Meeting the New Ostomates' Needs in an Enhanced Recovery Protocol

MEETING THE NEW OSTOMATES’ NEEDS IN AN ENHANCED RECOVERY PROTOCOL

With an increase in laparoscopic colorectal surgeries and enhanced recovery protocols, wound ostomy continence (WOC) nurses face even greater challenges to educate and help new ostomates adjust psychologically to living with an ostomy. Objective: In our 500+ bed facility we typically have 3 or 4 days, including weekends, post surgery to ensure our new ostomates and their caregivers are fully prepared to care for their ostomy before discharge. These new ostomates are post anesthesia; on pain medication with residual post op pain; have disrupted sleep; and are in emotional/psychological turmoil regarding the ostomy. Collaborating with surgeons, the surgical nurse practitioner, and Pre Surgical Services staff we developed an early referral process enabling the WOC nurse to meet with potential new ostomates and their caregiver(s) two to four sessions prior to surgery. This process provides the opportunity to build a trusting supportive rapport with the patient and their caregiver(s); assess for optimal learning styles, psychosocial and physical needs and enables initiation of measures to meet post discharge needs in addition to providing the patient and caregiver(s) time to become familiar with the appliances and adjust to living with an ostomy all prior to surgery. In order to ensure positive outcomes and ease adjusting to living with an ostomy we provide individualized post discharge support including outpatient visits, follow up calls and ongoing coordination of care with home health and/or post-acute care staff. Outcomes: This process has improved overall patient outcomes evidenced by early independence in ostomy care; effective teach back of all education during review sessions post op; and positive patient and caregiver feedback. As WOC nurses we must adapt our educational programs and methods to continue to meet the needs of our new ostomate patients and their caregiver(s).