Ostomy Home Care Challenges: Collaborating for Success

Purpose:  The objective of this poster is to look at creative options for the home care setting which will help improve satisfaction, education and product solutions for the ostomy patient.

 Statement of Problem: With shorter length of hospital stays, needs of the ostomy patient cannot be completely addressed before discharge.  More responsibility for education, stoma management and follow-up happens in the home care environment.  There are fewer WOC nurses in this setting which leaves the care of the ostomy patient in the hands of the generalist nurse.

 Summary:  Our large home care agency has an average daily census of 2700 patients throughout Connecticut.  In the early home care period, quantities of ostomy supplies may be ordered when the abdomen and stoma are still changing.  This results in increased supply costs and a pouching system that may not provide a secure fit.  Sometimes the non-specialized nurse may find themselves with a challenge and no resource available to them at the time of the home visit.  This may cause staff frustration, decreased trust on the part of the patient/family and poor patient outcomes.  Therefore, we are utilizing a variety of approaches to improve service to our patients.  Our specialty nurses serve as resources, see problematic ostomies and educate staff on routine ostomy care.  We utilize a transition of care service which helps supplement education and support for patients, families and home care nurses.  We have a pilot program to see if we can improve the timeliness of support so that solutions will be determined before the nurse leaves the home which can minimize return visits.

 Conclusions:  We want to elevate the level of care provided to our ostomy patients in home care.  This is requiring us to be creative and collaborate more so ostomy patients receive the care and education they need.