Convexity in stoma care: developing a new ASCN UK guideline on the appropriate use of convex products
One of the biggest challenges for specialist stoma care nurses (SCNs) caring for anyone living with a stoma is that of being confronted with a problematic stoma. This can be described as an ostomy that continues to cause leakage issues for the patient which, if persistent can quickly impact negatively on their quality of life. A convex stoma appliance, also termed convexity, is a possible solution to a problematic stoma. However, the use of a convex appliance should be considered only after a thorough assessment has been undertaken by a specialist SCN. Professionally, stoma care nursing has advanced greatly in recent years and there has been a realisation that there is a need for clinical guidelines to direct practice and offer a process for the novice SCN to follow. This realisation has been the catalyst behind the development of the new guideline for the assessment and use of convexity by the Association of Stoma Care Nurses UK, which was published this year (https://ascnuk.com/). This article explores the concept of convexity and how the guideline can assist the practice of specialist SCNs, as well as that of ward and community-based nurses who wish to gain more information on using convexity within the specialist sphere of stoma care.
For many individuals the prospect of living life with a stoma is daunting: the alteration to one's body image can be challenging and the necessary adjustment to lifestyle can be difficult. It is, however, widely accepted that the support of a specialist stoma care nurse (SCN) is advantageous, and positively impacts on a patient's quality of life (Claessens et al, 2015; Association of Stoma Care Nurses UK (ASCN UK), 2019). Support is offered in many ways; for example, patients can be provided with psychosocial support, as well as physical and practical support—all fundamental aspects of care. The ASCN UK (2021)Stoma Care Nursing Standards and Audit Tool (Quality Statement 7) states that people living with a stoma should have access to long-term/lifelong specialist SCN support.
Such support is necessary throughout a patient's time of living with a stoma, but it is even more crucial when a patient has issues with their stoma management. Patients can experience leakage from their appliance for many reasons, a discussion of which is beyond the scope of this article. However, where patients are able to access the input and support of a specialist SCN, these problems should hopefully be short lived.
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