TY - JOUR
T1 - Institution of a preoperative stoma education group class decreases rate of peristomal complications in new stoma patients
AU - Stokes, Audrey L.
AU - Tice, Shelly
AU - Follett, Suzi
AU - Paskey, Diane
AU - Abraham, Lini
AU - Bealer, Cheryl
AU - Keister, Holly
AU - Koltun, Walter
AU - Puleo, Frances J.
N1 - Publisher Copyright:
© 2017 by the Wound, Ostomy and Continence Nurses Society.
PY - 2017
Y1 - 2017
N2 - PURPOSE: The purpose of this study was to compare selected postoperative complications (including stomal and peristomal complications), hospital length of stay, and readmission rates in a group of patients who attended a preoperative educational intervention to a retrospective group of patients who did not receive the intervention. DESIGN: Retrospective, comparison cohort study. SUBJECTS AND SETTING: The intervention group comprised 124 patients who attended an educational session for persons with fecal ostomies at a single tertiary care center in the Northeastern United States. They were compared to f ndings from a group of 94 individuals who underwent ostomy surgery during a 1-year period before initiation of the class. Patients undergoing emergent procedures or who had previous stomas were excluded. We found no signif cant differences between the 2 cohorts with respect to age, gender, comorbidities, open versus minimally invasive procedures, or colorectal diagnoses. METHODS: A preoperative 2-hour stoma education class was led by certif ed WOC nurses for all patients undergoing colorectal surgeries in which the creation of a stoma was anticipated. This session included a didactic portion outlining postoperative expectations in the management of new ostomies (including dietary changes, prevention of dehydration, and an overview of ostomy supplies), as well as a hands-on portion to practice stoma care skills. We compared postoperative complications within 30 days (particularly stoma-related complications, including pouch leakage due to loss of seal, and peristomal skin irritation) between the group attending the education session and the control group. We also compared length of stay and 30-day readmission rates. RESULTS: Patients who participated in the educational intervention experienced signif cantly fewer peristomal complications than did patients in the historic control group (44.7% vs 20.2%, P =.002). Logistic regression analysis revealed that participation in the group was associated with a lower likelihood of peristomal skin complications (odds ratio = 0.35; 95% conf dence interval, 0.18-0.67). Their length of stay (median 6 days vs 5 days, P = NS), and the proportion who experienced 30-day readmission (20.2% vs 15.3%, P = NS), did not signif cantly differ. CONCLUSIONS: A preoperative stoma education group class signif cantly reduced the likelihood of frequent leakage from the ostomy pouching system and peristomal skin irritation.
AB - PURPOSE: The purpose of this study was to compare selected postoperative complications (including stomal and peristomal complications), hospital length of stay, and readmission rates in a group of patients who attended a preoperative educational intervention to a retrospective group of patients who did not receive the intervention. DESIGN: Retrospective, comparison cohort study. SUBJECTS AND SETTING: The intervention group comprised 124 patients who attended an educational session for persons with fecal ostomies at a single tertiary care center in the Northeastern United States. They were compared to f ndings from a group of 94 individuals who underwent ostomy surgery during a 1-year period before initiation of the class. Patients undergoing emergent procedures or who had previous stomas were excluded. We found no signif cant differences between the 2 cohorts with respect to age, gender, comorbidities, open versus minimally invasive procedures, or colorectal diagnoses. METHODS: A preoperative 2-hour stoma education class was led by certif ed WOC nurses for all patients undergoing colorectal surgeries in which the creation of a stoma was anticipated. This session included a didactic portion outlining postoperative expectations in the management of new ostomies (including dietary changes, prevention of dehydration, and an overview of ostomy supplies), as well as a hands-on portion to practice stoma care skills. We compared postoperative complications within 30 days (particularly stoma-related complications, including pouch leakage due to loss of seal, and peristomal skin irritation) between the group attending the education session and the control group. We also compared length of stay and 30-day readmission rates. RESULTS: Patients who participated in the educational intervention experienced signif cantly fewer peristomal complications than did patients in the historic control group (44.7% vs 20.2%, P =.002). Logistic regression analysis revealed that participation in the group was associated with a lower likelihood of peristomal skin complications (odds ratio = 0.35; 95% conf dence interval, 0.18-0.67). Their length of stay (median 6 days vs 5 days, P = NS), and the proportion who experienced 30-day readmission (20.2% vs 15.3%, P = NS), did not signif cantly differ. CONCLUSIONS: A preoperative stoma education group class signif cantly reduced the likelihood of frequent leakage from the ostomy pouching system and peristomal skin irritation.
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U2 - 10.1097/WON.0000000000000338
DO - 10.1097/WON.0000000000000338
M3 - Article
C2 - 28549049
AN - SCOPUS:85019744831
SN - 1071-5754
VL - 44
SP - 363
EP - 367
JO - Journal of Wound, Ostomy and Continence Nursing
JF - Journal of Wound, Ostomy and Continence Nursing
IS - 4
ER -