: Low-Cost, High-IMPACT Ostomy MINI-Simulation for Undergraduate Nursing Students

The United Ostomy Associations of America reports over 700,000 people in the United States have a stoma. Less than half educated in ostomy self-care are taught by nurses with specialist-level schooling. The majority are taught by nurses with generalist-level knowledge of pre-operative, post-operative and post-acute (community) ostomy care. One survey reported 60% of nurses were uncomfortable with performing ostomy education and/or hands-on procedures. Low-cost “mini-simulations” equip baccalaureate-nursing students with the basic skills required to deliver empathetic, high-impact self-care to the new ostomate. Ostomy mini-simulations are hour-long, intensive, small-group learning experiences with highly interactive scenarios emphasizing communication, psychomotor skills, and patient education. OBJECTIVE: The purpose of this ostomy mini-simulation is to demonstrate the cost-effective impact of low-tech teaching approaches utilizing reusable, inexpensive supplies. All three learning domains were incorporated; affective (empathetic communication), cognitive (assessment, troubleshooting) and psychomotor (stoma measurement, pouching techniques and emptying). METHOD: Pre-simulation: Instructional objectives were defined. Students reviewed 3 free resources; a pamphlet, “Basic Ostomy Skin Care” (WOCN, 2017), the “Ostomate Bill of Rights” (UOAA, 2017), and a video of a simulated home-care visit filmed by NYU faculty (one WOC nurse). Scenario: 15 minutes: Individualized hands-on instruction in stoma measurement, peristomal skin assessment, and pouching, utilizing reusable measuring guides, scissors, teaching models, flexible drainable transparent pouches and disposable skin prep. 15 minutes: Students paired portraying the homecare nurse and the ostomate (wearing a stoma simulation belt). The nurse demonstrated pouch removal/wafer inspection, stoma/skin assessment, pouching and emptying with teach-back. 15 minutes: Roles reversed, the second scenario additionally incorporating minor skin denuding management with stoma powder. Debriefing: 15 minutes: Students reflect on their overall experience and receive constructive feedback first from peers, then faculty in each learning domain. CONCLUSION:High-impact ostomy simulation that includes all 3 domains of learning can be provided in virtually any setting at minimal cost.