Skills Checklist ostomy care PDF

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Summary

Skills checkoff list for Ostomy care...

Description

FOR FACULTY USE ONLY STUDENT’S NAME

DATE

EDUCATOR’S NAME

DATE

SCORE

Skills Modules 2.0 Checklist for Ostomy Care General

CHECK/ INITIAL

COMMENTS

EDUCATOR IMPLEMENTATION GUIDE

Verify prescription Patient record Assess for procedure need

Identify, gather, and prepare equipment and supplies Colostomy irrigation (clean gloves, gown, goggles, washcloths, absorbent pad, colostomy irrigation set, warm tap water, IV pole or wall hook, ostomy pouch system, graduated cylinder) Draining an ostomy pouch (clean gloves, absorbent pad, wet washcloths, graduated cylinder) Replacing the one-piece ostomy system (clean gloves, absorbent pad, washcloths, stoma measurement guide, skin barrier, one-piece pouching system) Ileostomy and urostomy care (clean gloves, drainage catheter, water-soluble lubricant, washcloth and towel, stoma dressing)

Apply principles of aseptic practice Hand hygiene Personal protective equipment Disposal of waste

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STUDENT

SKILLS MODULES 2.0 CHECKLIST FOR OSTOMY CARE

General

CHECK/ INITIAL

COMMENTS

Communicate effectively EDUCATOR IMPLEMENTATION GUIDE

Privacy Patient identification Patient teaching

Provide for a safe environment Body mechanics Equipment placement Patient safety

Demonstrate procedural steps

CHECK/ INITIAL

COMMENTS

Colostomy irrigation Hang irrigation bag with warmed tap water on IV pole or wall hook. Raise bed level. Prepare supplies. Place pad under pouch. Don gloves, gown, and goggles. Remove ostomy pouch. Remove fecal material from stoma. Discard supplies, remove gloves, perform hand hygiene, and don clean gloves. Secure irrigation sleeve. For two-piece ostomy pouching system, attach irrigation sleeve using flange mechanism. Lubricate cone with water-soluble lubricant.

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SKILLS MODULES 2.0 CHECKLIST FOR OSTOMY CARE

Demonstrate procedural steps

CHECK/ INITIAL

COMMENTS

Colostomy irrigation (continued) EDUCATOR IMPLEMENTATION GUIDE

Insert cone into top opening of irrigation sleeve and then into stoma at angle that matches bowel. Unclamp irrigation tubing and allow water to flow slowly. If patient reports cramping, slow or stop flow, keep cone in place, and have patient take deep breaths until cramping resolves. After irrigant and effluent have drained, place bottom of irrigation sleeve into graduated cylinder and remove clamp. Remove irrigation sleeve, clean peristomal area, and reapply pouching system.

Draining an ostomy pouch Empty ostomy pouch when one third to one half full. Choose time when bowel is least active, usually between 2 to 4hours after meals or just before meal. Don gloves. Raise bed. Place pad underneath pouch. Tilt bottom of pouch upward and remove closure clamp. If fecal material is thick, fold ends of pouch over to make cleaning easier. Place graduated cylinder underneath open end of pouch. With two-piece flanged system, empty pouch by unsnapping it. If effluent is draining continuously, use clipped opening fordrainage. Drain pouch. Clean opening of pouch. Replace clip.

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SKILLS MODULES 2.0 CHECKLIST FOR OSTOMY CARE

Demonstrate procedural steps

CHECK/ INITIAL

COMMENTS

Replacing the one-piece ostomy system EDUCATOR IMPLEMENTATION GUIDE

Choose time when bowel is least active, usually between 2 to 4 hours after meals or just before meal. Don gloves. Prepare supplies. To remove pouch, begin at one corner and slowly pull off remaining portion of barrier while pushing on underlying skin. Cleanse stoma and peristomal skin with warm water and washcloth or gauze pads. Dry peristomal skin by patting gently with gauze or soft cloth. Remove gloves, perform hand hygiene, and don clean gloves. Inspect color and turgor of stoma and peristomal skin. Use commercially prepared measuring guide in pouching system kit to measure stoma. Select opening size that matches stoma. Trace selected size opening onto paper back of skin barrier’s adhesive side. Cut opening about 1/8 larger than stoma. Bevel edges. Make sure skin is dry. Remove backing from skin barrier and center hole over stoma. Apply pressure evenly by pressing finger on adhesive backing and going around stoma to help it adhere to skin. Maintain that pressure for 1 to 2 minutes to ensure optimal adherence. Connect pouch to skin barrier by pressing pouch opening onto ring until it snaps into place.

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STUDENT

SKILLS MODULES 2.0 CHECKLIST FOR OSTOMY CARE

Demonstrate procedural steps

CHECK/ INITIAL

COMMENTS

Ileostomy and urostomy care EDUCATOR IMPLEMENTATION GUIDE

Empty pouches when one third full. If possible, have patient sit on toilet. Place towel underneath stoma. Lubricate tip of drainage catheter with water-soluble lubricant and insert it into stoma, gently pushing downward. Instruct patient to take deep breath and gently apply pressure on catheter to move it past nipple valve. Once tip of catheter passes through valve, gently advance catheter to suture marking surgeon made. Allow pouch to drain completely. After pouch is empty, remove catheter, measure output, and rinse catheter with warm water. Clean peristomal skin and apply new stoma dressing.

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SKILLS MODULES 2.0 CHECKLIST FOR OSTOMY CARE

Documentation

CHECK/ INITIAL

COMMENTS

Document per facility policy EDUCATOR IMPLEMENTATION GUIDE

Date and time Assessment findings (bowel sounds, flatus, abdominal distention,tenderness) Characteristics of stoma and peristomal skin Appearance of any sutures Type of skin barrier or accessories used (paste, powder, skin sealant, strips, rings) to prevent or treat complications Measurement of stoma Type of pouching system used, especially if this has changed Any changes in peristomal skin care procedures or products used Characteristics and amount of output Any complications of procedure performed Patient’s level of participation Strategies to promote self-management Patient’s ability to manage skills required for ostomy care

Comments

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