Dr Linda Vu1, Mrs Deborah Sinclair1, Mrs Laura Hughes1, Dr. Mary Theophilus1
1St. John Of God, Subiaco, Australia
Purpose: Preoperative stoma site marking is supported by research and professional organisations as an intervention that can reduce the incidence of stoma complications. This study investigates the application of this research into practice in an Australian metropolitan hospital. The aim was to achieve 100% preoperative stoma marking for elective patients and determine the rate of preoperative stoma marking in the emergency population.
Methods: A retrospective review of prospective collected data was conducted. Data from January 2018 to October 2018 was reviewed. The end point was the rate of preoperative stoma marking. Descriptive analysis examined the percentage of patients marked preoperatively in the elective and emergency setting, stoma complications, the relationship between preoperative length of stay (LOS) and sited emergency patients.
Results: A total of 67 patients underwent a surgical procedure that resulted in a faecal ostomy over a 10 month period. In total 59.7% (40/67) were emergency patients and 40.3% (27/67) elective. The median age was 64 (Range 26-91), 53.7% (36/67) females and mean BMI of 27.1 (SD = 7.16). In all, 52.2% (35/67) of the stomas were sited. Of the elective patients, 77.8% (21/27) were sited compared to 35% (14/40) emergency patients. Of the emergency population, median LOS preoperatively for non-marked patients was 0 (Range 0-6) compared to 2 (Range 0-10) for marked patients.
Conclusions: At this metropolitan hospital three quarters of the elective population are marked preoperatively and only one third are marked in the emergency setting. This rate is partly contributed to by only having 2 stoma trained nurses and lack of communication about surgery dates.
Reference: Hendren S, Hammond K, Glasgow S,Perry B. Clinical Practice Guidelines for Ostomy Surgery. Diseases of the Colon and Rectum. 2015; 58:375-387.
Dr. Linda Vu is an unaccredited surgical registrar from WA. She graduated from the University of Notre Dame in 2014. She completed a Masters of Science in 2018 looking at risk factors in anastomotic leaks. She has worked in different general surgery and colorectal units for the last 3 years. She has a keen interest in colorectal surgery, patient outcomes and holistic multidisciplinary care.