ABSTRACT
Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.
Subject(s)
Algorithms , Home Care Services/standards , Ostomy/nursing , Quality Improvement/statistics & numerical data , Adult , Aged , Aged, 80 and over , Colostomy/adverse effects , Colostomy/nursing , Education, Nursing, Continuing/methods , Education, Nursing, Continuing/standards , Education, Nursing, Continuing/statistics & numerical data , Evidence-Based Nursing/methods , Evidence-Based Nursing/statistics & numerical data , Home Care Services/statistics & numerical data , Humans , Ileostomy/adverse effects , Ileostomy/nursing , Middle Aged , Nurses/psychology , Nurses/statistics & numerical data , Ostomy/statistics & numerical data , Pennsylvania , Pilot Projects , Program Evaluation/methods , Program Evaluation/statistics & numerical data , Self Efficacy , Skin/injuries , Skin Care/nursing , Skin Care/statistics & numerical data , Surgical Stomas/adverse effects , Surgical Stomas/statistics & numerical data , WorkforceABSTRACT
BACKGROUND: The management of chronic (nonhealing) wounds with epibole is challenging and costly, especially when the problem is not promptly identified or the patient is intolerant to conventional treatments. CASE DESCRIPTION: We describe the use of a polymeric membrane dressing (PMD) in 3 patients with chronic (nonhealing) wounds and epibole who were unable to be treated with traditional interventions such as silver nitrate or sharp debridement. Patient 1 was a 51 year-old male with a right foot stasis ulcer with 60% fibrin/slough to the wound bed, patient 2 was a 58-year-old female with a stage 4 pressure injury of the left hip with undermining, and patient 3 was a 62-year-old female with a dehisced abdominal surgical wound. CONCLUSION: The use of PMD, when applied using a specific technique, proved to be effective for resolving epibole in 3 patients with nonhealing wounds of differing etiologies. Based on these experiences, we postulate that topical therapy using a PMD may provide an effective alternative means for resolving epibole and promoting wound healing in patients unable to undergo surgical excision or chemical cauterization.
