ABSTRACT
For years the influence of progressive digitalization has become noticeable in the work areas of care experts in ostomy, continence and wounds (PSKW). A few years ago the feasibility of tele-healthcare and the resulting quality of care for ostomates in the out of hospital area were also tested in international studies. The driving forces included the insurance companies in the healthcare system who wanted to build a cost-effective supply structure for the insured people using digital aids. Even before the corona crisis a health insurance service contract included the requirement that service providers also offer stoma care for ostomates via online access. For the first time, the option of remote care for people with an ostomy by service providers in the outpatient area was defined as part of the contract. In this article the possibility of telecare stomatherapy as a supplement to face to face care of ostomates by SKW care experts is presented and the situation under the current corona pandemic is considered.
ABSTRACT
Medical professionals follow evidence-based practice guidelines to achieve effective patient outcomes. Traditionally, to develop guidelines, a small group of experts examine evidence then agree on a set of statements, which are then published in journals. However, more than 7000 primary care journal articles are published monthly. This study examined a different way of drawing up practice guidelines, which involved large numbers of nurses from different countries directly in developing then disseminating the guidelines to speed up acceptance and the implementation of best practice. The results were consensus-based best practice guidelines for the treatment of patients with ostomies, which have received a high level of acceptance and enthusiasm from practitioners in 27 countries.
Subject(s)
Consensus , Nurses/psychology , Ostomy/nursing , Practice Guidelines as Topic , HumansABSTRACT
Evidence indicates that a common problem for the person with an ostomy is pouch leakage and the development of peristomal skin irritation, which can negatively affect quality of life. While it is clear that the pouching system seal leakage can cause profound problems for the person with an ostomy, little information is available on interventions that focus on leakage. To address this gap, an international group of ostomy nurse experts was convened to develop consensus-based practice guidelines to assist ostomy nurses in determining the best pouching system for the patient. The outcomes of these guidelines for the person with a stoma are to decrease leakage and increase security and confidence leading to an increased quality of life. A large-scale Modified Delphi Consensus-Building Process was used to identify key factors in assessing body and stoma profiles to determine the best pouching system. The resulting consensus provides practice guidelines on how to assess body and stoma profiles, engage and educate patients, and when to follow up with patients after hospital discharge or product change.
Subject(s)
Patient Participation/psychology , Practice Guidelines as Topic , Surgical Stomas/classification , Aftercare/methods , Delphi Technique , Humans , Physical Examination/methods , Program Development/methods , Surgical Stomas/adverse effects , Surveys and QuestionnairesABSTRACT
Ostomy skin barriers that incorporate a convexity feature have been available in the marketplace for decades, but limited resources are available to guide clinicians in selection and use of convex products. Given the widespread use of convexity, and the need to provide practical guidelines for appropriate use of pouching systems with convex features, an international consensus panel was convened to provide consensus-based guidance for this aspect of ostomy practice. Panelists were provided with a summary of relevant literature in advance of the meeting; these articles were used to generate and reach consensus on 26 statements during a 1-day meeting. Consensus was achieved when 80% of panelists agreed on a statement using an anonymous electronic response system. The 26 statements provide guidance for convex product characteristics, patient assessment, convexity use, and outcomes.
