RESUMO
OBJECTIVE: We evaluated a new fistula and wound management system; ostomy and wound care nurses were queried about willingness to use the product in future patients, product wear time and pouch leakage, perifistular skin condition, access for wound care, pouching time, patient mobility and comfort, odor management, pouch flexibility, adhesiveness, and erosion. A health economic assessment was also done. METHOD: Twenty-two patients (5 males and 17 females) with an abdominal fistula participated in the study. Participants tested 75 pouches, representing an average of 3.4 pouches per subject. The investigator at each site who performed the pouch changes completed a questionnaire at baseline, during the test, and after testing the pouches. Participants also completed a set of questions after each test pouch was removed. RESULTS: In 21 of 22 cases, the nurses would consider using the new system on future patients. After each pouch removal, patients were asked whether they were able to move around while wearing the test pouch and they answered yes 95% of the time. The new system was found to have significantly longer wear time than traditional systems (P = .003), but the average time spent on changing the pouches was not significantly different (P = .07). Access for fistula and wound care was rated as excellent in the new pouching system, and comfort was rated as very good. CONCLUSION: The results of the study suggest that all of the key requests received from nurses for an improved system for fistula and wound management were met by the new system.
Assuntos
Fístula do Sistema Digestório/enfermagem , Abdome , Bolsas Cólicas , Feminino , Humanos , Masculino , Estomia/enfermagem , Higiene da Pele/enfermagem , CicatrizaçãoRESUMO
If your patient has cancer, be prepared to help her manage such serious GI complications as bowel obstruction, peritonitis, fistula formation, and intestinal perforation.
Assuntos
Neoplasias Abdominais/complicações , Neoplasias Abdominais/enfermagem , Gastroenteropatias/etiologia , Gastroenteropatias/enfermagem , Idoso , Fístula do Sistema Digestório/diagnóstico , Fístula do Sistema Digestório/etiologia , Fístula do Sistema Digestório/enfermagem , Fístula do Sistema Digestório/terapia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/enfermagem , Obstrução Intestinal/terapia , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Perfuração Intestinal/enfermagem , Perfuração Intestinal/terapia , Peritonite/diagnóstico , Peritonite/etiologia , Peritonite/enfermagem , Peritonite/terapiaAssuntos
Doenças da Aorta/enfermagem , Doenças da Aorta/cirurgia , Fístula do Sistema Digestório/enfermagem , Fístula do Sistema Digestório/cirurgia , Enfermagem Perioperatória/métodos , Idoso , Doenças da Aorta/mortalidade , Fístula do Sistema Digestório/mortalidade , Educação Continuada em Enfermagem , Humanos , Masculino , Avaliação em Enfermagem , Fatores de RiscoRESUMO
OBJECTIVES: To provide a review of metastases involving the gastrointestinal system, including the specific problems of liver metastasis, bowel obstruction, ascites, biliary obstruction, and gastrointestinal fistulas. DATA SOURCES: Research studies, review articles, and book chapters. CONCLUSIONS: When metastasis involves the gastrointestinal tract, the emotional distress is coupled with debilitating symptoms and marked nutritional deficits. Treatment decisions must consider potential benefits and risks and affect on quality of life. IMPLICATIONS FOR NURSING PRACTICE: An understanding of the disease process and alternative treatment interventions will assist nurses to effectively anticipate and manage symptoms that may develop and educate patients and families so they can participate in decisions regarding their treatment.