Ms Kate Brereton, Ms Leanne Monterosso
1St John Of God Murdoch , West Leederville, Australia
A recognised need for nurses to perform stoma site selection out of stoma therapist working hours initiated development of a Self-Directed Stoma Learning Package for surgical nurses in a large tertiary private hospital.
The current self-directed learning package (2007) was reviewed and updated by the stoma therapist, including current evidence and gold standard practice guidelines for stoma siting. The package also included pre and post-questionnaires, one face-to-face teaching session and supervised practice, followed by a post-questionnaire at 6-months.
Interested registered nurses were sought from general surgical and emergency ward to pilot the package; ten nurses participated.
Following completion of the reading materials in the package, nurse participants were asked to site a stoma on their own abdomen and wear a pouch for 48 hours to facilitate understanding of subtle and more specific difficulties patients may experience with a stoma. The pre-questionnaire was then administered prior to nurse participants attending the face-to-face learning session, conducted by a stoma therapist and a learning and development nurse.
Supervised practice with patients followed, and included an explanation of the surgery to the patient/family members, explanation of the stoma therapist role and how the patient would be supported while they had a stoma, demonstration of selected stoma products appropriate to the surgery and stoma site selection.
Nurse participants are achieving competency at different rates and recognise when they do not feel competent.
Competent nurses offered debriefing when they perform stoma site selection out of stomal therapy hours to discuss any difficulties they encountered.
As a stomal therapist for 7 years I endeavour to provide the best possible service to patients who are admitted to the hospital. I work as a stomal therapist at a large private hospital providing care to both metropolitan and rural patients.