Ostomy care

Ostomy care

1. Assessment

   • Determine the indication for stoma
   • Assess stoma for color, drainage or excoriation
   • Assess for latex or adhesive allergies.
   • Ensure you have the proper appliance

2. Risks

   • Infections
   • Impaired skin integrity
   • Injury from insertion or removal of appliances.

3. Ostomy Supplies

   • Bedpan, graduated cylinder, toilet access
   • Clean gloves
   • Washcloth, towel , waterproof pad.
   • Wash basin with warm water
   • Gauze, skin barrier cream
   • Stoma measuring guide
   • Ostomy appliance and bag
   • Clamp, trash bag

4. Documentation

   • Date and Time of procedure.
   • The cause of the procedure
   • Size of the stoma
   • Characteristics of the stoma
     • color
     • excoriation
     • redness
     • drainage
     • odor
   • Characteristics of feces
     • amount
     • color
     • odor
   • How the client tolerated the procedure

5. Patient Teaching

   • Explain procedure
   • Explain the stoma should be a juicy red color not pale
   • Maintain privacy
   • Ask if they have brought their own appliance
   • Encourage self care

6. Procedure

   • 2. Confirm client (ID, DOB)
   • 3. Provide privacy and introduce yourself
   • 1. Confirm HCP order, obtain consent
   • 4. Perform hand hygiene
   • 5. Place graduated cylinder under bag for measurement
   • 6. Remove the clamp and uncuff the bag and allow contents to empty into the measuring device
   • 7. Discard the appliance unless reusable
   • 8. Gently clean the surrounding skin with a washcloth and warm water
   • 9. Pat the skin dry and apply barrier cream no closer than 2 in. from the stoma. Let dry completely
   • 10. Cut a hole in the appliance to ⅛ inch larger than the stoma
   • 11. Carefully peel the backing of the appliance and lay over the stoma
   • 12. Smooth out air and hold even pressure for 5 minutes
   • 13. Apply the clamp to the bottom of the new pouch
   • 14. Wash hands and Document

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