy resource team (PORT)
• preparing the PORT based on knowledge, skill and judgment competencies

Results

Quantitative and qualitative measures used to demonstrate outcomes will be discussed.

Discussion

• implications to practice related to “putting the patient first” and building a sustainable PORT program and;
• ‘change concepts’ related to the professional collaborative roles between the ETN team and PORT members.