Ostomate Education from Acute Care and Beyond

In 2017, a 201 bed hospital in the mountain region discovered a great need for more extensive new ostomate education as evidenced by reported difficulties at home with self-care and complications after surgical discharge.  A literature search found that most education was not multimodal or either occurred pre or post discharge, but rarely both.  This practice innovation project sought to extend the education across the continuum of care until all post ostomy patients felt confident and independent in self-care.  This new program was a three step approach.  Step 1:  Inpatient education with a structured checklist, PowerPoint (delivered by the WOC nurse) written material, a self-care video, hands on demonstration pouch practice and the first ordering of supplies.  Step 2:  Upon discharge a wound ostomy clinic appointment scheduled with the WOC nurse, to assess pouching skills, address any peri-stomal skin issues and to continue ostomy education.  These weekly visits continue until the patient feels comfortable and independent.  Stage 3:  Outpatient support group is available to all ostomy patients as well as continued access to the WOC nurse as needed.  Since January of 2018, 17 patients have received this comprehensive colostomy/ileostomy/urostomy education.  An anonymous survey was administered to the patients after they completed the program.  Results by patients have been positive for finding this education useful while also increasing their comfort level and independence with self-care.  This across the continuum of education has also had a profound effect on the medical offices of the surgeons performing these procedures, reducing the number of phone calls to the surgeons, reducing the need for additional education in the office and has significantly reduced post-surgical complications due to poor self-care.