Using Technology to Keep the Motivated Individual with Complex Ostomies and Fistulas at Home

Technology can be used to keep the motivated individual with complex fistulas and ostomies at home safely. The WOC Nurse is able to receive photos and documents to develop and revise plans of care to meet the needs of patients with complex needs. This case study demonstrates a highly motivated individual who took charge of his care using his technology skill set. He has a chronic illness and had been hospitalized for several months for complications after abdominal surgery. He has a wife and two young children at home. He had a strong desire to be discharged and using his background in technology made this a reality. Working with his very supportive wife he developed a spreadsheet that documented his intake which included daily totals of his total peripheral nutrition, intravenous fluids and medications, output daily totals which included his drains, ileostomy output, high output fistula, colostomy output, vital signs and weight. He would take weekly photos of his abdomen to demonstrate the changes that occurred over a nine month period. These photos documented the changes in shape and size of the ostomies and fistulas, the condition of his peristomal skin, use of products and type of effluent. Most importantly he would email how he was coping and many times prompt a phone call.  He would send the information once a week to his doctor, nutritionist and the WOC nurse. Using this information changes were made in his treatment plan and clinic appointments were arranged. The patient received a phone call from the WOC nurse at least once a week initially, then every 2 weeks. Recommendations were made. This treatment plan had bumps in the road, yet it allowed him to vacation on Cape Cod with his young family where he stayed in communication with us.