Set of activities performed by the nurse with the patient or family to replace the used digestive ostomy collection device with a new one, when the patient needs it.
Objectives:
– Maintain the stoma in hygienic conditions. – Maintain the integrity of the peristomal skin in the ostomized patient. – Educate the patient and family on changing the stoma collection device.
Equipment:
– Trough. – Dressing trolley. – Scissors. – Towel.
Material:
– Ostomy drainage bag. – Waste bag. – Soaker. – Gauze. – Non-sterile gloves. – Neutral soap. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material. – Put on non-sterile gloves. – Preserve the patient’s privacy.
– Inform the patient. – Ask the patient and family to cooperate. – Place the patient in the supine decubitus position with the abdomen uncovered. – Protect the bedclothes with the soaker. – Gently remove the used bag (avoiding skin traction) from top to bottom, it should be removed when the bag is half full, leaks or causes discomfort or itching. – Remove the remains of stool with a gauze moistened with water. – Clean stoma and peristomal skin with warm water and neutral soap. – Dry the stoma and surrounding skin thoroughly. – Observe skin and stoma condition. – Place the clean device. Trim according to the stoma. – Dispose of fecal matter in the toilet and the rest of the material in the waste bag. – Remove gloves. – Leave the patient in a comfortable position. – Wash hands. – Record in the nursing documentation: quantity, appearance, texture, color of stool and appearance of the stoma, date and time, incidents and patient response.
Observations:
– Skin irritation is the most frequent complication in the ostomized patient. – In ileostomy, special care should be taken with the surrounding skin. – If there is hair, cut with scissors but do not shave. – The pouches should be changed as often as necessary.
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