Six Pack Abs and a Hook

Nicolien Wilder, RN, CRRN, WCC, CFCN, Nursing, UVA-HealthSouth Rehabilitation Hospital, Charlottesville, VA
Fifty-three year old female, Sarah (not her real name), status post sigmoidectomy with end ileostomy. History of Guillain-Barre at age 18, functioning at wheelchair level since then. Contractures in both hands, no fine-motor control. To go home, she needed to be able to empty her high output ileostomy bag on her own.

Sarah, the occupational therapist, and the nurse problem-solved together. To simplify the process, we chose to use the closed, two-piece disposable ostomy bags. With the barrier in place, Sarah had to have the ability to do two things: 1) pull the bag off and 2) snap a new bag on.

The occupational therapist noticed the belt loops on the ostomy bag. She created a hook on a stick that Sarah could hold between her palms. Now Sarah could place this hook through a belt loop and pull the full bag off and place it into a readied garbage bag.

Sarah could not snap a new bag to the barrier. Pushing down on this was ineffective and painful to her stomach. She could not place her fingers under the floating ring for support. The nurse searched for a support that could slide under the floating ring. She chose a thin plastic ostomy education template. The plastic stoma was cut away from the template, a little bigger than the size of the ring on the barrier, so that it would slide effortlessly under the ring. This now gave the necessary support, so that Sarah could indeed push down on the bag and her stomach. She now could snap the bag in place on the barrier.  

Sarah was now able to go home as she had wished and manage most of her ostomy care. Sarah dubbed the device her 'six-pack abs'.