Postoperative education and information-giving for the individual undergoing elective ostomy surgery.

Postoperative stoma education is an essential aspect of care for all types of stoma formation because having a stoma impacts on every aspect of a person's life. This critical review of the literature explores stoma patients' needs and wants; postoperative education care guidelines; the role of ward link nurses; and care pathways. The findings from this review demonstrate that there is no national standard postoperative stoma care pathway, yet such pathways are a cost-effective means to improve patient outcomes and care. The review also identified that structured care pathways are not a new concept, but there is a lack of formal research to determine best practice in postoperative stoma education. In the UK, there is wide variation in practice and outcomes, which means that effectiveness cannot be accurately measured. The author has developed and implemented a multidisciplinary postoperative education pathway in line with a national need to further refine postoperative stoma care services to meet stoma patients' needs.

Treatment of Chronic Parastomal Ulceration with Silver Sulfadiazine and Hyaluronic Acid: Two Case Reports.

ABSTRACT: Skin complications in individuals with an ostomy are widely reported and can cause physical and emotional challenges in everyday life. Chronic parastomal skin complications can be difficult to heal and cause significant pain.Two patients presented to the stomal therapy clinic for treatment and were diagnosed with chronic parastomal skin ulceration. Following standard treatment of wound management, topical corticosteroid ointment, and appliance review, the ulcers either were not improving or had reoccurred. Treatment with a combination cream consisting of 0.2% hyaluronic acid and 1% silver sulfadiazine was initiated, and both patients demonstrated complete healing.Treatment of parastomal skin ulceration with dual-action cream 0.2% hyaluronic acid and 1% silver sulfadiazine was successful for these two patients, with a reduction in pain and purulent fluid noted throughout treatment, in addition to a reduced cost of treatment when compared with standard protocols.

Ostomy Care Nurses' Knowledge and Practice Related to Prevention and Management of Parastomal Hernias in Adults: A Nationwide Survey of UK Stoma Care Nurses.

PURPOSE: The purpose of this study was to describe the knowledge and practices of ostomy care nurses related to the United Kingdom's Association of Stoma Care Nurses (ASCN) 2016 guidelines for prevention and management of parastomal hernia (PSH) in adults. DESIGN: Cross-sectional descriptive study. SUBJECTS AND SETTING: The target population was approximately 300 stoma care nurses; 120 useable responses to the survey were received, reflecting a response rate of approximately 40%. METHODS: A 31-item questionnaire was developed for the purposes of this study, consisting of multiple choice and short answer questions grouped into 2 sections; demographics, and knowledge and practices. The questionnaire was distributed to members of the ASCN who work with adults via an online survey platform with the aim of reaching as many respondents as possible. The Chi-square test was used to determine relationships between the nominal demographic data and the nominal knowledge and practices data. RESULTS: Almost two-thirds of respondents (65%, n = 78) rated their knowledge relating to prevention and management of PSH as good or excellent. Nevertheless, 79.8% (n = 95) indicated they needed additional education to improve their knowledge and practice related to prevention of PSH. Those who rated their knowledge as excellent or good were significantly more likely to be aware of the guidelines compared to those who ranked their knowledge as average or poor. CONCLUSIONS: Study findings suggest variability in knowledge among UK stoma care nurses, along with a desire for additional education in this area of care.

Predictors of Health-Related Quality of Life in Younger Persons With a Fecal Ostomy and Inflammatory Bowel Disease.

PURPOSE: The purpose of this study was to determine predictors of health-related quality of life (HRQOL) in persons aged 18 to 40 years living with inflammatory bowel disease (IBD) and a fecal ostomy. DESIGN: Descriptive cross-sectional study. SUBJECTS AND SETTING: The sample comprised 98 participants recruited from online discussion boards/support groups for individuals living with IBD and an intestinal ostomy. More than three-quarters (76.5%) were female; 45.9% (n = 44) had lived with an ostomy for 2 years or less. Data were collected through an online survey made available from October 2018 to December 2018. METHODS: HRQOL was measured using the Healthy Days Core Module (Centers for Disease Control and Prevention HRQOL-4). Item 1 from the CDC HRQOL-4 represented the variable self-rated health (SRH). The subscales of bodily pain, general mental health, and vitality from the Short-Form 36 Health Survey and the subscales of ostomy function and body image/sexuality plus skin irritation item from the Young-Fadok Stoma Quality of Life (QOL) Scale were used to measure predictors of pain, psychological distress, fatigue, peristomal skin irritation, leakage of ostomy appliance, and body image/sexual disturbance. Correlational and hierarchical multiple linear regression analyses were conducted to complete hypotheses testing. RESULTS: Significant correlations were found between pain, fatigue, peristomal skin problems, psychological distress, SRH, and HRQOL. Pain, fatigue, psychological distress, and self-related health explained 53.2% of the variance in HRQOL based on hierarchical multiple linear regression and controlling for demographic variables such as marital and employment status. CONCLUSIONS: Findings suggest global disease symptoms of IBD in the form of pain, fatigue, and psychological distress and individual perception of health (SRH) are more important than transient ostomy symptoms of peristomal skin complications and leakage of ostomy appliance in predicting HRQOL. Individuals in this population regularly use online resources indicating a need to understand and gain insight into the information posted online in the management of the fecal ostomy and IBD.

Enhancing Specialized Nursing Practice Through Collaborative Academic Advancement: A Joint Initiative by Nurses Specialized in Wound, Ostomy, and Continence Canada and Curtin University, Perth, Australia.

In response to the escalating demand for highly skilled nursing practitioners in wound, ostomy, and continence (WOC) care, a collaboration between the Nurses Specialized in Wound, Ostomy, and Continence Canada (NSWOCC) and Curtin University, Perth, Australia, has emerged. This unique pathway aims to bridge the gap between practical expertise and academic excellence, offering a transformative opportunity for nursing professionals to elevate their skills and credentials. This comprehensive program integrates real-world experience with advanced academic concepts, enabling participants can to pursue a Master of Advanced Practice (MC-ADVPRC) in Wound, Ostomy, and Continence Nursing, positioning themselves as leaders in specialized health care. NSWOCC Feature highlights the programs' unique features and potential impact on the future of nursing practice.

Body Fit With a Pouching System With Concave Contour for People With an Outward Peristomal Body Profile: Effects on Leakage, Wear Time, and Quality of Life: A Randomized Controlled Cross-Over Trial.

PURPOSE: The purpose of the study was to investigate the fit of a two-piece pouching system with a concave-shaped skin barrier on people with an outward peristomal body profile and its effect on leakage, wear time, and quality of life (QoL) related to using an ostomy product. DESIGN: Randomized, controlled, open-label, cross-over trial. SUBJECTS AND SETTINGS: The sample comprised 53 subjects with outward peristomal body profiles and problems with leakage of ostomy effluent from their pouching system. Participants were randomized to the concave two-piece pouching system or a comparator (two-piece pouching system with a flat skin barrier) for 3 weeks. Subjects were then crossed over to the opposite skin barrier for an additional 3 weeks. The study was conducted in Denmark, Norway, Germany, and the Netherlands; data were collected in multiple ambulatory clinics or during home visits. METHODS: The primary end point was the ability of the skin barrier to fit body contours; secondary outcomes were leakage of effluent from the pouching system, wear time, and QoL related to using an ostomy product via the validated Ostomy-Q questionnaire. Primary comparisons between concave and comparator pouching systems were evaluated using proportional odds models and mixed models taking test period into account. RESULTS: Analysis included randomized subjects who had been exposed to at least one product and with information on at least one end point (full-analysis-set, n = 52). The concave pouching system provided a better fit to body contours than the comparator (P< .001) and reduced the degree of leakage underneath the skin barrier (LS mean difference = -1.84, 95% CI -3.31 to -0.37; P = .016). Participants experienced fewer episodes of leakage outside the skin barrier when using concave versus comparator pouching system (13.0% vs. 26.7%, respectively). Participants reported significant improvements in QoL (LS mean difference = 14.3; 95% CI 9.4 to 19.2; P < .001). No significant difference in wear time between skin barrier shapes was reported. CONCLUSIONS: Study findings indicate that a pouching system with a concave skin barrier achieved a better body fit on people with an outward peristomal body profile and resulted in fewer leakage incidents and higher QoL compared to using a pouching system with a flat skin barrier.

The psychometric properties of the Turkish version of the Ostomy Self-Care Index and the Caregiver Contribution to Self-Care in Ostomy Patient Index.

BACKGROUND: Living with an ostomy is a chronic condition, and self-care in such cases improves patient outcomes. PURPOSE: To adapt and test the psychometric properties of the Turkish version of the Ostomy Self-Care Index (T-OSCI) and the Turkish version of the Caregiver Contribution to Self-Care in Ostomy Patient Index (T-CC-OSCI). METHODS: A psychometric study was conducted on a convenience sample of 202 adult patients with an ostomy and their 165 caregivers. Translation and back translation, face and content validity, construct validation, and reliability assessment of the T-OSCI and the T-CC-OSCI were performed. Exploratory factor analysis was used to evaluate the construct validity. Reliability was established using Cronbach α coefficients, ceiling and floor effects, and the Hotelling T2 test, Wilcoxon signed rank test, and intraclass correlation coefficient. RESULTS: Content validity values were in the range of 0.85 to 1 for both the T-OSCI and the T-CC-OSCI. Exploratory factor analysis demonstrated generally acceptable factor loadings. The overall index revealed a high level of internal consistency (T-OSCI = 0.968, T-CC-OSCI = 0.862). No statistically significant difference was found between test-retest measurements. There was no indication of either ceiling or floor effects, or response bias. CONCLUSION: The T-OSCI and the T-CC-OSCI are valid and reliable indexes to measure the self-care of patients with an ostomy and their caregivers. These indexes may allow health care professionals to evaluate self-care in research and clinical settings, identify educational needs, and collaborate in developing and supporting appropriate self-care initiatives for patients with an ostomy and their caregivers.

The Effectiveness of Development mHealth Apps on the Self-Care Ability of Patients with Ostomy.

Intestinal cancer, severe injury, and severe inflammation are most often treated with surgery, and an ostomy will be left in place after surgery[1]. An ostomy is a portion of the intestine that is surgically removed and pulled up to the abdominal wall, creating a temporary or permanent opening that serves as a pathway for intestinal waste to be discharged from the body, usually called a stoma. Stoma may be temporary (2 months to 6 months) or permanent. The goal for people with a stoma is to have the knowledge and ability to care for an ostomy to avoid peristomal moisture-associated skin damage. After patients return home, self-care knowledge and skills can help them adapt to the disease and maintain quality of life. Therefore, this study examined the effects of developing mobile Health applications on improving self-care knowledge and skills in patients who underwent ostomy surgery.

Evaluating the Application of Nail Polish as an Ostomy Baseplate: A Comparative Analysis With Conventional Ostomy Pastes in the Market and a Clinical Trial.

BACKGROUND: Peristomal skin complications are prevalent among patients with ostomies and significantly impact their quality of life. Ostomy care is crucial for patients with ostomies because it ensures proper adhesion and protects and reduces the peristomal skin complications. OBJECTIVES: To assess the effectiveness of nail polish as a novel skin barrier and compare its performance with the commonly available ostomy barriers in the market. DESIGN: Phase I randomized controlled trial. SETTINGS: A single trauma and surgery center. PATIENTS: Forty patients who were hospitalized for ostomy implantation were enrolled. Twenty cases were included in each group. MAIN OUTCOME MEASURES: The use of nail polish as a baseplate was tested against the common ostomy pastes. Over 6 months, the study enrolled 40 patients who required loop ileostomy and were followed up for 8 weeks. Postoperative evaluation was performed using the City of Hope-Quality of Life ostomy and 36-Item Short Form questionnaires, as well as physical examinations conducted 1 day after surgery and at 4 and 8 weeks after surgical treatment. RESULTS: Forty patients were included in the study. At all 3 time points, significant differences were observed in 36-Item Short Form scores, time, and costs spent on ostomy care. The intervention group experienced fewer peristomal skin complications (skin itching, redness, inflammation, and burning) and skin allergies at the first and second time points (p < 0.05). Furthermore, none of the patients in the intervention or control group experienced rare complications such as folliculitis, candidiasis, contact dermatitis, or pyoderma gangrenosum. LIMITATIONS: Single institution. CONCLUSIONS: The utilization of nail polish as a baseplate reduces skin allergies, peristomal skin complications, and the time and financial resources spent on ostomy care. Furthermore, using nail polish has demonstrated promising results in patients' quality of life. Consequently, using nail polish emerged as the preferred choice among study participants. See the Video Abstract . EVALUANDO LA APLICACIN DE ESMALTE DE UAS COMO PLACA BASE DE OSTOMA UN ANLISIS COMPARATIVO CON PASTAS DE OSTOMA CONVENCIONALES EN EL MERCADO EN UN ENSAYO CLNICO: ANTECEDENTES:Las complicaciones de la piel periestomal son frecuentes entre los pacientes con ostomías y afectan significativamente su calidad de vida. Los cuidados de la ostomía son cruciales para los pacientes ostomizados, ya que garantizan una adhesión adecuada y protegen y reducen las complicaciones de la piel periestomal.OBJETIVOS:Evaluar la eficacia del esmalte de uñas como nueva barrera cutánea y comparar su rendimiento con las barreras de ostomía comúnmente disponibles en el mercado.DISEÑO:Ensayo clínico aleatorizado de fase I.ENTORNO:Un único centro de traumatología y cirugía.PACIENTES:Se incluyeron cuarenta pacientes hospitalizados para la implantación de una ostomía. Se incluyeron veinte casos en cada grupo.MEDIDAS DE RESULTADO PRINCIPALES:Se probó el uso de esmalte de uñas como placa base frente a las pastas de ostomía comunes. Durante un periodo de 6 meses, el estudio incluyó a 40 pacientes que necesitaban una ileostomía en asa y fueron sometidos a un seguimiento de 8 semanas. La evaluación postoperatoria se llevó a cabo mediante los cuestionarios City of Hope-quality of life ostomy y SF-36, así como mediante exámenes físicos realizados 1 día después de la cirugía y a las 4 y 8 semanas del tratamiento quirúrgico.RESULTADOS:Se incluyeron en el estudio cuarenta pacientes. En los 3 puntos temporales, se observaron diferencias significativas en las puntuaciones SF-36, el tiempo y los costos dedicados al cuidado de la ostomía. El grupo de intervención experimentó menos complicaciones cutáneas periestomales (picor, enrojecimiento, inflamación y quemazón de la piel), así como alergias cutáneas en el primer y segundo momento (p < 0,05). Además, ninguno de los pacientes del grupo de intervención ni del de control experimentó complicaciones poco frecuentes como foliculitis, candidiasis, dermatitis de contacto o pioderma gangrenoso.LIMITACIONES:Una sola institución.CONCLUSIÓN:La utilización de esmalte de uñas como placa base reduce las alergias cutáneas, las complicaciones cutáneas periestomales y el tiempo y los recursos económicos dedicados al cuidado de la ostomía. Además, el uso de esmalte de uñas ha demostrado resultados prometedores en la calidad de vida de los pacientes. En consecuencia, la utilización de esmalte de uñas resultó ser la opción preferida entre los participantes en el estudio. (Traducción-Dr. Aurian Garcia Gonzalez).

Telehealth vs in-person education for enhancing self-care of ostomy patients (Self-Stoma): Protocol for a noninferiority, randomized, open-label, controlled trial.

INTRODUCTION: Postoperative patients with ostomies experience significant changes in their lives as a result of the device implantation. Self-care is important to improve their health outcomes. Telehealth provides an opportunity to expand access to self-care education. AIM: This is a multicenter, non-inferiority randomized, open-label, controlled trial to evaluate the non-inferiority of a telehealth intervention to the standard in-person approach in improving self-care behaviors. METHODS AND ANALYSIS: Three hundred and eighty-four patients aged ≥ 18 years, with a recently placed ostomy, no stomal/peristomal complications, and documented cognitive integrity will be randomly assigned (1:1) to receive either a telehealth intervention (four remote educational sessions) or a standard educational approach (four in-person sessions) delivered in outpatient settings. Every session (remote and in-person) will occur on Days 25, 32, 40, and 60 after discharge. Follow-ups will occur 1, 3, and 6 months after the last intervention session. Primary outcome is self-care maintenance measured using the Ostomy Self-care Index (OSCI). Secondary outcomes include self-care monitoring, self-care management, self-efficacy (OSCI), quality of life (Stoma specific quality of Life), depression (Patient Health Questionnaire-9), adjustment (Ostomy Adjustment Inventory-23), stomal and peristomal complication rates, healthcare services utilization, mobility, and number of working days lost. Analyses will be performed per intention-to-treat and per protocol. ETHICS AND DISSEMINATION: This study has been approved by the Institutional Review Board of the main center (registration number: 119/22). Following completion of the trial, dissemination meetings will be held to share the results of the study with the participants and the health-care team. Adoption of telehealth technologies for ostomy patients can improve service organization by ensuring better integration and continuity of care. If the remote intervention produces comparable effects to the in-person intervention, it would be wise to make telehealth education an alternative treatment for addressing the educational needs of uncomplicated postoperative ostomy patients. TRIAL REGISTRATION: ClinicalTrials.gov (identifier number: NCT05796544).

Impact of pandemic and socioeconomic influences on decision-making for emergency ostomy procedures: Key factors affecting hospital visit decisions.

Emergency surgeries are linked with increased morbidity and reduced life expectancy, often associated with low socioeconomic status, limited access to healthcare, and delayed hospital admissions. While the influence of socioeconomic status on elective surgery outcomes is well-established, its impact on emergency surgeries, including ostomy creation and closure, is less clear. This study aimed to explore how the pandemic and socioeconomic status affect emergency ostomy procedures, seeking to determine which has a greater effect. It emphasizes the importance of considering socioeconomic factors in patient care pathways for ostomy procedures. A total of 542 patients who underwent emergency ostomy formation between 2016 and 2022 were retrospectively analyzed and divided into pre-pandemic and pandemic periods. The pre-pandemic and pandemic periods were compared between themselves and against each other. Demographic data (age and sex), comorbidities, socioeconomic status, etiology of the primary disease, type of surgery, stoma type, length of hospital stay, ostomy closure time, and postoperative complications were retrospectively analyzed for all patients. In total, 290 (53%) patients underwent surgery during the pandemic period, whereas 252 (47%) underwent surgery during the pre-pandemic period. Emergency surgery was performed for malignancy in 366 (67%) patients. The number of days patients underwent ostomy closure was significantly higher in the low-income group (P = .038, 95% CI: 293,2, 386-945). The risk of failure of stoma closure was 3-fold (95% CI: 1.8-5.2) in patients with metastasis. The risk of mortality was 12.4-fold (95% CI: 6.5-23.7) when there was failure of stoma closure. When compared to pandemic period, the mortality risk was 6.3-fold (95% CI: 3.9-10.2) in pre-pandemic period. Pandemic patients had a shorter hospital stay than before the pandemic (P = .044). A high socioeconomic status was significantly associated with early hospital admission for ostomy closure, and lower probability of mortality. More metastases and perforations were observed during the pandemic period and mortality was increased during pandemic and in patients without ostomy closure. The socioeconomic status lost its effect in cases of emergency ostomy creation and had no impact on length of hospital stay in either the pre-pandemic or pandemic period.

Enhancing drug therapy in ostomy patients: Best practice recommendations for medication management.

BACKGROUND: Ostomy surgery is a common procedure that poses various challenges for patients and healthcare professionals. There are numerous guidelines addressing different ostomy-related problems (ORPs) and supporting an interdisciplinary approach for ostomy care, but evidence-based literature for optimizing drug therapy after ostomy surgery is lacking. AIM: To investigate and characterize typical ORPs in relation to drug therapy and provide best practice recommendations from a pharmaceutical point of view. METHODS: Patients with an ileo- or colostomy were consecutively enrolled in a prospective, interventional monocentric cohort study during hospitalization, with particular attention to medication. A clinical pharmacist assessed DRPs by performing level 3 medication reviews and patient interviews. Pharmacists' interventions (PIs) were evaluated by two senior clinical pharmacists and documented in DokuPIK (Documentation of Pharmacists' Interventions in the Hospital). Following interdisciplinary discussions, physicians either accepted or rejected the proposed changes in drug therapy. Comparisons were made between ileostomy and colostomy patients regarding type and extent of PIs. RESULTS: Out of the 80 patients included in the cohort, 54 (67.5%) had an ileostomy and 26 (32.5%) a colostomy. In this study, 288 PIs were documented (234 ileostomy vs. 54 colostomy), of wich 94.0% were accepted and implemented by the physicians. The most common reason for PIs in both subgroups (29.6% ileostomy vs. 26.1% colostomy) was a missing drug although indicated (e.g. no loperamide, but high stoma output). The proportion of PIs associated with the ostomy was higher in ileostomy patients (48.3% ileostomy vs. 31.5% colostomy; p = 0.025). Typical ORPs were extracted and analyzed as case studies including recommendations for their respective management and prevention. CONCLUSION: This study highlights the importance of clinical pharmacists being a part of interdisciplinary teams to collaboratively improve ostomy care and patient safety. Especially ileostomy patients are more vulnerable for ORPs in the context of drug therapy and need to be monitored carefully.

Ostomy Information on the Internet-Is It Good Enough?

PURPOSE: The aim of this study was to determine which internet search engines and keywords patients with ostomies utilize, to identify the common websites using these terms, to determine what aspects of information they wanted, and to perform a quality and readability assessment for these websites. DESIGN: A cross-sectional survey of persons with ostomies to identify search engines and terms, followed by a structured assessment of the quality and readability of the identified web pages. SUBJECT AND SETTINGS: The sample comprised 20 hospitalized patients with ostomies cared for on a colorectal surgical ward of a tertiary care hospital located in Melbourne, Australia. There were 15 (75%) adult males and 5 (25%) adult females; their mean age was 52.2 years. Participants were surveyed between August and December 2020. METHODS: Patients with newly formed ostomies were surveyed about which search engines and keywords they would use to look for information and for which questions regarding ostomies they wanted answers. In addition, 2 researchers then performed independent searches using the search terms identified by patient participants. These searches were conducted in August 2021, with the geographical location set to Australia. The quality of the websites was graded using the DISCERN, Ensuring Quality Information for Patients, and Quality Evaluation Scoring Tool scoring assessments, and their readability was graded using the Flesch Reading Ease Score tool. RESULTS: Participants used Google as their primary search engine. Four keywords/phrases were identified: stoma for bowel surgery, ileostomy, colostomy, and caring for stoma. Multiple web pages were identified, 8 (21%) originated from Australia, 7 (18%) were from the United Kingdom, and 23 (61%) were from the United States. Most web pages lacked recent updates; only 18% had been undated within the last 12 months. The overall quality of the online information on ostomies was moderate with an average level of readability, deemed suitable for patient educational purposes. CONCLUSIONS: Information for persons living with an ostomy can be obtained from multiple web pages, and many sites have reasonable quality and are written at a suitable level. Unfortunately, these websites are rarely up-to-date and may contain advice that may not be applicable to individual patients.

Supportive Care Needs of Patients With Temporary Ostomy in Enhanced Recovery After Surgery: A Mixed-Methods Study.

BACKGROUND: Enhanced recovery after surgery (ERAS), a global surgical quality improvement initiative, reduces the length of stay in the hospital. Temporary stoma care for rectal cancer is complex, and patients require prolonged care services to adjust to the stoma. The shorter stay durations in the new model challenge the conventional care pathways and create new patient needs. PURPOSE: This study was designed to explore the supportive care needs of patients under the new surgical model to provide a reference for the design of ERAS nursing care plans. METHODS: A convergent parallel mixed-methods design was used in this study. Patients with temporary stomas for rectal cancer were recruited using a convenience sampling method in gastrointestinal surgery wards and wound & stoma clinics in two public tertiary care hospitals in China. Standardized questionnaires were administered to 140 patients to collect quantitative data, and semistructured interviews were conducted individually with 13 patients to collect qualitative data. The questionnaire data were analyzed using descriptive statistics, and the interview data were analyzed using thematic analysis. RESULTS: "Health system and information needs" and "care and support needs" were identified in both the qualitative and quantitative analyses as the most significant unmet needs of the participants. In addition, the qualitative analysis identified receiving focused stoma care instructions and easily understandable information as essential to fulfilling health system and information needs. Care and support needs included access to continued postdischarge services and attention from medical professionals. CONCLUSION/IMPLICATIONS FOR PRACTICE: The participants in this study experienced a variety of unmet supportive care needs under the ERAS protocol, with gaps particularly notable in two categories: "health system and information needs" and "care and support needs." Increased perioperative care and shorter hospital stays under the ERAS protocol reduce opportunities for patients to receive targeted instruction and shift much of the ostomy education and care workload out of the hospital, requiring greater attention from clinical nurses to ensure quality of care.

Exploring Nursing Students' First Experiences Providing Wound and Ostomy Care to Patients: A Qualitative Study.

BACKGROUND: Undergraduate nursing students experience significant differences between practice with models, manikins, or simulation applications and real patients in a clinical setting. Students' experiences applying their theoretical knowledge to real patient-care practices are little understood. OBJECTIVE: To determine the experiences of nursing students in providing skin, chronic wound, and ostomy care to real patients for the first time in a clinical setting within the content of the Ostomy and Wound Care Nursing Track Program (OWCNTP) and to define factors affecting this program. METHODS: The research was conducted qualitatively using the individual critical incident technique, and 17 senior undergraduate nursing students enrolled in the Nursing OWCNTP were selected using a simple random sampling method. In the classroom setting, individual face-to-face interviews were conducted using the critical incident technique. Data were analyzed with inductive content analysis. RESULTS: The research found that students experience genuine caregiving in putting their experiences from the Track Program into practice with real patients in a clinical setting. Three main themes were identified: experiencing real patient care in a clinical setting, being a competent student, and being a novice student. CONCLUSIONS: The study found that nursing students enrolled in the OWCNTP could apply their theoretical knowledge to care for real patients in clinical settings. Therefore, it is recommended that these programs be integrated into nursing curricula.