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PubMed2006

Estimation and comparison of ostomy appliance costs with tariffs in Belgium.

This study estimated costs of production and distribution of ostomy appliances, and compared cost estimates with tariffs in Belgium. The cost model took into account manufacturing costs, overhead, R&D, warehousing, profits, and distribution margins. Data were derived from manufacturers, a decomposition of finished products, and interviews with stakeholders. The cost model generated estimated retail prices of euro 2.96 for one-piece appliances, euro 1.62 for two-piece pouches, and euro 2.06 for two-piece flanges. Production and distribution costs accounted for 40 and 60% of retail prices, respectively. Estimated retail prices corresponded well with tariffs for one-piece appliances and for two-piece pouches. For two-piece regular flanges, a substantial difference was observed between the calculated price of euro 2.06 and the tariffs of euro 6.05. In the absence of publicly disclosed information on the cost structure of appliances, estimating ostomy appliance costs is valuable to reimbursement agencies when setting tariffs.

Belgium↗
PubMed1996

Changes in Medicare reimbursement for ostomy supplies: an overview.

Medicare reimbursement and utilization for ostomy supplies have undergone dramatic change in the last year. This article provides an introduction for health care professionals to the Medicare system, Durable Medical Equipment Regional Carriers, Medicare participating and nonparticipating suppliers, and practical examples of how reimbursement may affect the selection of ostomy products. The topics covered refer to Medicare Part B. ET nurses must be cognizant of the ongoing changes in reimbursement and must collaborate with suppliers, manufacturers, and other health care professionals to provide patients with the highest quality care, products, and services.

Durable Medical Equipment↗
PubMed1996

Sexual issues for the person with an ostomy.

The person with an ostomy faces many adjustments that affect sexuality. He or she must adjust to changes in body image and in sexual self-image, all while learning new techniques of self-care. The PLISSIT (Permission, Limited Information, Specific Suggestion, and Intensive Therapy) theory of Annon is useful when providing sexual health care education. Communication, education, and experimentation are the key elements to sexual rehabilitation for the person with an ostomy. Multiple holistic therapeutic suggestions are proposed for client education.

Body Image↗
PubMed2001

The evolution, current status, and regulation of ostomy products in the United States.

In today's rapidly evolving health care environment in which quality, cost-effectiveness, and outcomes are among the most valued health care products, significant issues must be addressed regarding ostomy products and how persons with stomas use them. The lack of evidence-based data has a direct impact on the pocketbooks of many patients with ostomies in the United States and their quality of life. Regulators, accrediting agencies, and payers look to WOC nurses and other providers to provide a sound scientific base upon which they can develop standards and regulations that will improve the life of Americans with stomas.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2001

Multiple ostomy complications in a patient with Crohn's disease: a case study.

This case study highlights the many complications that may arise for an ostomy patient--specifically, a 68-year-old woman with a chronic history of irritable bowel syndrome. It demonstrates the importance of WOC nurse involvement in minimizing complications and optimizing patient outcomes. Further, it confirms the fundamental role of the enterostomal therapist in managing ostomy cases.

Aged↗
PubMedDate not supplied

Infection in the cancer patient with an ostomy.

One of the most common reasons for ostomy surgery today is cancer. Because cancer is frequently treated with combined therapy, the surgery that results in an ostomy may be only one component of the overall therapy. The ET nurse is frequently the only nurse who cares for the patient on a consistent basis as he or she crosses medical-surgical therapies, and the ET nurse may be the one to first notice changes in the patient. Knowledge of the increased risks of infection and methods of prevention and therapeutic approaches are critical to the care of a patient who is undergoing such therapy.

Aged↗
PubMed1995

Uncertainty and the role of the credible authority during an ostomy experience.

The associated stress of an ostomy experience can threaten a patient's security and sense of control. One major stressor is the influence of uncertainty, when patients lack a clear perception of what will happen and are unable to define meaning or personally interpret information bombarding them from the complex health care system. Mishel's Uncertainty in Illness Theory offers the ET nurse a practical framework for understanding how the patient attaches meaning to illness cues and how the ET nurse can positively affect the desired adaptation process. Because the patient trusts the ET nurse's expertise and experience, the nurse can help the patient to understand the ostomy experience and perceive its structure. As a credible authority, the ET nurse has the expert power to facilitate patient coping and adaptation by minimizing ambiguity through individualized education, counseling, and support while simultaneously constructing a sense of order and predictability for both patient and family.

Attitude to Health↗
PubMed2005

Ostomy patients' perceptions of quality of care.

AIM: This paper reports a study whose aim was to assess the quality of care in ostomy patients seen from a patient perspective. BACKGROUND: A stoma operation causes profound changes in a patient's life because of resulting physical damage, disfigurement, loss of bodily function, and change in personal hygiene. Such changes are a cause of major concern for patients and raise important issue for the quality of care. METHODS: The study group comprised patients who had undergone a colostomy for rectal cancer or an ileostomy for ulcerative colitis, all attending a stoma outpatient clinic. Quality of care was assessed using the identity-oriented dimension of the validated questionnaire 'Quality of Care from the Patient's Perspective'. Forty-two ileostomy and 49 colostomy patients completed the questionnaire. RESULT: While the vast majority of patients in both groups thought that most topics in the questionnaire were important, most rated many aspects of their quality of care as unsatisfactory. One-third of the colostomy patients and one-half of the ileostomy patients were dissatisfied with the information they received about the results of medical examinations and laboratory tests, and an even higher proportion was dissatisfied with their opportunities to participate in the decision-making process or to discuss sexual matters. Stoma-related complications, which occurred in 71% of the ileostomy patients and in 43% of the colostomy patients, had no impact on these results. CONCLUSION: Information and counselling for patients having ostomies, both on the part of specialist nurses and colorectal surgeons, appeared to deficient, suggesting that standards for quality of care require continuous evaluation and revision.

Adult↗
PubMedDate not supplied

[Performance of stoma therapy in the process of rehabilitation of ostomy patients].

The enterostomal therapy is a nurse specialty, yet new and little diffused in Brazil. It comprises the nursing management with ostomies, continent diversions, incontinent and acute and chronic wounds. The ostomies management has been very important national wide, and it is necessary the participation and involvement of multiprofessional staff in this assistance. The enterostomal therapist has a fundamental role on the ostomates rehabilitation process. His performance begins during the preoperative period and continues up to the ambulatorial accompaniment. The author discusses the enterostomal therapist performance in ostomates assistance, regarding to the rehabilitation process.

Brazil↗
PubMed1990

Helping ostomy patients back to independence.

Because elderly ostomy patients must deal with numerous challenges, be sure to identify their strengths and enhance their self-esteem. When teaching the older adult, remember factors that may affect learning, such as sensory changes, slowed reaction time, decreased short-term memory, and motivation. Consider the effects of other chronic illnesses and medications when developing a routine for ostomy care, and be sure to discuss dietary considerations with the patient.

Aged↗
PubMed2000

A practical ostomy guide. Part one.

Ostomy surgery is a life-enhancing procedure that restores a vital bodily function, but it's not easy to accept. In a two-article package, we'll walk you through the nursing care that will help patients accept the physical changes their surgery entails. In this article, we review the most commonly performed ostomies and the basics of teaching self-care techniques. Next month, we'll look in more depth at the care and education of patients who don't need to worry about changing an external pouch--their condition allowed the creation of a more normal excretory route through an internal pelvic pouch.

Drainage↗
PubMedDate not supplied

[The meaning of ostomy care among nurses: a case study].

This study aimed to identify how nurses working in a hospital interpret ostomy care. The case-study methodology was used. The obtained results originated four categories: the patient needs special care, it is necessary to provide orientation, in order to provide orientation, the nurse needs..., the recognition of difficulties in delivering special care. These categories express that the care given to ostomy patient by the nurses is not appropriate due to the lack of specific knowledge.

Case-Control Studies↗
PubMed1998

The Ostomy Assessment Inventory: a data-gathering process to enhance appropriate pouching system selection.

Due to the dramatic changes occurring in our healthcare delivery system, many levels of care providers across the care continuum are challenged with the task of recommending pouching systems for ostomy patients. Selecting a pouch can often be a costly process and can prolong rehabilitation. Experience and research shows that certain data relating to the patient's performance capabilities, physical and psychological status, and patterns of daily living merged with the individual's personal preferences, are the infrastructure needed to select appropriate pouching systems for patients. A tool was developed to establish a standard data collection format for ostomy assessment; to provide the non-specialized care provider the necessary assessment criteria needed for pouch selection, and to serve as a communication tool.

Activities of Daily Living↗
PubMed1985

Allergic contact dermatitis to epoxy resin in ostomy bags.

Six ostomy patients presenting with peristomal rashes have been shown to be allergic to their ostomy bags and to epoxy resin. Subsequent investigation confirmed the presence in the bags of low molecular weight epoxy resin oligomers, which are known as potent contact sensitizers.

Colostomy↗
PubMed1984

Perceptions of sexual attractiveness following ostomy surgery.

This study was conducted to obtain information regarding sexual adjustment following ostomy surgery and to explore the influence of surgery on an individual's body image. Home interviews were conducted with 40 subjects, where the mean length of time since surgery averaged 4.6 years. Retrospective perceptions of attractiveness decreased in the first year after surgery, then continued to improve with time. Most comments relative to body image during the first year after surgery had a negative connotation. Persons who saw themselves as most sexually attractive at the time of interview were most often female; however, males had seen themselves as more sexually attractive than females before surgery. Management problems significantly decreased feelings of attractiveness no matter when they occurred. Those with ileostomies who had been ill for over 10 years preoperatively tended to have enhanced feelings of attractiveness at the time of interview compared to those with other types of ostomy surgery and lengths of illness.

Adaptation, Psychological↗
PubMed1992

Colorectal trauma: primary repair or anastomosis with intracolonic bypass vs. ostomy.

This prospective, randomized, controlled study was undertaken to compare primary repair or anastomosis with intracolonic bypass vs. ostomy in severe colon and intraperitoneal rectal injury. Patients were randomized at surgery following confirmation of injury. Data collected included demographics, mechanism and location of injury, trauma score (TS), injury severity score (ISS), penetrating abdominal trauma index (PATI), complications, length of hospital stay, and hospital charges. Twenty-two patients were studied: 11 with intracolonic bypass and 11 controls. The experimental and control groups were statistically similar in demographics and mechanism of injury, severity of injury (TS = 13.8 vs. 12.8; ISS = 27.5 vs. 24.2; PATI = 40.5 vs. 35.0), and complication rate. Length of stay (12.2 days vs. 20.7 days) and charges $27,885 vs. $53,599) tended to be greater in controls, and the comparison did not include subsequent colostomy closure. This study supports intracolonic bypass as a safe alternative to ostomy in severe colon and intraperitoneal rectal trauma.

Adolescent↗