1WA Country Health Service – South West, , Australia
A high output stoma (HOS) is a common complication experienced by patients with a small bowel faecal stoma, enterocutaneous fistula or the result of intestinal failure or short bowel syndrome. A HOS has been defined as fluid losses between 1000-2000ml over 24- 48hours which results in water, sodium and magnesium depletion. If the high output is not managed appropriately it can lead to dehydration, electrolyte imbalances, malnutrition, acute renal failure, poor quality of life, readmissions to hospital and increased length of hospital stay. There are various management strategies for a HOS which aim to reduce and prevent further complications, but they do require coordination within the multidisciplinary team to be effective. The aim of the project was to develop a clinical practice guideline for HOS management for adult patients in a regional hospital in Western Australia. The development of a clinical practice guideline is to assist health care practitioners in the provision of a standardised and structured approach to care for these patients, and to facilitate optimal care outcomes for patients with a HOS. The clinical practice guideline was developed using current evidence found in the literature and in consultation with the multidisciplinary team of health care professionals and an external peer review group. The evidence based clinical practice guideline developed will be presented to the hospital for consideration for implementation.
Felicity Jones is a Clinical Nurse Specialist in Stomal Therapy and Wound Management at Bunbury Regional Hospital in Western Australia. Felicity works in the acute care setting and provides nurse led outpatient clinics. She also has a regional role providing clinical support and education to 12 sites in the south west region. Felicity is committed to rural health care and has recently completed her Master of Nursing Nurse Practitioner with a view to improving access to specialty services outside the metropolitan area.