Clinical management of high output ileostomates to prevent dehydration and acute kidney injury: A quality improvement activity

Ms Jodie Gordon
1MNHHS – Redcliffe hospital, Redcliffe, Australia, 2MNHHS , Herston, Australia

Ileostomates are at risk of developing high output stoma (>1000mls per day) and may be readmitted to hospital with dehydration and acute kidney injury (AKI) (Hayden 2013, Mackowski et al 2015, Slater 2012 & Villafranca et al 2015).  These poor outcomes were identified at our hospital as an area for improvement and an interdisciplinary working party was convened to improve patient outcome with a secondary aim to reduce readmission rates directly attributed to dehydration or AKI for our ileostomate cohort.  This team included STN, Director of Surgery, Colorectal Surgeons, Nursing and Dietetics.

We identified that there is no consistent clinical management for high output stoma within our facility; with multiple accepting teams across critical care, medicine and surgery in terms of readmission.

This inconsistent approach led to treatment plans that were not in keeping with current evidence based practice of high output stoma.

Our motivation was to develop a clinical management tool that was easy to use, evidenced based and enabled early intervention for high output stoma management.  This in turn will aid in the reduction of readmissions for dehydration and AKI for high output ileostomate as our quality improvement outcome.


Jodie has Master Degrees in Wound Management and in Health Administration and a Grad Cert Stomal Therapy Nursing.  Her commitment to lifelong learning, value based healthcare, and providing the right care to the right patient at the right time continues to be a driver in improving patient care.