Staff nurse confidence in their skills and knowledge and barriers to caring for patients with ostomies.

PURPOSE: Patients with ostomies often state that staff nurses display a lack of confidence in knowledge and skills related to ostomy care. This study examined the confidence and perceptions of barriers among hospital staff nurses when caring for ostomy patients. DESIGN: Descriptive, cross-sectional study. SUBJECTS AND SETTING: A convenience sample of 576 staff nurses, including 510 registered, 61 licensed practical, and 5 unspecified nurses, participated in the study. The study sample practiced at 3 sites: an academic medical center, a Veteran's Administration Center, and a not-for-profit hospital in the state of New York. METHODS: Links to a 17-question electronic survey were distributed by e-mail. The survey included items that queried demographics, availability of an ostomy nurse, ostomy training in school, and frequency of care of ostomy patients. Participants also responded to 22 statements using a 6-point Likert Scale (1 = Strongly Disagree, 6 = Strongly Agree). These statements queried confidence in providing ostomy care and perceived barriers. RESULTS: Higher confidence in ostomy care knowledge (k) and skills (s) was associated with being an LPN (P < .0001 [k], P = .003 [s]), years of nursing experience (P = .009 [k], P = .01 [s]), having ostomy training (P = .002 [k], P = .02 [s]), frequency of providing ostomy care (P < .0001 for each), and knowing how to obtain and use ostomy supplies (P < .0001 for each). The highest reported confidence was associated with emptying a pouch (mean ± SD, 5.32 ± 0.91), and the lowest was knowledge of nutrition for persons with ostomies (3.96 ± 1.21). Almost 1 in 5 respondents (18.6%) was unaware that a certified ostomy nurse practiced at their institution. CONCLUSION: Confidence of staff nurses in delivering ostomy care was higher with training and experience. Opportunities for continuing education may increase staff nurse confidence in providing ostomy care. The greatest barrier was lack of knowledge about the presence of an ostomy nurse as a resource in caring for patients.

Starting and maintaining a hospital-based ostomy support group.

Ostomy surgery alters body image; this process can be distressing for patients, who must transition through a type of grieving process. Attending an ostomy support group provides an atmosphere of acceptance, a feeling of being able to cope, and mutual respect. The WOC nurse employed by an acute care facility is well positioned to facilitate such a group. Our clinical experiences strongly suggest that patients move more rapidly through the stages of grief to acceptance of the ostomy when they interact with others who have shared similar experiences. This article describes how one hospital started and maintains an ostomy support group, and gives suggestions for successful implementation of a support group.