Colostomy Care

Placement of a colostomy often is due to complications related to trauma, infection, cancer, congenital abnormalities, and inflammatory diseases (Walker, Rau, & Green, 2015). Colostomies can be permanent or temporary. Receiving a colostomy requires a big adjustment for patients and their caregivers, not only from a physical perspective but also from a psychological perspective. Patients who have a surgical colostomy placed stay in the hospital on average 5 days. The shortened stay limits the time for education. Because the average complication rate from ostomies is 24%59%, education must be consistent throughout the hospitalization to reduce complications and readmission. Patient education is one of the most important roles of the registered nurse with involved patients. It is an ongoing process which starts with the first patient interaction and continues throughout hospitalization. Walker and colleagues suggested nurses who provide effective education often can identify issues related to colostomy care early so patient success is improved before discharge through an interprofessional approach.

Basics of Colostomy Education

Education to patient and caregiver is important to ensure appropriate ostomy care. Before providing education, the nurse should ensure the patient is comfortable with minimal pain or discomfort. A patient who is in pain will not engage in the education session. Thus, pain must be well-managed. It also is important to assess the patient's and caregiver's manual dexterity. Because colostomy care involves manipulation of the supplies, the nurse should ensure the patient and caregiver are able to manipulate them without difficulty. With a limited amount of time during hospitalization, several key components of education must be addressed (Kirkland-Kyhn, Martin, Zaratriewicz, Whitmore, & Young, 2018), including changing the pouching system, emptying the appliance, planning adequate nutrition, and avoiding complications. As much as possible, the patient and caregiver should work with the colostomy equipment and be active participants in changing and emptying the pouching system.

Changing the Pouching System

Two types of ostomy pouching systems can be used by patients: one-piece and two-piece systems. A onepiece system has the wafer (skin barrier that attaches to the skin) and appliance attached together. The twopiece system has an...