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    Exploring The Intricacies of Stoma Care

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    This document discusses stoma care and explores various topics related to stomas. It provides an overview of the 3 main types of stomas - colostomies, ileostomies, and urostomies. It describes the common reasons for stoma formation and details key information about each type of stoma such as output, pouch usage, and changing schedules. The document also discusses the importance of skin health for stoma patients and introduces West Suffolk's "P Ratings" system for grading stoma quality. The goal of this system is to improve stoma formation and reduce complications. In conclusion, the author emphasizes that their role is to explore all aspects of stoma care to help patients maintain an active

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    Exploring The Intricacies of Stoma Care

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    This document discusses stoma care and explores various topics related to stomas. It provides an overview of the 3 main types of stomas - colostomies, ileostomies, and urostomies. It describes the common reasons for stoma formation and details key information about each type of stoma such as output, pouch usage, and changing schedules. The document also discusses the importance of skin health for stoma patients and introduces West Suffolk's "P Ratings" system for grading stoma quality. The goal of this system is to improve stoma formation and reduce complications. In conclusion, the author emphasizes that their role is to explore all aspects of stoma care to help patients maintain an active

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    stoma ostomy

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    stoma care

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    This document discusses stoma care and explores various topics related to stomas. It provides an overview of the 3 main types of stomas - colostomies, ileostomies, and urostomies. It describes the common reasons for stoma formation and details key information about each type of stoma such as output, pouch usage, and changing schedules. The document also discusses the importance of skin health for stoma patients and introduces West Suffolk's "P Ratings" system for grading stoma quality. The goal of this system is to improve stoma formation and reduce complications. In conclusion, the author emphasizes that their role is to explore all aspects of stoma care to help patients maintain an active

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    83 views21 pages

    Exploring The Intricacies of Stoma Care

    Uploaded by

    Meta Paramita
    This document discusses stoma care and explores various topics related to stomas. It provides an overview of the 3 main types of stomas - colostomies, ileostomies, and urostomies. It describes the common reasons for stoma formation and details key information about each type of stoma such as output, pouch usage, and changing schedules. The document also discusses the importance of skin health for stoma patients and introduces West Suffolk's "P Ratings" system for grading stoma quality. The goal of this system is to improve stoma formation and reduce complications. In conclusion, the author emphasizes that their role is to explore all aspects of stoma care to help patients maintain an active

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    Exploring the Intricacies of Stoma Care

    Date: 25 June 2018


    Presented by: Bernadette Ambrose
    Stoma Care Nurse Specialist
    West Suffolk Community

    1
    Introduction

    • Some common reasons for stoma formation


    • Overview of the 3 types of stomas
    • The importance of Skin Health
    • ‘p’ Ratings in West Suffolk
    • Accessory usage

    2
    Some common reasons for Stoma formation

    • Carcinoma (bowel & bladder)


    • Diverticulitis
    • Inflammatory Bowel Disease
    • Familial Polyposis
    • Trauma
    • Neurological damage (M.S.)
    • Incontinence
    • Congenital Disorders

    3
    Colostomy

    A colostomy is formed from the large bowel


    Can be permanent or temporary
    Can be a loop or an end stoma
    Output is usually formed or soft faeces
    Generally use a closed bag
    Pouch change depends on bowel function can be
    2-3 times a day

    4
    Loop Colostomy

    6
    Ileostomy

    • Formed from the ileum


    • Generally on the R side
    • May be temporary or permanent
    • Loop or end, should be spouted (2.5cm)
    • Output – loose, porridge like consistency
    • Use a drainable bag
    • Empty 4-6 x day and change alternate days

    7
    Urostomy

    • Formed form a section of bowel used to form a


    conduit into which ureters are attached.
    • Always permanent, end stoma
    • Urine will always contains some mucus
    • Pouch with a tap or a bung
    • Emptied 5-6 times a day
    • Bag changed alternate days

    9
    The ‘Perfect’ Stoma

    • Until the advent of the Brookes ileostomy, there was no


    gold standard for the formation of a spouted ileostomy
    & ileal conduit.1

    • St Marks’ Hospital London UK published a paper


    written by Celia Myers and Robin Phillips to set the
    new standard for a slightly spouted colostomy.2

    1. History of Ostomy Surgery – D. Doughty. Journal of Wound, Ostomy, & Continence Nursing Vol. 35, No. 1. 2008
    2. 2. Minimally Raised End Colostomy – B.M. Stephenson., C. Myers, R.K.S. Phillips. International Journal of Colorectal Disease Vol. 10.
    No. 4. 1995.
    Perfect Ileostomy/Urostomy
    However
    ……
    The Skin
    • Largest organ

    • Divided into 2 Layers


    – Epidermis
    – Dermis

    • Functions
    – Thermoregulation
    – Protection
    – Waterproofing
    – Synthesis of Vit D
    – sensation

    • Differs in appearance &


    Structure
    – Location
    – Age
    – Disease
    Consequences of a NOT so perfect stoma

    15
    16
    The Problematic Stoma

    • Many people with a stoma may experience


    complications at some point.
    • Many factors contribute to a problematic stoma
    • In 2008 we initiated the ‘P’ Rating system where
    each stoma formed at the WSH was given a rating
    depending on the number of accessories required
    to ensure a secure fit.
    • The purpose of this was to initiate discussion and
    help improve the quality of the stomas formed,
    thereby improving the patients quality of life and
    reducing the cost in accessory usage.
    ‘P’ RATINGS - A STOMA GRADING TOOL

    Number of
    Grading Accessories Accessory Type
    Required
    0
    p0 N/A
    1
    p1 Convex
    2
    p2 Convex, belt
    3
    p3 Convex, belt, paste
    4
    p4 Convex, belt, paste, seals
    5
    p5 Convex, belt, paste, seals & extenders
    ‘p’ Ratings Overview of p0 – p1 Stomas

    2008 2010 2012 2015 2016 2017


    78% 82% 72% 77% 92% 98%

    In 2017 72% of all stomas formed at the WSH did


    not require any accessories to achieve the perfect
    Fit.

    19
    The Importance of a Good Fit
    Conclusion
    • My role as a Stoma Care nurse explores the
    intricacies of Stoma Care on a daily basis.

    • Skin Health is paramount to ensure the patient


    continues to have the confidence and ability to
    lead an active and full life following this life
    changing surgery.

    21

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