Implantación de la Guía de buenas prácticas para el cuidado y manejo de la ostomía: resultados en cuidados / Implementation of best practice guidelines for ostomy care and management: Care outcomes

INTRODUCCIÓN: Los cuidados proporcionados a las personas ostomizadas son cruciales para su evolución y rehabilitación. Las Guías de práctica clínica de la Registered Nurses' Association of Ontario recogen las intervenciones enfermeras con mayor evidencia en el cuidado del paciente ostomizado. El objetivo del estudio es analizar el impacto en los cuidados y los resultados de salud de los pacientes tras la implantación de la guía Cuidado y manejo de la ostomía. MÉTODO: Estudio cuasiexperimental pre-post test en todos los pacientes a los que se les realizó una ostomía digestiva o urológica en 8 Centros Comprometidos con la Excelencia en Cuidados® donde se implanta la guía para el cuidado y manejo de la ostomía, desde 2012 hasta 2018. Se analizaron y compararon variables clínicas de proceso y de resultados en salud en 3 períodos de tiempo. Se realizó un análisis descriptivo y se compararon las proporciones entre períodos, mediante Chi cuadrado, aplicando la corrección de Yates, considerando un nivel de confianza del 95%. RESULTADOS: La educación preoperatoria pasó del 36,7 al 47,3% (p < 0,05); el marcaje de la ostomía, del 25,2 al 33,8% (p < 0,05); la evaluación postoperatoria, del 94,8 al 59% (p < 0,05); la educación postoperatoria, del 75,5 al 91,9% (p < 0,05); las complicaciones en la piel periestomal, del 16,6 al 10,9% (p < 0,05), y las complicaciones en la ostomía, del 21,8 al 27,9% (p < 0,05). CONCLUSIONES: La implantación de la guía para el cuidado y manejo de la ostomía produjo mejoras en los cuidados preoperatorios, el marcaje del estoma y en las complicaciones de la piel periestomal

INTRODUCTION: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications

Implementation of best practice guidelines for ostomy care and management: Care outcomes. / Implantación de la Guía de buenas prácticas para el cuidado y manejo de la ostomía: resultados en cuidados.

INTRODUCTION: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.