Patient and Family Centered Ostomy Care: An Evaluation of a 20 Day Post Hospital Discharge Ostomate Follow-up Program by a "World" Ostomy Nurse Practitioner.

Purpose: A continuum of study to evaluate the effectiveness of a 20 day post discharge hospital ostomate follow-up program, as conducted by the “World” ostomy nurse practitioner, to assess the effectiveness of the nurse practitioner role as a resource in the community and to identify problems ostomates continue to face after discharge from a Level One Trauma Center in Southeast Michigan.

Patients receive limited education during hospitalization due to the global push to decrease hospital length of stay. Following hospitalization, patients transition home for additional ostomy education and support from the visiting home nurse. Some patients refuse homecare due to economics and a variety of other reasons.  Eventually, all patients are discharged back into their community.  For ostomates, the “World” ostomy nurse practitioner is the first line resource for questions and concerns outside the hospital setting.

The 20 day ostomate follow-up program interviewed 91 discharged patients. Interview results indicated the educational level of the ostomate and the perceived quality of ostomy care, current problems with self-care, any skin breakdown, leaking pouches, the understanding of the use of convexity to secure the pouching seal, hydration and nutrition goals, and education and access to ostomy medical supplies. It also examined the individual perceived awareness of the “World”ostomy nurse practitioner as a community resource available to all ostomates.  

The goal of such a follow-up program is to provide access to the “World” ostomy clinician in the community, as well as, empower ostomates in ostomy self-care, to identify normal verses abnormal peristomal skin, to resolve acute skin care issues with available tools and to seek professional assistance for complicated skin issues, to understand the topographical nature and anatomy of the peristomal skin and stoma, to recognize change, and to obtain the correct ostomy supplies in a timely manner.