Preparing the novice nurse to care for the ostomy patient

We identified an opportunity for improvement in our level one trauma, an academic medical center where we create an estimated 60 new ostomies annually.  Approximately one-third of our registered nurses employed have completed the nursing residency program.  Prior to initiating our performance improvement project, nurses in the residency program received a 30 minute canned lecture on basic ostomy and nursing diagnoses.  Patients indicated the nurses didn't know how to pouch their stomas or answer their questions.  Our novice nurses identified a lack of self-confidence when caring for the ostomate.  We developed an educational program to address these needs in the form of the Ostomy Workshop.  We presented a power point lecture on basic ostomy: types, reasons for stoma creation, nursing assessment, diagnosis and care planning.  The second part of the workshop includes volunteer members of the United Ostomy Association of America (UOAA), Greater St. Louis Support Group who shared their personal experience and, pouching techniques, and showed their supplies, and, upon request, their pouched stomas with the novice nurses.  This section was interactive with opportunities for question and answer.  The final part was hands-on with pouching supplies.  Our ostomy industry representative distributed modeling clay, paper plates, measuring guides, scissors, and pouching supplies on our formulary.  The nurses paired up to create a stoma, to practice pouching and to acclimate themselves with the supplies.  We asked the nurses to complete pre- and post- workshop surveys to evaluate their learning.  We looked at attitudes and beliefs toward managing the patient with an ostomy and nurses’ confidence in their  knowledge, skills and ability to obtain correct supplies.  The surveys indicated effective learning, improved attitudes, and increased self-confidence in caring for the patient with an ostomy.