References
Enhancing patient outcomes through proactive stoma care
Abstract
A well-sited stoma can reduce the risk of complications such as leakage, which in turn can damage skin. Although many patients may experience problematic skin, this should not be considered an acceptable norm; people with a stoma should have confidence in their appliance to continue their usual lifestyle. The Nursing and Midwifery Council code states that nurses must always practise in line with the best available evidence. With increasing demand for healthcare and limited financial resources, there are ongoing challenges to deliver care at the required level. A recent advance in stoma care includes adhesive flanges permeated with skin-friendly ingredients. In line with value-based procurement and Getting it Right First Time, the stoma care clinical nurse specialist should consider being proactive in their approach and look to use these products before the patient experiences problems rather than waiting until a problem occurs.
It is well documented that a well-sited stoma can reduce the risk of complications such as leakage, which can lead to skin damage (Le Ber, 2021). This has been confirmed by Kim et al (2021), who found that preoperative stoma siting reduced the incidence of stoma complications by 53%. It also makes stoma care management less complicated as some skin creases/folds can be avoided, and the stoma can be sited away from potential wound/drain sites or other areas known to be problematic for stoma management. Kim et al (2021) also highlighted that a well-sited stoma can increase independence with stoma care.
Management of stoma-related complications, such as leakage and peristomal skin problems, accounts for a substantial burden on the healthcare system (Kugler et al, 2021). It is therefore essential that the stoma care clinical nurse specialist (CNS) makes informed clinical decisions to optimise the care given to this patient group so they can achieve the best outcome regarding quality of life as well as to ensure the patient pathway provides value-based procurement.
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