Quality of life for patients living with ostomies: influence of contact with an ostomy nurse.

PURPOSE: This study was conducted to determine whether or not contact with a WOC nurse improves quality of life for ostomy patients. METHODOLOGY: Home health care agencies, hospitals, and a durable medical equipment company in northern Florida were contacted to participate in the study. The role of the participating facilities was to address the provided envelopes and mail the patient survey packet (introductory letter, Ostomy Quality of Life Questionnaire [OQLQ], and demographic survey) directly to the patient. RESULTS: The mean age or respondents was 62 years, and the mean time of living with an ostomy was 10 years. Ninety-six percent of the sample participants did not attend support groups, yet nearly 50% reported receiving education following discharge home. Analysis of OQLQ scores revealed statistically significant differences based on who the respondent lived with, the number of comorbidities, how the respondent received supplies, and the type of appliance worn. There was no significant difference between respondents who saw an ostomy nurse and those who did not among the various sections of the OQLQ, even though 83% indicated seeing an ostomy nurse. Body image was a concern to respondents. CONCLUSION: The data demonstrated that most participants maintained satisfactory quality of life despite the presence of an ostomy. Individuals who were working part-time had a better health-related quality of life than those who worked full-time. More than 50% of our study sample participants reported satisfaction with the healthcare services they received, regardless of whether services were provided by a WOC or a nonspecialist nurse.

Intraoperatively acquired pressure ulcers: are there common risk factors?

Surgery puts patients at risk for developing pressure ulcers. Studies examining factors most likely associated with intraoperatively acquired pressure ulcers have not resulted in the development of a risk assessment tool specific to the surgical patient population. To ascertain the current national rate and potential risk factors of intraoperatively acquired pressure ulcers, a survey method was used to obtain data from a 1-day descriptive study. Between May and August 2003, Wound Ostomy Continence Nurses in 37 participating facilities in 21 states completed 281 individual patient surveys. Nine patients (3.5%) developed pressure ulcers related to a surgical event. Most (six patients, 66.7%) had at least one comorbidity and were managed with a warming device and 89% received three or more anesthetic agents. The median operative time for patients developing a pressure ulcer was 4.48 hours. While the external validity of these findings is limited by the current study sample size, the observations confirm previously reported trends and the need for research to improve risk factor identification of surgical patients to improve pressure ulcer prevention efforts.

Falls and patient safety for older adults.

The risk of falling increases with age. Falls in the elderly have been found to raise mortality and morbidity rates and are a leading cause of premature admission to long-term care facilities. Attention to known intrinsic and extrinsic factors that predispose to falling is important in community dwelling and institutionalized older adults. New government guidelines for long-term care facilities have helped focus attention on the safety aspect of fall risk and information about the physical and psychological impact of falling is increasing. Implementation of fall prevention protocols, including the use of fall risk assessment tools, may help reduce the incidence of falls and resultant complications.