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Objective To cultivate specialist nurses to perform preoperative stoma site marking in patients to receive enterostomy and improve the rate of preoperative stoma site marking and the ability of preoperative stoma site marking in specialist nurses. Methods The rate of preoperative stoma site marking in 148 patients from July 2016 to October 2016 was investigated and the reason of not receiving preoperative stoma site marking was analyzed. Nineteen primary nurses were trained to perform preoperative stoma site marking instead of the traditional pattern which was performed by enterostomy therapist and physician. The training included the criteria of preoperative stoma site marking, difficult preoperative stoma site marking, demonstration, group exercises, theoretical and operational assessment. The preoperative stoma site marking of 156 patients were performed by specialist nurses from November 2016 to February 2017.Then,the rate of preoperative stoma site marking,accuracy of stoma location,and knowledge of preoperative stoma site marking were compared between the traditional and new management pattern. Results The preoperative stoma site marking rate was 91.89%(136/148)and the accuracy rate was 94.12%(127/136)in traditional management pattern.The lack of enterostomy therapist, surgery performed on weekends and emergency surgery were the reasons that preoperative stoma site marking was not performed.After changing the management pattern,the preoperative stoma site marking rate was increased to 98.72%(154/156) and there was a significant difference between them (χ2=8.06, P <0.05).The accuracy of localization was decreased to 92.86%(143/154),but there was no significant difference between them(χ2=0.03,P>0.05).The rate of acquiring preoperative stoma site marking knowledge in nurses was increased from 8/19 to 18/19 with a significant difference(χ2=12.18,P<0.01). Conclusions The pattern of preoperative stoma site marking was changed and the new pattern improved the rate of preoperative stoma site marking,and didn′t affect the accuracy of preoperative stoma site marking.Meanwhile,we also improved the nurses′level of preoperative stoma site marking in our department.
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PURPOSE: The complication after colostomy formation may place undue hardship and emotional trauma on the ostomates. The purpose of this study was to find the effect of preoperative stoma site marking on postoperative stoma related complication. METHODS: We recruited 127 colostomy patients who underwent sigmoid or descending end colostomy, by elective operation. Transverse colostomy, loop colostomy, and emergency operation were excluded in this study. We divided the patients into two groups according to pre-operative stoma site marking by an enterostomal therapist. Postoperative stoma related complications were compared and analysed prospectively using chi-square test and paired t-test. Significance was assigned to a P value of < 0.05. RESULTS: Among 127 patients, 49 were marked preoperatively (marking group) while 78 were not marked (non- marking group). Overall stoma related complications were developed in 32 (25%) cases. Major complications including prolapse, parastomal hernia, stenosis were developed in 10 (8%) cases and minor complications including peristomal dermatitis and wound infection were developed in 22 (17%) cases. Stoma related complications were developed in 7 (14%) cases in the marking group and 25 (32%) cases in the non-marking group (P<0.05). Major complications were developed in 2 (4%) cases in the marking group and 8 (10%) cases in the non-marking group. Minor complications were developed in 5 (10%) cases in the marking group and 17 (22%) cases in the non-marking group. However, the difference in major and minor complications between the groups was not statistically significant. Of minor complications in the non-marking group, 9 (53%) cases due solely to postoperative frequent stool leakage caused by inappropriate location of the stoma. However, in the marking group, postoperative stool leakage was not observed. CONCLUSIONS: Preoperative stoma site marking by an enterostomal therapist may reduce postoperative stoma related complication. All elective procedure that result in stoma formation should be assessed and marked preoperatively.