ABSTRACT
With an ageing population and an increase in the prevalence of dementia, stoma care nurses (SCNs) are experiencing greater challenges in their role supporting this group of patients with their stoma care. Following concerns raised in our department by relatives about the care and teaching provided in this area, with patients occasionally denying having even seen an SCN, the need for a visual tool to enable timely interventions and increase knowledge for family, carers and ward staff became apparent. There is a comprehensive list of local and national guidelines underlining the need to provide more support and an increased comprehensive teaching plan specially tailored to dementia patients' needs. The development of a patient progress diary, with a traffic light system showing each stage that the patient has reached, has provided a visual, up-to-date guide to the patient's stoma management and highlights the need for further input to enable the patient to be discharged home safely and in a timely manner. The diary was formulated by the SCNs and printed by Coloplast, culminating in an easy-to-read booklet with a pictorial step-by-step guide to be inserted into patients' washbags. The diary was reviewed by Great Western Hospitals Patient Advice and Liaison Service (PALS) and the Carers Committee, who provided positive feedback and subsequently supported the development of this patient-focused tool. Since introducing the diary, our team has decided to implement it with all patients, with positive feedback from patients, relatives, carers and ward staff. This has assisted in safe, timely and effective discharge planning.
Subject(s)
Dementia , Caregivers , Humans , Palliative Care , Pamphlets , Patient DischargeABSTRACT
Regular service audits since 2008 gave a stoma care department confidence in the service it provides. In 2016 the department undertook a new audit to benchmark its services, using the Association of Stoma Care Nurses (ASCN) UK Revised Stoma Care Nursing Standards and Audit Tool (2015) . Of the 60 questionnaires given out, 43 were returned (71%). The results highlighted areas of good practice with positive patient feedback. However, it also identified that the team needed to improve documentation when offering patients the opportunity to meet a former patient with a stoma preoperatively and when discussing lifestyle issues. The results demonstrated poor preoperative compliance; this was lower than expected and did not concur with department statistics. The audit highlights the importance of clarity when developing a questionnaire to ensure all respondents not only interpret its meaning in the same way, but also only answer the questions specific to them.