Perfil Biossociodemográfico e Digital de Participantes de uma Intervenção Educativa Online sobre Colostomia / Biosociodemographic and Digital Profile of Participants in an Online Educational Intervention on Colostomy / Perfil Biosociodemográfico y Digital de los Participantes en una Intervención Educativa Online Sobre Colostomía

Objetivo:Identificar o perfil biossociodemográfico e digital das pessoas com colostomia e dos cuidadores que participaram da intervenção educativa online sobre colostomia. Método: Estudo transversal realizado com 20 pessoas com colostomia e 32 cuidadores, no período de setembro/novembro de 2020, em um centro integrado de saúde de Teresina, Piauí. Utilizaram-se instrumentos de caracterização sociodemográfica e clínica, acesso ao computador e à internet e proficiência digital básica, todos submetidos à análise estatística. Resultados: Das pessoas com colostomia e cuidadores, 60% eram do sexo masculino e 75% do feminino. Predominou a colostomia temporária (55%) de cor vermelho vivo e formato regular (80%). A maioria dos cuidadores tinha ocupação laboral (46,9%), e 8 horas/semanais eram dedicadas ao cuidado. O grau de proficiência digital foi baixo (76,9%). Conclusão: A identificação do perfil biossociodemográfico e digital dos participantes pode contribuir na adoção de estratégias educativas conforme a maturidade digital ou a necessidade de suporte para o uso de tecnologias, para otimização do cuidado em saúde e qualificação da assistência prestada.

Objective:To identify the biosociodemographic and digital profile of people with colostomy and caregivers who participated in the online educational intervention on colostomy. Method: Cross-sectional study carried out with 20 people with colostomy and 32 caregivers, in the period of September/November 2020, in an integrated health center in Teresina, Piauí, Brazil. Sociodemographic and clinical characterization instruments, computer and internet access, and basic digital proficiency submitted to statistical analysis were used. Results: Among people with colostomy and caregivers, 60% were male and 75% female. Temporary colostomy (55%) with bright red color and regular shape (80%) predominated. Most caregivers had a job (46.9%), and 8 hours/week were dedicated to care. The degree of digital proficiency was low (76.9%). Conclusion: The identification of the biosociodemographic and digital profile of the participants can contribute to the adoption of educational strategies according to digital maturity or the need for support for the use of technologies, to optimize health care and qualify the assistance provided.

Objetivo:Identificar el perfil biosociodemográfico y digital de personas con colostomía y cuidadores que participarían de la intervención educativa en línea sobre colostomía. Método: Estudio transversal, realizado con 20 personas con colostomía y 32 cuidadores, en el período de septiembre/noviembre de 2020, en un Centro Integrado de Salud de Teresina, Piauí. Se utilizaron instrumentos de caracterización sociodemográfica y clínica, acceso a computador e internet y competencia digital básica sometidos a análisis estadístico. Resultados: La mayoría de las personas con colostomía y cuidadores eran hombres (60%) y mujeres (75%), respectivamente. Predominó la colostomía temporal (55%) de color rojo vivo y forma regular (80%). La mayoría de los cuidadores tenían trabajo (46,9%), y se dedicaban al cuidado 8 horas/semana. El grado de competencia digital fue bajo (76,9%). Conclusión: La identificación del perfil biosociodemográfico y digital de los participantes puede contribuir para la adopción de estrategias educativas de acuerdo con la madurez digital o la necesidad de apoyo para el uso de tecnologías, para optimizar la atención en salud y calificar la asistencia brindada

[Experience of reconstructive laparoscopic procedures in patients with terminal colostomy]. / Opyt osvoeniia vosstanovitel'nykh operatsii laparoskopicheski-assistirovannym sposobom u bol'nykh s kontsevoi kolostomoi.

AIM: To analyze the ways and terms of training for laparoscopy-assisted reconstruction operations via learning curves analysis and to compare the outcomes obtained both during training for technique and after that. MATERIAL AND METHODS: There were 93 reconstructive laparoscopic procedures in 58 (62.36%) patients with terminal colostomy. All patients were operated by the same surgeon. Learning curves have been created and analyzed. RESULTS: Analysis showed that all surgical features are achieved by the 30th intervention indicating the end of learning period. Significantly less surgical trauma has been observed along with development of surgery. CONCLUSION: Improved results are achieved by reduced dissection of adhesions, the use of mechanical suture for intestinal anastomosis and increased number of anastomoses made in intracorporeal fashion.

Autocuidado com a estomia intestinal e equipamento coletores: perspectiva das pessoas estomizadas intestinais, familiares e equipe multidisciplinar do programa de ostomizados / Self-care with intestinal ostomy and collecting equipment: perspective of ostomized people, relatives, and the multidisciplinary team of the Program for Ostomized People

Resumo: Trata-se de um estudo de desenho misto, do tipo sequencial explanatório, sendo que na primeira etapa quantitativa descritiva e transversal o objetivo foi analisar as características sociodemográficas, clínicas e de capacidade de autocuidado de pessoas estomizadas intestinais cadastradas em um Programa de Ostomizados do interior paulista; e na segunda etapa qualitativa exploratória foi analisar e construir o significado da experiência de autocuidado com a estomia intestinal, na perspectiva de pessoas estomizadas intestinais, familiares e da equipe multidisciplinar do Programa de Ostomizados (Parecer nº 896.782/2014 CEP/EERP-USP). Na etapa quantitativa aplicou-se dois instrumentos, um para caracterização sociodemográfica de pessoas estomizadas e seu familiar e outro para mensurar a capacidade de autocuidado de pessoas estomizadas intestinais e de seus familiares, mediante critérios de inclusão e exclusão. A análise estatística descritiva dos dados indicou, que do total de 120 pessoas estomizadas intestinais, predominou 57,5% participantes do sexo masculino; 64,9% com idade até 73 anos; 68,4% com até cinco anos de estudo e 71,0% casados; 76,0% possuíam colostomia, sendo 62,6% por neoplasia colorretal; com presença complicações em 54,2% destas pessoas, principalmente a hérnia paraestomal em 39,1%; e 68,5% utilizavam a bolsa coletora de uma peça drenável. Quanto à capacidade de autocuidado geral, 95,9% pessoas estomizadas apresentaram capacidade plena, contudo, 56,8% apresentaram capacidade plena para o autocuidado específico com a estomia intestinal e equipamentos coletores. Ainda, participaram desta etapa, 32 familiares, com predomínio de 75% do sexo feminino; 56,2% acima de 60 anos; 46,9% com estudo entre 5 e 10 anos; com 71,9% casados/amasiados; 68,8% sem atividade laboral e 50,0% com renda familiar entre 3 e 4 salários mínimos. Estes resultados possibilitaram dimensionar o contexto do estudo e refinar os critérios de seleção dos possíveis participantes para a etapa qualitativa. Esta foi desenvolvida por meio de entrevistas em profundidade com a técnica do grupo focal, distintamente para os participantes estomizados, familiares e profissionais do Programa de Ostomizados, além do diário de campo, da observação não participante e participante para a obtenção dos dados, com utilização da Análise Temática e do Modelo Social da Deficiência para a interpretação. A experiência de pessoas estomizadas intestinais foi categorizada com o tema "A experiência da necessidade do autocuidado após o processo de estomização intestinal", com dois núcleos temáticos "Assistência interdisciplinar necessária às pessoas estomizadas intestinais"; e "O autocuidado para a reabilitação da pessoa estomizada intestinal", que evidenciou a necessidade de assistência especializada hospitalar e a continuidade do suporte profissional interdisciplinar para o seguimento ambulatorial. Os dados dos familiares foram discutidos mediante o tema: "Desafios do familiar no convívio com a pessoa estomizada intestinal", com as unidades temáticas "A sobrecarga da responsabilização pelo cuidado e o preconceito da estomia intestinal"; e "Nova dinâmica familiar para a reabilitação da pessoa estomizada intestinal", que enfatizou a importância da inserção da família no planejamento da assistência especializada e o suporte profissional para estes. A experiência dos profissionais foi explorada com o tema "Desafios para a implementação do Programa de Ostomizados", composta pelos núcleos temáticos "Em busca do trabalho em equipe no Programa de Ostomizados"; e "Demandas de assistência especializada para pessoas estomizadas intestinais", que evidenciou as suas expectativas sobre as necessidades de assistência especializada de pessoas estomizadas intestinais e o trabalho em equipe. Diante da consonância da análise interpretativa sobre as experiências das pessoas estomizadas, dos familiares e dos profissionais do Programa de Ostomizados, o significado construído para a experiência de necessidade de autocuidado com a estomia e equipamentos coletores foi "a luta cotidiana para adoção de um novo estilo de vida para além da estomia e dos equipamentos coletores, em busca de reabilitação". Os resultados das duas etapas do estudo evidenciaram a complexidade sobre o autocuidado para esta clientela, que constitui o início de sua reabilitação. Para tanto, há necessidade da inclusão do conceito de deficiência física, no preparo das pessoas estomizadas intestinais e dos familiares, assim como na capacitação dos profissionais de saúde, para o enfrentamento do estigma e preconceito social e do auto preconceito, assim como dos desafios cotidianos para o estabelecimento de um novo estilo de vida, com seguimento especializado interdisciplinar

Abstract: This is a study of mixed design, typified as explanatory sequential, where, in the first quantitative, descriptive and cross-sectional stage, the objective was to analyze the sociodemographic, clinical and self-care characteristics of ostomized individuals enrolled in a Program for Ostomized People in the countryside of the state of São Paulo; and, in the second exploratory qualitative stage, it aimed to analyze and to construct the meaning of the self-care experience with intestinal ostomy, from the perspective of patients, relatives, and the multidisciplinary team of the Program for Ostomized People (Opinion nº 896.782/2014 CEP/EERP-USP). In the quantitative stage, we applied two instruments, one for the sociodemographic characterization of the ostomized subjects and their relatives, and another to measure the self-care capacity of the ostomized subjects and their relatives, through inclusion and exclusion criteria. The descriptive statistical analysis of the data indicated that, of the total of 120 surveyed ostomized subjects, there was a predominance of 57.5% male; 64.9% aged up to 73 years; 68.4% with up to five years of schooling and 71.0% married; 76.0% had colostomy, of which 62.6% due colorectal neoplasm; with complications present in 54.2% of ostomized patients, mainly the parastomal hernia in 39.1%; and 68.5% used the one-piece drainage bag. As for the general self-care capacity, 95.9% of ostomized subjects showed full capacity; however, 56.8% showed full capacity for the specific self-care with intestinal ostomy and collecting equipment. Moreover, 32 relatives took part in this stage, with a predominance of 75% female; 56.2% aged over 60 years; 46.9% with schooling between 5 and 10 years; with 71.9% married/stable relationship; 68.8% without work activity and 50.0% with family income between 3 and 4 minimum wages. These results allowed us to measure the context of the study and to refine the criteria for selecting the possible participants for the qualitative stage. This was developed by means of in-depth interviews with the focal group technique, distinctly for the ostomized participants, relatives, and the professionals of the Program for Ostomized People, besides field diary, non-participant and participant observation to obtain the data, using Thematic Analysis and the Social Model of Disability for interpreting them. The experience of the ostomized patients was categorized with the theme "The experience of the need for self-are after the process of intestinal ostomization", with two thematic cores "Interdisciplinary care required for the ostomized people"; and "Self-care for rehabilitating the ostomized person", which highlighted the need for specialized hospital care and the continuity of interdisciplinary professional support for outpatient follow-up. The data about the relatives were discussed through the theme: "Challenges of the relative in living with the ostomized person", with the thematic units "The overload of responsibility for caring for and the prejudice arising from intestinal ostomy"; and "New family dynamics for rehabilitating the ostomized people", which underlined the importance of inserting the family in planning specialized care and professional support for them. The experience of the professionals was explored with the theme "Challenges for implementing the Program for Ostomized People", composed by the thematic cores "Seeking teamwork in the Program for Ostomized People"; and "Demands for specialized care for ostomized people", which highlighted their expectations about the needs for specialized care of ostomized people and teamwork. Given the consonance of the interpretative analysis about the experiences of the ostomized people, relatives, and the professionals of the Program for Ostomized People, the meaning constructed for the experience of need for self-care with ostomy and collecting equipment was "the daily fight to adopt a new lifestyle that goes beyond the ostomy and the collecting equipment, seeking rehabilitation". The results of the two stages of the study highlighted the complexity of the self-care for this clientele, which constitutes the beginning of its rehabilitation. Accordingly, there is a need to include the concept of physical disability in preparing ostomized people and their relatives, as well as in training health professionals, with the purpose of facing stigma, social prejudice and self-prejudice, in addition to dealing with daily challenges for establishing a new lifestyle, with specialized interdisciplinary follow-up

Educational video as a healthcare education resource for people with colostomy and their families. / Vídeo educativo como recurso para educação em saúde a pessoas com colostomia e familiares.

OBJECTIVE: To know the perceptions of participants in a support group for people with colostomy on the use of video as a resource for health education. METHOD: Qualitative research with 16 participants in a support group for people with colostomy in Santa Maria, Rio Grande do Sul, Brazil. Data were collected in April and May of 2016, through a focus group, and subjected to the thematic analysis proposed by Minayo. RESULTS: The results led to three categories: care and self-care are learned alone: the lived reality; health education and learning through educational video: perceived opportunities; the singularities of the educational video from the viewpoint of people with colostomy and their families. CONCLUSION: The scarcity of guidelines retards independence and hinders autonomy in care and self-care. The audio-visual technology applied in this study complements the educational guidelines, and can enable changes and the opportunity to rethink pedagogical nursing practices.

The effect of educational program on stress, anxiety and depression of the mothers of neonates having colostomy.

OBJECTIVE: One of the problems that mothers of neonates having colostomy face is their disability in caring colostomy at home. This article is going to demonstrate the impact of educational program for these mothers on their sense of empowerment in caring their neonates. METHODS: This clinical trial was performed in the Neonatal Intensive Care Units (NICUs) to evaluate the level of stress, anxiety and depression of mothers of neonates having colostomy before and after the educational program. In this program, 42 mothers were divided into two groups: experimental group (21 mothers who went under educational plan) and control group (21 mothers who only received the routine care). The levels of stress, anxiety and depression in all mothers were evaluated before and after the educational program with DASS 21 questionnaire. RESULTS: The results showed that educational program in the NICU for experimental groups made them independent and also empowered to care better for their babies. In addition, their depression, anxiety and stress levels were decreased. CONCLUSION: Since the educational program led to a decrease in the levels of stress, anxiety and depression in mothers, this program is recommended to mothers of neonates having colostomy.

Vídeo educativo como recurso para educação em saúde a pessoas com colostomia e familiares / Video educativo como un recurso para la educación salud a las personas con colostomia y familiares / Educational video as a healthcare education resource for people with colostomy and their families

RESUMO Objetivo Conhecer as percepções de participantes de um grupo de apoio para pessoas com colostomia sobre a utilização de um vídeo educativo como recurso para atividade de educação em saúde. Método Pesquisa qualitativa com 16 participantes em um grupo de apoio a pessoas colostomizadas de Santa Maria, Rio Grande do Sul, Brasil. Os dados foram coletados em abril e maio de 2016, por meio de grupo focal, submetidos à análise temática proposta por Minayo. Resultados Emergiram três categorias: O cuidar e o cuidar-se aprendido sozinho: a realidade vivida; Educação em saúde e aprendizagem por meio do vídeo educativo: possibilidades percebidas; As singularidades do vídeo educativo na ótica de pessoas colostomizadas e seus familiares. Conclusão A exiguidade de orientações posterga a independência e dificulta a autonomia para o cuidado e o autocuidado. A aplicabilidade da tecnologia audiovisual desenvolvida complementa as orientações educativas, possibilitando transformar e repensar as práticas pedagógicas na enfermagem.

RESUMEN Objetivo Conocer las percepciones de los participantes de un grupo de apoyo para personas con colostomia acerca de la utilización de un video educativo como recurso para la actividad de educación para la salud. Método Estudio cualitativo con 16 participantes de un grupo de apoyo a las personas colostomizada, de Santa Maria, Rio Grande do Sul, Brasil. La recogida de datos ocurrió en abril y mayo de 2016 y se hizo por medio de un grupo focal, que se sometió a análisis tematico propuesto por Minayo. Resultados Emergieron tres categorías: El cuidar y el cuidarse aprendido por sí mismo: la realidad vivida; Educación para la salud y aprendizaje por medio del video educativo: posibilidades percibidas; Las singularidades del video educativo en la óptica de las personas colostomizadas y sus familiares. Conclusión La escasez de orientaciones retrasa la independencia y autonomía para el cuidado y autocuidado. La aplicabilidad de la tecnología audiovisual desarrollada complementa las orientaciones educativas, posibilitando transformar y repensar las prácticas pedagógicas en enfermería.

ABSTRACT Objective To know the perceptions of participants in a support group for people with colostomy on the use of video as a resource for health education. Method Qualitative research with 16 participants in a support group for people with colostomy in Santa Maria, Rio Grande do Sul, Brazil. Data were collected in April and May of 2016, through a focus group, and subjected to the thematic analysis proposed by Minayo. Results The results led to three categories: care and self-care are learned alone: the lived reality; health education and learning through educational video: perceived opportunities; the singularities of the educational video from the viewpoint of people with colostomy and their families. Conclusion The scarcity of guidelines retards independence and hinders autonomy in care and self-care. The audio-visual technology applied in this study complements the educational guidelines, and can enable changes and the opportunity to rethink pedagogical nursing practices.

Preoperative teaching and stoma marking in an inpatient population: a quality improvement process using a FOCUS-Plan-Do-Check-Act model.

Preoperative teaching and stoma marking are supported by research and included in clinical practice guidelines from the WOCN Society and others. Using a FOCUS-Plan-Do-Check-Act model of Total Quality Management, a multidisciplinary team was formed that developed a flow chart outlining the process of care for patients undergoing planned ostomy surgery that included an educational intervention that enabled staff nurses to perform preoperative stoma site marking and education. After 3 months, we found a statistically significant increase in the number of surgical patients who received these evidence-based interventions (14% vs 64%; χ = 9.32; P = .002).

[The training of stomatherapy nurses]. / La formation des infirmières stomathérapeutes.

Advising and educating patients and resource people, providing information and training, leading a public-private-freelance and associative care network as well as being involved in a research process are essential elements of the practice of a stoma therapist. Although based on specific training this practice is not so much a speciality as a specificity.

The cluster-randomized Quality Initiative in Rectal Cancer trial: evaluating a quality-improvement strategy in surgery.

BACKGROUND: Following surgery for rectal cancer, two unfortunate outcomes for patients are permanent colostomy and local recurrence of cancer. We tested whether a quality-improvement strategy to change surgical practice would improve these outcomes. METHODS: Sixteen hospitals were cluster-randomized to the intervention (Quality Initiative in Rectal Cancer strategy) or control (normal practice) arm. Consecutive patients with primary rectal cancer were accrued from May 2002 to December 2004. Surgeons at hospitals in the intervention arm could voluntarily participate by attending workshops, using opinion leaders, inviting a study team surgeon to demonstrate optimal techniques of total mesorectal excision, completing postoperative questionnaires, and receiving audits and feedback. Main outcome measures were hospital rates of permanent colostomy and local recurrence of cancer. RESULTS: A total of 56 surgeons (n = 558 patients) participated in the intervention arm and 49 surgeons (n = 457 patients) in the control arm. The median follow-up of patients was 3.6 years. In the intervention arm, 70% of surgeons participated in workshops, 70% in intraoperative demonstrations and 71% in postoperative questionnaires. Surgeons who had an intraoperative demonstration provided care to 86% of the patients in the intervention arm. The rates of permanent colostomy were 39% in the intervention arm and 41% in the control arm (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.63-1.48). The rates of local recurrence were 7% in the intervention arm and 6% in the control arm (OR 1.06, 95% CI 0.68-1.64). INTERPRETATION: Despite good participation by surgeons, the resource-intense quality-improvement strategy did not reduce hospital rates of permanent colostomy or local recurrence compared with usual practice.

Preoperative stoma siting and education by stomatherapists of colorectal cancer patients: a descriptive study in twelve Spanish colorectal surgical units.

OBJECTIVE: Patients with colorectal cancer who need a stoma should undergo preoperative marking of the stoma site and education by a trained stomatherapist. This study examined the care received by ostomy patients with colorectal cancer in Spanish colorectal surgery units, to assess its quality and to detect areas for improvement. METHOD: A prospective study was conducted in twelve Spanish colorectal surgery units in Spain including patients visited by the stomatherapist after surgery for colorectal cancer. Each patient answered a questionnaire about their stoma care. RESULTS: Between September 2007 and May 2008, 270 patients were included, (63% colostomies, 37% ileostomies). Of whom; 75% had elective and 25% emergency surgery. Stomatherapist marked the stoma site in 45,6% of patients (0% emergency created stomas and 58,8% elective). However, patients who saw a stoma therapist preoperatively presented significantly lower rates of stoma complications (p < 0.001) and anxiety (p < 0.001) compared to those who did not postoperatively. CONCLUSIONS: The study has demonstrated the importance of preoperative stomatherapy assessment.

[The ostomy support team. A reality for ostomates]. / Elemente de management ale colostomelor. Echipa de suport si consiliere a pacientilor stomizati.

Stoma is a Greek word meaning mouth or opening. There are many types of surgical stomas and they may be raised on many areas of the abdominal wall. A stoma may be temporary or permanent, may be needed in any age group and may be sited on any part of the abdomen. The specific digestive pathology that could have as result of the surgical management a stoma is represented by colon, rectal and anal cancer, diverticular disease of the colon and rectum, Crohn's disease, ischaemic bowel, volvulus, trauma, Hirschprung disease, imperforate anus, fecal incontinence. This paper aim is to asses the management of fecal stomas and the necessity of a trained ostomy support team.

[The impact of preoperative stoma siting and stoma care education on patient's quality of life]. / Tinkamai parinktos stomos vietos bei jos prieziuros reiksme pacientu gyvenimo kokybei.

The aim of study was to assess if preoperative stoma selection and adequate patient's teaching can affect the postoperative patient's quality of life. The study was performed in two university hospitals of Lithuania: Kaunas University of Medicine Hospital and Kaunas Oncology Hospital. Patients were divided into three groups. Patients were asked to answer the questionnaire the day before the stoma creation operation and two months after the operation. Questionnaires EORTC QLQ-C30, EORTC QLQ-CR38 and 10 supplementary questions were used. The results of the study show that following the stoma operation, when compared with preoperative results, general quality of life did not change significantly in groups I and II. Patients who received adequate education and preoperative stoma siting had better emotional functioning and less gastrointestinal problems. The financial problems of the patients in group I were significantly less than in the control group. Patients who received the adequate teaching without preoperative stoma selection experience better sexual satisfaction compared with control group. Stoma related problems were less in group I and II when comparing with the control group. The quality of the patients' teaching, adequacy and comfort of stoma site and satisfaction with the medical staff were significantly better in the group I and group II when compared to control group. Moreover, these results were significantly higher in the group I than in group II. CONCLUSIONS. The teaching the patients preoperatively and postoperative proceeding helps them to gain better experience in self stoma care hence reducing the psychological, physical, emotional, social and sexual problems.

An assessment of surgeons' abilites to site colostomies accurately.

AIMS: The ability of surgeons to site a colostomy is assessed in a clinical model. In addition, the tuition received by surgical trainees in stoma siting is also reviewed. MATERIALS AND METHODS: Eleven surgeons (trainees--six, colorectal subspeciality interest--two) were asked to site an end colostomy on nine patients using an adhesive disc (diameter--1cm). The position of the stoma was then measured on the 'x' and 'y' axis of a 2cm box grid, (maximum error--1cm) which was placed on the abdomen and centred on the umbilicus. The positions were then compared with that chosen by the stoma nurse who was taken as the gold standard. Results were compared using ANOVA and the Mann Whitney--U test. A telephone questionnaire was then undertaken to review the training of junior surgeons. RESULTS: There was variance present within the group of surgeons studied (p<0.01). Trainees and consultants had a similar accuracy in stoma-siting (p<0.2). Consultants with a colorectal subspeciality interest were better at placing stomas than those with a general interest (p<0.002). Badly placed stomas were three times more likely to be too low than too high (p<0.002). Thirty of 37 trainees reported receiving no undergraduate training from a specialist stoma nurse. Ninety per cent received postgraduate training from another surgeon while a specialist nurse trained only 35%. CONCLUSION: There was no difference between trainees and consultants in their ability to site a colostomy. However, surgeons with a subspeciality interest chose stoma sites that were more consistent with the specialist nurse than general surgeons. Training is haphazard and ability is frequently assumed rather than proven.

Providing library services for an enterostomal therapy nursing education program.

Serving a hospital-based educational program such as the School of Enterostomal Therapy (E.T.) provides the opportunity to teach library skills and expand library services to meet the needs of a growing specialty. This article includes: a synopsis of the E.T. educational program, a history of the specialty, and an explanation of the separate library services provided to students and faculty. Search strategy developed to more easily access literature pertinent to the E.T. nurse is described and examples given.