Identifying Gaps in Ostomy Care Across the Continuum

The new ostomate has complex education and care needs in the postoperative period.¹   There are time, financial and access constraints imposed by health systems and insurers that restrict ongoing assistance to meet patient needs. Additionally, patients receive ostomy care and education across various health settings.  These factors can impact abilities to develop ostomy self-care skills.   To promote seamless care, patients were asked to provide feedback regarding their experiences related to a new ostomy to identify care and education gaps across the care continuum.

 Background

An Ostomy Steering team at a 1000 bed academic hospital, composed of nurses, physicians and administrators across the health system who intersect with the ostomy population, identified education and care needs of the ostomy patient across the continuum as problematic.    This was evidenced by hospital readmissions related to dehydration and MASD, patient complaints about access to knowledgeable post-discharge care, and observed patient knowledge deficits with pouching technique errors accompanied by MASD as noted by WOC nurses at 4-6 week postoperative clinic visits.

Methods

A patient satisfaction survey was used to provide insight into gaps in care and education across the care continuum.

Results

Seventy patients responded to an eleven question survey from August 2014 to April 2015 at a 4-6 week postoperative visit.  Patient surveys reflected three areas of concern: nursing knowledge in rehab and home care settings and patient dissatisfaction in providing independent ostomy care.

Implications

 As increasing knowledge about ostomy care can improve the skills of the bedside nurse,² next steps will focus on improving communication and education with local SNF's and home care agencies.