Component Task: Care of Stoma or Ostomy and Changing of Pouch

It is the removal of the pouch and cleaning of an artificial opening created on the lower abdominal surface of a patient. The opening may be temporary or permanent.

Aims

·         Assist in the elimination of faecal matter

·         Make patient clean and comfortable

Requirements

A trolley containing the following:

·         New stoma pouch

·         Sterile gloves

·         Disposable gloves

·         Wipes or tissue

·         Measuring template

·         Gallipot with gauze swabs

·         Mackintosh and dressing towel

·         Towel

·         Bowl of tepid water

·         Barrier cream

·         Large receiver

·         Deodorizing tablet or liquid

·         Plastic bag

·         Scissors

·         Soap/mild detergent

Steps

1.        Establish rapport with patient (Refer to steps)

2.      Explain procedure to patient (Refer to steps)

3.      Provide privacy

4.      Prepare and send trolley to bedside

5.      Position the patient and turn down top sheet to expose stoma

6.      Protect site with mackintosh and dressing towel

7.       Preform hand hygiene and put on disposable gloves

8.      Gently remove soiled pouch and places in large receiver/plastic bag

9.      Remove disposable gloves and perform hand hygiene

10.    Put on sterile gloves

11.      Examine the stoma and note any abnormalities

12.    Clean the stoma with the wipes/tissue

13.    Wash area around the stoma with mild soap/detergent and tepid water

14.    Dry area gently with sterile swabs

15.    Cover the stoma with a swab while you prepare a new pouch

16.    Estimate stoma using the measuring template and cut the desired opening on the pouch

17.    Apply barrier cream

18.    Put few drops of the deodorizing liquid or tablets in the pouch if available

19.    Attach the one side of the edge of the pouch to the skin, rolling it up and over the stoma

20.  Press the edges of the pouch to secure it in position

21.    Remove gloves and perform hand hygiene

22.  Reposition patient

23.  Remove mackintosh and dressing towel

24.  Dispose off, decontaminate, clean and stores used items

25.  Document procedure and report findings to appropriate officer

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