Colostomy care at home:
As home caregivers, we care for a lot of home care patients that have had a colostomy. As home health nurses we will regularly aid with the maintenance of the stoma and ostomy bag. The motive of this article is to provide home health care nurses and patients alike, and preferable understanding of what a Colostomy is, why clients have a Colostomy, and what is required to care for patients that have had a Colostomy.
What is a Colostomy?
A Colostomy is a surgery where the colon and anus are detached from the intestines. A new colon is forming on the front of the abdomen. The new colon is known as a stoma.
Why People Do a Require Colostomy?
People require a colostomy for different causes. Some causes involve cancer, Crohn’s disease, bowel obstruction, a birth bug, or even only to enhance quality of life. People with a spinal injury or MS will frequently have a colostomy to enhance the quality of their life. Most people that have a colostomy do not require to make any important changes to their lifestyle.
Role of Colostomy Care at Home:
The most general home health care services for Colostomy care involve maintaining a healthy stoma and emptying and replacing the Ostomy pouch or bag.
How to maintain a healthy Stoma?
The home health nurse should look at the skin around the stoma every time the pouch is replaced. The stomas should appear pink and it should be wet. The ostomy bag has a skin barrier that adheres to the abdomen and holds the ostomy bag in the area. It is major that the size of the skin barrier is adjusted with a change in the size of the stoma. When the home care patient first has a Colostomy, the stoma tends to be greater. It gets smaller over time, and the skin barrier requires to be adjusted for this. Sometimes if the skin barrier is on too long without replacing the skin around the stoma can become irritated. The home care helper should inform the nurse or physician when this happens so the irritation could be treated.
What issues with Stoma should home care nurses look for?
The stoma can retract. Stoma withdrawal is when the stoma can go down to or beneath the skin level. There could be a Peristomal hernia. This is when the intestines bulge into the place around the stoma. This could be agonizing for the home care patient. Surgery is generally required to treat the hernia. The stoma can prolapse. This is when there is boosted abdominal pressure leading to part of the intestines shove out of the stoma. Surgery is as well as generally required to fix the prolapse. The stoma may have stenosis. This is when the stoma becomes cramped. This can reason a blockage. If there is a blockage, surgery is generally required to fix the issue. The nurse manager and physician should be notified instantly if any of these issues are monitored.
Step for the home care nurse to alter the ostomy pouch or bag.
1. Decide if the patient has a 1-piece or 2-piece ostomy pouch.
2. Collect your material:
lA new pouch
lA pouch clip or Velcro
lScissors
Clean towels or paper towel
Stoma powder
Stoma paste or a ring seal
Skin clean
A measuring card and pen
3. Wash your hands with soap and warm water following good infection control quality.
4. Eliminate the pouch:
- One-piece pouch – With one hand shove the skin around the pouch below and far from the sticky skin barrier. With another hand, pull the pouch up and far from the stoma.
- Two-piece pouch – With one hand shove the skin around the pouch below and far from the sticky skin barrier. With another hand eliminate the seal with your other hand. Then eliminate the pouch.
5. Put the used ostomy pouch in a plastic bag and put it in the waste.
6. Wipe the skin around the stoma with soap and warm water. And dry the skin.
7. Check the stoma and skin around the stoma to make ensure there are no issues.
8. If there are no issues clean around the stoma with the skin clean. If the skin is a little moist sprinkle some stoma powder on the moist place. Let the place air dry for a few minutes.
9. Measure the stoma using the stoma measuring card and a pen forming to ensure not to touch the measuring card to the skin. Use an ostomy pouch that is 1/8th of an inch greater than the stoma. If you have a 2 piece ostomy pouch, trace the right size on the back of the ring seal, and cut out this size with the scissors. Prepare to ensure the borders are smooth.
10. Place the new pouch:
- one piece pouch – Put the stoma mash around the hole on the pouch. Center the pouch over the stoma and place the sticky skin barrier in place. Hold it there for 30 seconds to make sure it is safe.
- Two-piece pouch – Fix the pouch to the ring seal. Peel the paper off the ring seal and disclose the sticky. Put stoma mash around the hole in the seal. Center the seal around the stoma. Hold it there for 30 seconds to make sure it is safe.
11. Attach any pouch clips or place the Velcro if required.
12. Wash your hands again, following appropriate infection control standards.