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At least 127 records · Page 7Linked to original sources
PubMed1998

A clinical pathway for ostomy care in the home: process and development.

The health care environment is changing rapidly both in form and funding. Recognition of the need for organized, cost-efficient services across the health care continuum has resulted in a model identified as a clinical pathway. This article compares and contrasts key elements of the clinical pathway model as they apply to the acute care setting versus the home care setting. An example of a clinical pathway for ostomy patients in the home care setting is presented, followed by a discussion of its development, pilot testing, and outcomes evaluation. Conclusions regarding the validity of clinical pathways in home care are discussed, and the need for further research is considered.

Community Health Nursing↗
PubMed2002

Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery.

PURPOSE: The purpose of this study was to describe patients' experiences, with a focus on body image, 6 to 12 weeks after a stoma operation. METHOD: Nine patients (8 of whom received preoperative teaching) and who were expected to have their colostomy, ileostomy, or urostomy for at least 6 months were interviewed about their feelings, attitudes, and life experiences after undergoing ostomy surgery. MAIN OUTCOME: Seven themes were identified: alienation from the body, altered body image, influences on sexual life, uncertainty, influences on social life, influences on sports and leisure activities, and physical problems. CONCLUSION: Despite the fact that 8 of the 9 subjects were given comprehensive preoperative teaching, all of the interviewees reported that the stoma influenced their daily life in many unexpected ways, and some expressed severe difficulty in coming to terms with the stoma. With a deeper understanding of patients' experiences, the WOC nurse and other health care staff can more effectively prepare and support patients in adapting to their new situation.

Adult↗
PubMed1995

Multidisciplinary management of altered body image in the patient with an ostomy.

Many clinical studies have found patients with ostomies to be a group facing multiple adjustment demands. One of these demands is coping with a significant change in body image. At the Medical College of Wisconsin, a team approach has been initiated; the ET nurse, the psychologist, and the surgeon deal with body image concerns together. Problems requiring counseling have included difficulty with personal acceptance, personal and social body-image disruption, sexual concerns, reduced self-care skills, and the management of surgical complications. This article represents a study employing a methology of selected case presentations. Cases were chosen to outline the types of problems encountered and were selected from referrals made for psychologic intervention by the surgeon and ET nurse. The patients included four women and three men, ranging in age from 22 to 79 years. Data were compiled by examining the records of the surgeon, ET nurse, and psychologist. The primary needs revolved around personal or social acceptance of altered body image. By addressing these needs in a straightforward, time-limited manner, postsurgical counseling was delivered effectively for these patients. In conclusion, we have demonstrated the multidisciplinary approach to be successful in facilitating adaptation to an altered body image.

Adult↗
PubMed2000

Promoting outcomes for patients with spinal cord impairments and ostomies.

Patients with spinal cord impairments (SCI) and ostomies have unique needs which must be addressed by medical-surgical nurses. By considering the anatomy and physiology of SCI, functional ability, cognitive limitations, and a myriad of other factors, nurses can positively influence clinical and social outcomes.

Health Promotion↗
PubMed1997

Practical guidelines for developing a hospital-based wound and ostomy clinic.

Multidisciplinary teams save time and money while improving quality of patient care. Hospital-based wound/ostomy clinics provide patients with holistic, one-stop, expert care with access to a variety of diagnostic and treatment modalities. The authors discuss how to assemble all the ingredients for a successful multidisciplinary hospital-based clinic, how to make it work, and how to measure its cost-effectiveness for patient, hospital, community and nation. The original model clinic established in Costa Rica using these methods was so successful at providing efficient, high quality, cost-effective care that it has been adopted in 17 different locations there, and similar clinics are being developed in other countries. This model is applicable to industrialized and developing countries. By focusing hospital resources on evidence-based wound/ostomy care, it has the potential to revolutionize wound and ostomy care around the world.

Cost-Benefit Analysis↗
PubMed1998

High-tech wound and ostomy care in the home setting.

The role of the home health care nurse has expanded as a result of a burgeoning client base. This client group is sicker and relies on technology at an ever increasing rate. As the critical care nurse transitions into the homecare setting, wound, ostomy, and fistula management will require a broader base of expertise. Adequate reimbursement is tied to accurate assessment and documentation. The clinician armed with these skills is better prepared to develop an effective plan of care for this group of clients.

Bandages↗
PubMed1985

Ostomy and pregnancy.

Pregnancy in a woman with ostomy poses significant concern in its management. A search for literature addressing this problem revealed minimal information. Questionnaires on this subject were sent to all of the members of the American Society of Colon and Rectal Surgeons, and the replies received from them were analyzed by the computer. Attempts were made to answer questions regarding stoma complications, recurrence of disease during pregnancy, type of childbirth (vaginal or cesarean), special needs during pregnancy, and any recurring problems with subsequent pregnancies.

Adult↗
PubMed1984

"O" ring urinary ostomy appliance.

A non-adhesive urostomy system represents a major departure from ostomy appliances that have been used to date. Experience of 123 ostomates who have lived with the traditional as well as the new appliance indicates a high degree of patient acceptance and satisfaction. The "O" ring appliance promises to simplify and improve the quality of life for patients who are committed to this form of urinary disposition.

Disposable Equipment↗
PubMed1994

Innovative pouch modification for high-output ostomy drainage.

Numerous options are available for pouching fecal stomas when liquid output is relatively low. When output is high and stool has a mixed consistency, however, pouch selection is more limited. This article describes a method of utilizing a sputum specimen trap to modify a one-piece pouch to accommodate intermittently greater output. A successful experience with one patient is described, demonstrating how this pouch modification aided in a complex terminal care situation. Other alternatives in management of the high-output ostomy are also discussed.

Aged↗
PubMedDate not supplied

Information to the relatives of people with ostomies: is it satisfactory and adequate?

PURPOSE: The aim of this study was to evaluate how relatives of patients with an ostomy rated the various aspects of care, how they perceived the quality of the care provided, and how they ranked their involvement in the care. Patients' satisfaction was also sought, particularly their perception of relatives' involvement. DESIGN: Descriptive cross-sectional. SETTINGS AND SUBJECTS: The study comprised a colostomy group (32 pairs) and an ileostomy group (28 pairs). All patients attended a stoma outpatient clinic. METHODS: Quality of care was assessed using the identity-oriented dimension of the validated questionnaire Qualityof Care from the Patient's Perspective. Questionnaires were mailed to patients and their relatives. RESULTS: Relatives and patients in both study groups considered most topics covered by the questionnaire to be important. Half of the patients with an ileostomy and their relatives and approximately 30% of those in the colostomy group were dissatisfied with the information they received, however. Moreover, a greater proportion (41-89%) of the patients were unhappy with the opportunities they were offered to participate in the decision-making process. Patients with an ileostomy and their relatives tended to be more dissatisfied with the quality of care than the colostomy group, but the difference was not statistically significant. CONCLUSION: The topics covered by the questionnaire were considered important to both patients and their relatives. Information and counseling offered by the ET nurses and the colorectal surgeons were judged to be unsatisfactory, indicating the need for frequently assessing and improving general standards of quality of care.

Adult↗
PubMedDate not supplied

Neonatal ostomies.

Two methods of neonatal ostomy care, nonappliance and appliance, are discussed. Skin problems associated with stoma care, such as excoriation, fungal infections, and allergic reactions, are reviewed and a number of suggestions are made for the proper care of stomas in the newborn.

Colostomy↗
PubMedDate not supplied

NaturCare from AlphaMed: the non-scented ostomy deodorant.

NaturCare is an ostomy deodorant manufactured and distributed by AlphaMed. Currently, it is the only non-scented deodorant available on prescription. Odour can be extremely stressful to both the person with a stoma (ostomist) and those involved in their care. Since NaturCare has no artificial scents added to its formula, it can be extremely helpful to those who find the odour embarrassing.

Aerosols↗
PubMedDate not supplied

Principles of ostomy management in the oncology patient.

Fecal and urinary diversions are fairly common among patients diagnosed with abdominal and pelvic malignancies who have undergone removal of the bladder or rectum or who have suffered from obstruction caused by tumor invasion or radiation damage. Effective ostomy management is important in palliative care and involves establishment of an effective pouching system, attention to diversion-specific alterations in dietary and fluid intake, and management of peristomal and stomal complications. Management of colostomy must include measures to prevent or manage constipation, management of ileostomy must include strategies for maintenance of fluid-electrolyte balance and prevention of food blockage, and management of urinary diversion must include options to be used at night and a focus on consistent adequate fluid intake. Common peristomal and stomal complications may necessitate use of barrier products, convex pouching systems to compensate for retraction, and/or binders. Surgery may be needed if incarcerated hernias, persistent prolapse, or stenosis severe enough to interfere with function occur.

Colorectal Neoplasms↗
PubMed1987

Sexual function following ostomy surgery.

This article provides a brief examination of normal sexual function as well as sexual problems associated with ostomy surgery. It also discusses the means by which nurses can intervene effectively to minimize problems through counseling.

Colostomy↗
PubMed1987

A simple technique for constructing a loop enterostomy which allows immediate placement of an ostomy appliance.

A technique for constructing a loop enterostomy using a red Robinson catheter as a stabilizing "rod" is described. The catheter is placed subcutaneously and exits through skin stab wounds placed far enough from the stoma to allow immediate placement of a standard ostomy appliance. By eliminating the skin level rod common to most descriptions of loop enterostomy construction techniques, difficulty with good fixation of skin appliances is eliminated.

Catheterization↗