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Purpose – Patients undergoing radical cystectomy with urostomy formation usually receive ostomy education during their initial hospitalization. Many of these patients are not equipped to deal with these changes, which can lead to additional clinic visits, stoma-related complications, and decreased patient satisfaction/quality of life (QOL). Therefore, we sought to evaluate the effect of a pre-operative comprehensive stoma education session (“stoma boot camp”) on post-operative ostomy adjustment, length of stay, and stoma-related readmissions/interventions.
Methods – We performed an open enrollment, quality-improvement cohort study at an acute-care teaching facility. Patients scheduled to undergo a radical cystectomy with urostomy diversion for bladder cancer were offered enrollment into the study and either chose to enroll in the “stoma boot camp” or participate in the control group (no “boot camp”). The “stoma boot camp” consisted of a 3-hour group session within 2 weeks of surgery. Patients were given a short presentation by residents and advanced practice providers regarding the operation, recovery, and post-operative care. Ostomy nurses demonstrated urostomy care, trouble-shooting tips and concluded with ostomy site marking. Measurements of ostomy adjustment scale (OAS) scores and QOL questionnaires were completed at the initial visit, after “boot camp”, and at defined time points after surgery for 6 months. Length of stay, unplanned stoma-related interventions, and re-admissions within 30 days were tracked.
Results – 36 patients participated in the “stoma boot camp” with 4 patients acting as controls receiving education after surgery. Results demonstrated a significant improvement in OAS and QOL scores for patients who participated in the “boot camp” – along with decreased unplanned stoma-related interventions. No difference in length of stay and re-admission rate was demonstrated between the groups.
Conclusions – Structured pre-operative ostomy education for patients undergoing radical cystectomy with urostomy formation is associated with improved social readjustment and quality of life post-operatively.