This document provides a checklist for colostomy care procedures. It outlines 36 steps for assessing the patient, setting up supplies, emptying and changing a colostomy appliance, and post-procedure tasks. Key steps include introducing yourself to the patient, examining the current appliance and stoma, cleaning the skin around the stoma, applying a new appliance, and documenting the patient's response. The goal is to properly empty, measure, and change a colostomy bag or wafer according to best practices.

1. ST.THOMAS COLLEGE OF NURSING, KATTANAM
MEDICAL SURGICAL NURSING
CHECKLIST: COLOSTOMY CARE
Name of the student: Date:
Batch / Year: Time:
SL.NO
STEPS OF PROCEDURE YES NO REMARKS
PRE PROCEDURE
1. Introduce yourself and check patient identity
2. Check diagnosis and age of patient.
3. Assess current colostomy appliance by looking at
product style, condition of the appliance, and stoma (if
the colostomy pouch/bag is clear)
4. Note the length of time the appliance has been in place.
5. Identify the need for the change (e.g., leakage of stool,
discomfort in and around the stoma, the fullness of
pouch) and determine the patient’s knowledge of
colostomy care.
6. Assess for any abdominal scars, emotional status of the
patient.
7. Arrange all the articles near to the patient side.

2. 8. A clean tray containing;
 Basin with warm water
 soap or skin cleanser (if applicable)
 Small towel or wash cloth
 Toilet (wet) tissue
 2-3 pieces 4x4 Gauze squares
 One-piece or two-piece colostomy appliance
 Stoma measuring guide
 Marking pen
 colostomy scissors
 Small Mirror
 Bedpan
 Disposable clean gloves (at least 2-3 pairs)
 Water proof disposable pad/ Mackintosh
 Small plastic (moisture-proof) trash bag
 Additional optional colostomy care accessory
equipment/supplies
 Colostomy belt (optional)
 Skin protectant, such as Skin Preparator
 Pouch Deodorizer
 Stomal paste
 Additional PPE
9. Provide privacy by drawing curtains.
10. Assist patient to a comfortable sitting or lying position in
bed or a standing or sitting position in the bathroom.
 Position mirror or ask the client to hold it in a
manner that would facilitate that the stoma area
would be seen or visible to the client.
11. Remove the colostomy belt if the client is wearing one
12. Perform hand hygiene and wear clean gloves.

3. INTRA PROCEDURE
EMPTYING AN OSTOMY APPLIANCE WITH A
DRAINABLE POUCH
13. Tilt the bottom of the colostomy pouch upward and
remove the tail enclosure clamp, while maintaining the
cuff end of the pouch folded upward before emptying it.
14. Unfold the cuff end of the pouch and empty the effluent
or fecal contents into a bedpan, toilet bowl, or measuring
device.
15. Assess the amount and type of effluent/feces (color,
consistency and odor of stool) before discarding it.
16. Empty solid waste into the toilet or bedpan. If waste is
liquid, measure it before disposal and avoid splashing.
17. Wipe the lower 2 inches of the colostomy appliance
(pouching system) and the cuff end with toilet tissue.
18. Fold the cuff end of the pouch and reapply the closure
clamps.
CHANGING AN OSTOMY APPLIANCE
19. Set up the washbasin with warm water and the rest of the
supplies, including a trash bag that is within reach.
20. Place a waterproof pad or mackintosh under the patient
and at the surrounding (around and below) the stoma
site.
21. Empty the appliance and record the amount.
22. If using a one-piece pouching system(non-drainable
pouch):
 Gently remove colostomy pouch faceplate
(adhesive skin barrier) from the skin by pushing
skin from appliance rather than pulling appliance
from the skin.
 Start at the top of the appliance, keeping the
abdominal skin taut.

4.  Apply a silicone-based adhesive remover by
spraying or wiping with the remover wiper
23. If using a two-piece pouching system (drainable pouch):
 Empty first the contents of the colostomy pouch as
described above and then detach it from the wafer
and discard appropriately.
 Remove the wafer (skin barrier) by gently lifting
the corner with fingers of the dominant hand while
pressing skin downward with fingers of the non-
dominant hand.
24. Remove a small section at a time until the entire wafer is
removed.
 After removing the colostomy appliance, assess
the stoma (color, size, shape, and for any signs of
bleeding) and the status of the peristomal skin.
 Discard the old colostomy pouch. If the colostomy
appliance is reusable, empty the contents and set it
aside to wash in warm soap and water, and allow it
to air dry after the new appliance is in place.
 Dispose of soiled gloves and perform hand
hygiene.
25. Put on a new pair of disposable clean gloves.
26. Upon removal of the colostomy appliance, use toilet
(wet) tissue to remove any excess stool from the stoma.
Cover the stoma temporarily with a wet 4x4 gauze pad or
wet washcloth.
27. Clean the skin around the stoma(peristomal skin) with a
washcloth soaked in warm water and do not scrub the
skin.

5. 28. Do not apply lotion to the peristomal area.
29. Discard the soiled gauze/washcloth and replace it with a
new wet gauze to cover the stoma.
30. Remove the wet gauze covering over the stoma before
applying the new pouch.
31. One-Piece Pouching System
a) Center the one-piece skin barrier and pouch over
the stoma, and gently press it onto the client’s skin
for 30 seconds to 5 minutes.
b) Press the skin barrier firmly into place around the
stoma, while smoothing the surface including the
outside edges.
c) Advice to hold his or her hand over the pouch to
secure the seal with body heat.
32. Two-Piece Pouching System with drainable pouch.
a) Center the skin barrier over the stoma and gently
press it onto the client’s skin for 30 seconds to
5minutes.
b) Attach the drainable pouch onto the flange or skin
barrier wafer.
c) Close the bottom of the appliance or pouch by
folding the end upward and using the tail
enclosure clamp.
POST PROCEDURE
33. Remove the drape (soiled linen saver, disposable pads)
and help the patient into a comfortable and discard

6. gloves.
34. Perform hand hygiene.
35. Discard all the used things in appropriate waste boxes.
36. Document and report the patient’s response and expected
or unexpected outcomes.
a) amount, consistency, and color of the stool
b) the condition of the stoma including color,
any skin breakdown, bleeding, or irritation
Remarks and signature of supervisor: