The document provides an overview of the role of a nurse specialist in stoma care. It discusses the types of stomas formed, reasons for stoma surgery, and managing stoma appliances and common problems. As a nurse specialist, key responsibilities include educating patients pre-and post-operatively, providing holistic stoma care, managing wound and fistula care, and collaborating with other healthcare professionals to support stoma patients. Changing appliances properly and daily management is important for stoma patients' quality of life.

1. Liz Dannfald BSc CNS Stoma Care Southern General Glasgow

2. Caring for the Stoma Patient

3. Aim To give an overview of the role of a Nurse Specialist in Stoma Care To give an insight of stoma surgery Reasons for stoma formation How to change a stoma appliance

4. What is a stoma? Stoma is Greek for mouth or opening The most commonly formed stomas are Colostomy Ileostomy Urostomy

5. Colostomy – large intestine

6. Ileostomy – small intestine

7. Urostomy - i leal conduit

8. Types of stomas Bowel or urinary Temporary or Permanent A Loop or an End Elective or Emergency

9. Reasons for Stoma Formation To divert faeces away from a a surgical anastamosis, to allow healing Removal of or damage to sphincters which control continence To aid in symptom control where surgery is not possible Bladder disease

10. Conditions which may result in stoma formation Inflammatory Bowel Disease- ( IBD) Crohn’s Disease, Ulcerative Colitis Colorectal Cancer FAP- Familial Adenomatous Polyposis Diverticular Disease Anal Cancer Trauma

11. Some more conditions Spinal Injuries Incontinence Constipation Bladder Cancer Interstitial Cystitis Congenital Malformation Radiation Damage

12. Role Of The Stoma Nurse To provide holistic care for patients who require to have a stoma formed To educate patients/carers/staff in stoma care Wound and fistula management Research and audit Dissemination of information to multidisciplinary colleagues Time management

13. Pre-operatively Information and literature given Shown appliances Stoma siting Offer voluntary visitor These patients may be emergency or elective

14. Post-operatively Patient teaching Preparation for discharge Follow up- House Calls Out –Patient Clinics Liaise with District Nurses and Home Care Team Nursing Home/Hospice visits

15. Appliances One-piece Two-piece Drainable Closed Tap Clear Opaque Convex

16. Choice of appliance Depends on Type of effluent Physique of patient Potential for skin problems Physical dexterity Patient preference

17. Accessories Belts Adhesive Strips Cohesive Seals Convex Rings Adhesive Removers Skin Protectors Fillers/Pastes Deodorising Sprays Gell Capsules

18. Day To Day Management Appliances should be emptied/changed regularly When changing appliance things to get ready New appliance - Cut to correct size Warm Water Disposal Bag Wipes Any Accessories required

19. To change the appliance Empty if required Remove soiled appliance Wash and dry stoma and surrounding skin Apply new appliance from bottom up. Dispose of soiled equipment

20. Common problems Parastomal hernia Skin problems Constipation High Output Diarrhoea Excess flatus Stenosis Bleeding Prolapse

21. Conclusion 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.