Ostomy Management

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Public policy is an aspect that affects every day practice for most wound, ostomy and continence nurses, but is something that we do not generally think about. One health policy topic that is in the forefront of my mind is how the Centers for Medicare and Medicaid Services (CMS) is looking to change the process for how patients access or DME products. This change in public policy would affect the access of these necessary products to our patients.

By Janis E. Harrison, RN, BSN, CWOCN, CFCN

My Path to Becoming a Wound, Ostomy and Continence Nurse

"What did I get myself into?" There were several times over the first 10 years of my 20 year marriage to a person with an ostomy that I had to ask myself that question. Then came the revelation of the old saying "if you can't beat 'em…. join 'em." I decided that after major problems my spouse had with several surgeries – which included ostomy revisions, fistulae, abscesses, and surgical wounds – I would need to learn much, much more if I was going to spend the rest of my life with my husband, Daryl, and his maladies.

By Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN

Happy Spring! At least that is what the calendar indicates, but recent temperatures across much of the US seem to dispute that fact.

By Karen Zulkowski DNS, RN, CWS

I previously discussed the need for a complete head-to-toe skin assessment. Certainly this can tell you whether or not the person is dehydrated, has open or discolored areas, and many other things about their overall health. Color, for example, can give you clues to additional problems such as vitamin and mineral deficiencies that can show on the skin.

By Karen Zulkowski DNS, RN, CWS

All medical personnel strive to provide care based on the strongest available evidence. Yet how many of us provide culturally competent care? Culturally competent care is defined as having specific cognitive and effective skills that are essential for building culturally-relevant relationships between patients and providers.¹ We may know about local customs but in today’s global world our patients may be from a different area of the world. So how would you react if your Asian patient wanted to use non-traditional medicine or your patient of the Sikh faith refused to remove their underpants prior to surgery?

By Joy Hooper RN, BSN, CWOCN

Some people choose the J-Pouch procedure rather than the traditional colostomy or ileostomy.

By Aletha Tippett MD

For over a decade now I have treated wounds in palliative care patients and non-palliative care patients. The “funny” thing is that there is no difference in how I treat these wounds, all are approached the same way, with similar treatments used. As I teach more and more about palliative wound care, it seems obvious to me that all wounds and all people deserve this approach. Who does not deserve less pain? Who deserves to be embarrassed by wound odor? Who deserves to have an infection? Who deserves a lesser quality of life? When asked these questions I would think the answer would be NO ONE.

By Joy Hooper RN, BSN, CWOCN

The "J-Pouch" is an example of an internal intestinal pouch constructed of small intestine. The surgery is performed as an alternative to a permanent ileostomy when the large intestine (colon) needs to be removed. The J-Pouch procedure can be performed in a I, II, or III stage surgical procedure. Although there are many complications associated with this procedure such as anal leakage after surgery, bowel obstruction, and pouchitis, there are many people that feel the J-Pouch procedure literally gave them their life back. Below is a comment from a J-Pouch patient:

By Joy Hooper RN, BSN, CWOCN

A person with a colostomy has several options as to how they choose to manage their ostomy. The choice of which pouch is only the beginning when choosing the route they want to use to manage their stoma output. In this video, I will provide an overview of colostomy irrigation. For more resources on colostomy irrigation, see the UOAA website at www.ostomy.org . Other online groups and forums include “STOMACITY” or “COLONTOWN” on Facebook and www.meetanostomate.com.

By Joy Hooper RN, BSN, CWOCN

The appearance of a new stoma on a patient’s abdomen can be shocking for the patient, family members, caregivers, and even some healthcare professionals. Stomas presented in textbooks, educational literature, and diagrams often appear round and “budded.” Patients will sometimes see images of other stomas and compare it to the appearance of their stoma. If their stoma is flush with the skin on the abdomen or retracted they may feel the surgeon did a poor job. Actually, the patient's body can have just as much to do with the appearance of the stoma as the surgeons surgical technique does.