Breakthroughs and Barriers to Stoma Education: Wisdom Gained from a Pilot Study
Keywords:
Structured clinical guidelines, Preoperative site marking, structured patient education, peristomal complications, length of stay, readmissions, quality of life, ostomyAbstract
Background: The Ostomy and Continence Diversion Patient Bill of Rights asserts ostomates should receive standardized ostomy education. These programs reduce anxiety, improve self-efficacy, and directly address and lower health disparities.
Objective: The aim of this project was to implement a structured perioperative ostomy education program and evaluate the program’s effects on readmission rates due to ostomy complications, postoperative length of stay (PLOS), and quality of life after ostomy surgery.
Methods: A perioperative ostomy education program was implemented in an acute care hospital, with program evaluation. Adult patients undergoing fecal diversion surgery from July 1 to December 31, 2023, were recruited via convenience sampling. Participants completed two validated surveys: the Ostomy Self-Care Knowledge Assessment (OSCKA) (n = 7) and the Stoma Quality of Life survey (n = 7). Readmissions and PLOS were examined for six months before (n = 13) and six months after implementation (n = 13).
Results: Seven ostomates completed the OSCKA, with mean scores of 20, a high level of understanding. Seven ostomates completed the two-week Stoma-QOL survey, and three of those seven repeated the survey within two months. Ostomates related improved self-confidence, but sleep, and ostomy apparatus concerns persisted. No readmissions occurred in either cohort, but the PLOS decreased.
Conclusions: An evidence-based ostomy education protocol was implemented with subsequent evaluation. Participants showed a high level of comprehension at discharge. Quality of life measures show that further social support is needed. The postoperative length of stay was decreased by two days, and no readmissions occurred.