Liz Dannfald BSc CNS Stoma Care Southern General Glasgow
Caring for the Stoma Patient
Aim  <ul><li>To give an overview of the role of a Nurse Specialist in Stoma Care  </li></ul><ul><li>To give an insight of ...
What is a stoma? <ul><li>Stoma is Greek for mouth or opening </li></ul><ul><li>The most commonly formed stomas are </li></...
Colostomy – large intestine
Ileostomy – small intestine
Urostomy  - i leal conduit
Types of stomas <ul><li>Bowel or urinary </li></ul><ul><li>Temporary or Permanent </li></ul><ul><li>A Loop or an End </li>...
Reasons for Stoma Formation <ul><li>To divert faeces away from a a surgical anastamosis, to allow healing </li></ul><ul><l...
Conditions which may result in stoma formation <ul><li>Inflammatory Bowel Disease- ( IBD) Crohn’s Disease,  Ulcerative Col...
Some more conditions <ul><li>Spinal Injuries </li></ul><ul><li>Incontinence </li></ul><ul><li>Constipation </li></ul><ul><...
Role Of The Stoma Nurse <ul><li>To provide holistic care for patients who require to have a stoma formed </li></ul><ul><li...
Pre-operatively <ul><li>Information and literature given </li></ul><ul><li>Shown appliances </li></ul><ul><li>Stoma siting...
Post-operatively <ul><li>Patient teaching </li></ul><ul><li>Preparation  for discharge </li></ul><ul><li>Follow up-  House...
Appliances <ul><li>One-piece </li></ul><ul><li>Two-piece </li></ul><ul><li>Drainable </li></ul><ul><li>Closed </li></ul><u...
Choice of appliance <ul><li>Depends on  </li></ul><ul><li>Type of effluent </li></ul><ul><li>Physique of patient </li></ul...
Accessories <ul><li>Belts  Adhesive Strips </li></ul><ul><li>Cohesive Seals  Convex Rings </li></ul><ul><li>Adhesive Remov...
Day To Day Management  <ul><li>Appliances should be emptied/changed regularly </li></ul><ul><li>When changing appliance th...
To change the appliance <ul><li>Empty if required </li></ul><ul><li>Remove soiled appliance  </li></ul><ul><li>Wash and dr...
Common problems <ul><li>Parastomal hernia </li></ul><ul><li>Skin problems </li></ul><ul><li>Constipation </li></ul><ul><li...
Conclusion <ul><li>Patients who have had stoma surgery can face many physical and psychological challenges. However, with ...
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Stoma modules caring for the stoma patient

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Presenter: AlasdLiz Danfald
Date: 04/11/2007
Target Audience: All

Published in: Education, Health & Medicine
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Stoma modules caring for the stoma patient

  1. 1. Liz Dannfald BSc CNS Stoma Care Southern General Glasgow
  2. 2. Caring for the Stoma Patient
  3. 3. Aim <ul><li>To give an overview of the role of a Nurse Specialist in Stoma Care </li></ul><ul><li>To give an insight of stoma surgery </li></ul><ul><li>Reasons for stoma formation </li></ul><ul><li>How to change a stoma appliance </li></ul>
  4. 4. What is a stoma? <ul><li>Stoma is Greek for mouth or opening </li></ul><ul><li>The most commonly formed stomas are </li></ul><ul><li>Colostomy </li></ul><ul><li>Ileostomy </li></ul><ul><li>Urostomy </li></ul>
  5. 5. Colostomy – large intestine
  6. 6. Ileostomy – small intestine
  7. 7. Urostomy - i leal conduit
  8. 8. Types of stomas <ul><li>Bowel or urinary </li></ul><ul><li>Temporary or Permanent </li></ul><ul><li>A Loop or an End </li></ul><ul><li>Elective or Emergency </li></ul>
  9. 9. Reasons for Stoma Formation <ul><li>To divert faeces away from a a surgical anastamosis, to allow healing </li></ul><ul><li>Removal of or damage to sphincters which control continence </li></ul><ul><li>To aid in symptom control where surgery is not possible </li></ul><ul><li>Bladder disease </li></ul>
  10. 10. Conditions which may result in stoma formation <ul><li>Inflammatory Bowel Disease- ( IBD) Crohn’s Disease, Ulcerative Colitis </li></ul><ul><li>Colorectal Cancer </li></ul><ul><li>FAP- Familial Adenomatous Polyposis </li></ul><ul><li>Diverticular Disease </li></ul><ul><li>Anal Cancer </li></ul><ul><li>Trauma </li></ul>
  11. 11. Some more conditions <ul><li>Spinal Injuries </li></ul><ul><li>Incontinence </li></ul><ul><li>Constipation </li></ul><ul><li>Bladder Cancer </li></ul><ul><li>Interstitial Cystitis </li></ul><ul><li>Congenital Malformation </li></ul><ul><li>Radiation Damage </li></ul>
  12. 12. Role Of The Stoma Nurse <ul><li>To provide holistic care for patients who require to have a stoma formed </li></ul><ul><li>To educate patients/carers/staff in stoma care </li></ul><ul><li>Wound and fistula management </li></ul><ul><li>Research and audit </li></ul><ul><li>Dissemination of information to multidisciplinary colleagues </li></ul><ul><li>Time management </li></ul>
  13. 13. Pre-operatively <ul><li>Information and literature given </li></ul><ul><li>Shown appliances </li></ul><ul><li>Stoma siting </li></ul><ul><li>Offer voluntary visitor </li></ul><ul><li>These patients may be emergency or elective </li></ul>
  14. 14. Post-operatively <ul><li>Patient teaching </li></ul><ul><li>Preparation for discharge </li></ul><ul><li>Follow up- House Calls </li></ul><ul><li>Out –Patient Clinics </li></ul><ul><li>Liaise with District Nurses and Home Care Team </li></ul><ul><li>Nursing Home/Hospice visits </li></ul>
  15. 15. Appliances <ul><li>One-piece </li></ul><ul><li>Two-piece </li></ul><ul><li>Drainable </li></ul><ul><li>Closed </li></ul><ul><li>Tap </li></ul><ul><li>Clear </li></ul><ul><li>Opaque </li></ul><ul><li>Convex </li></ul>
  16. 16. Choice of appliance <ul><li>Depends on </li></ul><ul><li>Type of effluent </li></ul><ul><li>Physique of patient </li></ul><ul><li>Potential for skin problems </li></ul><ul><li>Physical dexterity </li></ul><ul><li>Patient preference </li></ul>
  17. 17. Accessories <ul><li>Belts Adhesive Strips </li></ul><ul><li>Cohesive Seals Convex Rings </li></ul><ul><li>Adhesive Removers </li></ul><ul><li>Skin Protectors </li></ul><ul><li>Fillers/Pastes </li></ul><ul><li>Deodorising Sprays </li></ul><ul><li>Gell Capsules </li></ul>
  18. 18. Day To Day Management <ul><li>Appliances should be emptied/changed regularly </li></ul><ul><li>When changing appliance things to get ready </li></ul><ul><li>New appliance - Cut to correct size </li></ul><ul><li>Warm Water </li></ul><ul><li>Disposal Bag </li></ul><ul><li>Wipes </li></ul><ul><li>Any Accessories required </li></ul>
  19. 19. To change the appliance <ul><li>Empty if required </li></ul><ul><li>Remove soiled appliance </li></ul><ul><li>Wash and dry stoma and surrounding skin </li></ul><ul><li>Apply new appliance from bottom up. </li></ul><ul><li>Dispose of soiled equipment </li></ul>
  20. 20. Common problems <ul><li>Parastomal hernia </li></ul><ul><li>Skin problems </li></ul><ul><li>Constipation </li></ul><ul><li>High Output </li></ul><ul><li>Diarrhoea </li></ul><ul><li>Excess flatus </li></ul><ul><li>Stenosis </li></ul><ul><li>Bleeding </li></ul><ul><li>Prolapse </li></ul>
  21. 21. Conclusion <ul><li>Patients who have had stoma surgery can face many physical and psychological challenges. However, with the support of the healthcare team, both in hospital and the community, these challenges can be overcome and the patient can lead a normal lifestyle. </li></ul>

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