Best Practice Guidelines for Ostomy Care in Neonates, Children, and Adolescents: An Executive Summary.

Pediatric ostomy care nursing is primarily based on best practice principles; evidence supporting care remains sparse. Although many principles of ostomy care are similar across the life span, the indications for ostomy surgery and clinical approach differ when working with neonates, children, and adolescents. An international group of pediatric ostomy care experts was brought together to offer their expertise on caring for children with an ostomy. Best practice guidelines were developed based on literature review and consensus among expert panelists. The purpose of these guidelines is to provide a resource for best practices to health care professionals caring for pediatric patients with an ostomy. This article is divided into 2 sections: the first highlights clinical aspects of pediatric ostomy care, while the second addresses psychosocial aspects of ostomy care, including effects of an ostomy on the family. These guidelines address ostomy care and need within the full spectrum of the pediatric age groups, from neonates to adolescents.

Challenges faced by people with a stoma: peristomal body profile risk factors and leakage.

AIM: The Ostomy Life Study 2019 aimed to obtain a better understanding of the challenges faced by people with stoma. METHODS: Online survey with participants from 17 countries. FINDINGS: Of the 54 614 individuals invited to take part, 5187 responded; 62% of the respondents avoided physical and social activities because of their stoma and 37% had never consulted their stoma care nurse to have the fit of their stoma product checked. In a subgroup receiving questions on leakage (n=4209), output under the baseplate and leakage onto clothes were experienced within the previous month by 76% and 26% of respondents, respectively. Higher chance of leakage was associated with an irregular stoma shape and peristomal body profile; a stoma level at or below the skin surface; and the presence of creases, folds and other changes in the peristomal area. CONCLUSION: Leakage and access to a stoma care nurse to provide the necessary care and guidance remain important concerns for individuals with a stoma.

Differences in Ostomy Pouch Seal Leakage Occurrences Between North American and European Residents.

PURPOSE: The purpose of this study was to compare experiences and concerns about pouch seal leakage between persons with ostomies residing in North America (Canada and the United States) and Europe (United Kingdom, Netherlands, Sweden, Germany, Belgium, France, and Italy). Differences in reported pouch wear time and accessories used between the 2 groups were also examined. DESIGN: Secondary analysis of data from a cross-sectional study (Ostomy Life Study). SUBJECTS AND SETTINGS: Responses from persons residing in European countries (n = 1939) were compared with responses of 1387 individuals residing in North American countries. METHODS: Persons with an ostomy completed a questionnaire that focused on 4 topics related to the daily use of an ostomy pouching system (pouch seal leakage, ballooning, appearance of pouching system such as color and size of the pouch and whether it is discrete under clothing, and coupling failure of 2-piece pouching systems). Pouch seal leakage was defined as stomal effluent seeping between the skin and the wafer of the ostomy pouching system. Statistical analysis was performed using a proportional odds model including various variable effects. Special attention was given to frequency of pouch seal leakage occurrences. All tests were 2-sided; P values ≤.05 were deemed statistically significant. RESULTS: Participants living in the North American countries indicated they were more likely to experience leakage from the ostomy (odds ratio = 2.610, 95% CI 2.187-3.115; P < .0001). Findings also indicated they were more likely to worry about pouch seal leakage than those in the European countries' data set (odds ratio = 2.722, 95% CI 2.283-3.246; P < .0001). Participants residing in the North American countries had significantly longer wear times than those participants in the European countries (P < .0001, χ test). The use of accessories was associated with a longer pouching system wear time. CONCLUSION: Study results suggest that participants from the North American countries indicated significantly more experience with and worries about leakage and longer wear time than the participants from the European population. Additional research is needed to determine the reasons for these differences.

Evaluation of a new ostomy mouldable seal: an international product evaluation.

A new mouldable seal, Brava® Protective Seal, was evaluated by patients on aspects related to residue, durability, and preference. A total of 135 patients from four countries participated (Denmark, Germany, Japan and the USA) and the new product was compared to the patients' usual pouching systems. Less residue and easier skin cleansing was observed, which may benefit patient quality of life. The possible benefits of less residue for peristomal skin health need further investigation.

Is Twice-Daily Skin Moisturizing More Effective Than Routine Care in the Prevention of Skin Tears in the Elderly Population?

BACKGROUND: Skin-moisturizing routines are part of a bundle of interventions designed to prevent skin tears. OBJECTIVE: This Evidence-Based Report Card reviews the effect of twice-daily moisturization of the skin on skin tear occurrence versus occurrence rates using routine skin care. SEARCH STRATEGY: The literature was systematically reviewed for studies that evaluated the use of standardized skin moisturizers on the rate of skin tears in the older adults (>60 years of age). A professional librarian performed the literature search, which yielded 446 articles. Following title and abstract reviews, we identified and retrieved 3 studies that met inclusion criteria. FINDINGS: Evidence concerning the effectiveness of routine twice-daily skin moisturizing reducing the rate of skin tears is mixed. Routine twice-daily skin moisturizing did not significantly result in a lower incidence of skin tears in long-term care residents compared to usual care in one study. However, the occurrence of skin tears per 1000 occupied beds was 50% lower when a moisturizer applied twice daily was compared to usual care. CONCLUSION: Routine skin moisturizing is recommended as one component of a prevention program for skin tears among aged adults residing in long-term care facilities.