Closing the Loop: Providing comprehensive ostomy care in a new Ostomy Center

Ostomates face many challenges post-surgery related to prolapse, dehydration, leakage, retraction, and herniation. Seventy five percent of these patients also have major peristomal skin issues. Multiple studies indicate that patients with ostomies who have a stoma site marked preoperatively have fewer ostomy related complications. Evidence also suggests that patients who receive preoperative ostomy education experience better recovery, shorter hospital stays, and fewer postoperative complications. In 2017, our acute care Magnet designated hospital placed 146 new ostomies with no provision for pre- or post-operative care support. This gap in available resources led to the conception of an Ostomy Center.

Due to the increasing volume of ostomies, hospital administration supported the creation of the Ostomy Center. The purpose of opening the Ostomy Center was to promote and encourage ostomates and their families to independently manage their ostomies. The Center provides services such as counseling and education, individualized care plans, support, and guidance for this independent care. In our new Ostomy Center, we deliver collaborative comprehensive care including: pre-operative counseling, stoma site marking, inpatient post-operative education, schedule post discharge follow-up appointments, and create moldable custom appliances for challenging stomas. Our Center is staffed with a WOCN Nurse Practitioner and WOCN Registered Nurse with medical oversight by a Colo-Rectal surgeon.

As the only outpatient Ostomy Center in Rhode Island, we have realized immense volume. Since opening in May of 2018, we have provided care to 88 ostomates. And, due to an increase in physician referrals, internal and external to the organization, we have had to expand our service hours from 1 day a week to 2.5 days a week. Our patients have reported exceptional experiences and a great appreciation for the delivery of the specialized care. We have also seen a decrease in Emergency Department visits from this patient population.