Challenges in Developing an Education Program for Caregivers in Management of the Person with a fecal or Urinary Diversion

Challenges in Developing an Education Program for Caregivers in Management of the Person  with a Fecal or Urinary Diversion

Jane E. Carmel, MSN, RN, CWOCN

Problem:  People with fecal or urinary diversions can undergo life changing situations that will impact their independence in caring for their diversion.  It was found that the nursing staff in Hospice was not comfortable with assessing and teaching caregivers.  The CWOCN was contacted to assist with their cases and identified staff’s need for education on these challenging cases.

Approach:  An in-service was provided by the CWOCN for the Hospice nursing staff.  The presentation consisted of assessment of diversions, review of ostomy system supplies, end of life issues, comfort measures and teaching caregivers. Situations were discussed on care of the Alzheimer’s patient, continent urinary diversions, colostomy irrigations and eroding tumors of the person with malignancy.

Outcome: The staff became more comfortable in assessing and working with families/caregivers to develop a plan that that would not overwhelm them in providing the care of the diversion.   Appropriated referrals were made to the CWOCN.

Conclusion: The CWOCN is valuable in providing their expertise in educating and developing a plan that a caregiver can follow to manage the diversion and promote quality of life for their loved ones. Future plans are to develop a resource manual for Hospice, Palliative and Home Care staff.