Stoma site selection outside stomal therapy hours – training hospital staff

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.


Biography:

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.

Stoma site selection outside stomal therapy hours – training hospital staff

Ms Kate Brereton, Ms Leanne Monterosso
1St John Of God Murdoch , West Leederville, Australia

STOMA SITE SELECTION OUTSIDE STOMAL THERAPY NURSE HOURS

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.


Biography:

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.

Essential paperwork for your new ostomate

Ms Julie Metcalf1
1Bega Community Health Centre, Bega, Australia

South East Regional Hospital in Bega employs a sole practicing stomal therapy nurse on a part time basis during office hours in the community health setting. This service relies on referral to assimilate ostomate care into the daily community health workload.

Too often new ostomates are not referred in a timely manner and/or discharged home without self-management education, completed essential paperwork or stomal appliances to use at home

In service and opportunistic education is offered on a regular basis within the facility but sessions are poorly attended, if at all, whilst on the job teaching appears to fall on deaf ears. The LHD strategic plan and hospital management does not recognise stomal therapy nursing as a priority so arousing interest and implementing change is difficult especially with staff shortfalls and heavy workloads

An informal survey was conducted asking nursing, medical and administration staff working in ICU, Surgical and Medical wards whether they knew what paperwork was required to be completed for a new ostomate prior to their discharge from hospital.

100% of staff pleaded ignorance


Biography:

Julie first became interested in stomal therapy nursing whilst working as a primary health nurse in a rural doctor’s surgery. Ostomates consulted their doctors expecting help in stomal assessment and self-management but did not get any. Julie decided to change her speciality from Midwifery to Stomal Therapy and has been working as a sole practitioner in the community health setting now for 10 years with the ongoing education and support of the AASTN

‘The OZtomy Nurse’. A series of YouTube videos and podcasts dedicated to education &sharing of knowledge relating to stoma care, products and scope of current stomal therapy practice in Australia

Mrs Felicity Rackham1
1Epworth Eastern, Box Hill, Australia

Stomal Therapy nurses have the ability to connect with ostomates, stoma nurses and the general public through social media networks such as YouTube, Spotify and other media platforms. These channels can be used to communicate educational material, make announcements on current events in stomal therapy and provide the general public with useful information. This fosters global engagement between nurses, ostomates and families which may help tackle gaps in knowledge regarding stoma care.

To date, no Australian social media outlet exists from qualified stoma nurses regarding ostomy care / information. Current educational material stems from individual ostomates, who share information that is anecdotal only. Effective communication from providers is not only critical for all ostomates, but possibly more so for those who may desire or require instant access to information in the pre-operative and post-operative periods, when access to a stoma nurse may not be achievable.

The Oztomy Nurse Project presents a free, public access series of YouTube videos and podcasts dedicated to the education and sharing of knowledge relating to ostomy care, products and scope of current stomal therapy nursing practice in Australia. The presentation will highlight the various chapters, from understanding stoma types and basics of stoma care, to navigation tips and helpful hints like exploring the Stoma Appliance Schedule on the Australian Department of Health website. Finally, a short visual preview of episodes will be displayed with instructions on how to access the content online and how to subscribe to online content via the OZtomy Nurse Channel.


Biography:

Felicity is a Clinical Nurse Consultant in both regional Victoria and metropolitan Melbourne. She qualified as a Registered Nurse in 2012 via the University of South Australia, graduated with a post graduate certificate in Stomal Therapy in 2014 and  is currently undertaking a Masters degree in Wound Care through Monash University.

Seeding Stomal Therapy in Mauritus

Ms Sharon Boxall1,2,3, Mrs Elizabeth  English2,3
1Silver Chain, Toodyay, Australia, 2AASTN, , Australia, 3WCET, , International

Mauritius is a developing nation with a population of 1.26 million people. Ex-pat Mauritians living in Australia became aware of the work of Australian stomal therapy nurses in establishing a Stoma, Wound, Continence Program in Kenya and approached Elizabeth English to investigate options for postoperative wound and ostomy care education in Mauritius.  As a result Elizabeth English and Sharon Boxall visited Mauritius to run a  5 day programme wound and ostomy resource person course. There were 47 attendees. The program was funded by the Mauritian ex-pat charity COMMSSA- SACIM (Children of Mauritius Medical and Surgical Support Association – Society for Aid to Children Inoperable in Mauritius).  The success of this programme  will lead to further educational opportunities across Mauritius and ultimately a full Stoma, Wound and Continence program in a similar format to that run in Kenya 2013-2017.


Biography:

Sharon Boxall is a Ph D Candidate at CUrtin University investigating skin characteristics related to chronic venous insufficiency. Since 2012 she has been a volunteer stomal therapy educator in numerous programs in Africa. She is currently working in Rural Serivices in the Silver Chain Group.

Advancing wound, ostomy and continence education for nurses

Mrs Joy Sears1
1Curtin University, Bentley, Australia

Worldwide, there are very few undergraduate and postgraduate nursing degrees that offer dedicated wound management units. Most nursing curriculums have an integrated approach to learning and the small amount of literature available on the subject is in agreeance, that this is insufficient for the provision of a fundamental skill for nurses. The School of Nursing, Midwifery and Paramedicine at Curtin University in Western Australia has had an innovative elective unit in this domain since 2010 that is available to students in the final semester of their Bachelor Degree.  To advance learning opportunities Curtin also offers a Graduate Certificate, Graduate Diploma and Master Degree Wound, Ostomy and Continence Practice  both in Singapore and Western Australia that provide students with a combination of didactic and online education in these domains. This paper will outline student satisfaction and perceived benefits with these units for advancing their understanding and clinical practice.  Plans to  commencement  of  an Innovation and Scholarship of Learning & Teaching that will ensure the successful continuance of future student learning  will be discussed.


Biography:

Joy is the Coordinator of the Curtin University, undergraduate Advanced Wound Care Unit at the Western Australian campus and Co-coordinator of the postgraduate Graduate Certificate Wound, Ostomy and Continence Practice that is available at the Western Australian and Singaporean campuses in the School of Nursing, Midwifery and Paramedicine.

Making the connection; enabling person centred care through facilitation and consumer involvement.

Mrs Julia Kittscha1, Mrs  Brenda Christiansen1, Ms Helen  Richards2
1Illawarra Shoalhaven Local Health District, Wollongong, Australia, 2Wollongong Private Hospital, Wollongong, Australia

Stoma education for nurses across the continuum is an essential part of the stomal therapy nurse’s role. Intentions are to help the nurse understand the care of someone with a stoma and enable them to provide nursing care and education in a person centred way. The author found that traditional educational methods became repetitive with unknown or absent outcomes in terms of clinical care.

This paper will present the processes and evaluation tools the authors used to transform their staff education program by replacing teaching with a more facilitative learning model. This was presented through a partnership of people living with a stoma and the clinical experts. The process involved the facilitators taking a risk by allowing the staff to identify their learning needs and not pre-empting the program. Nursing staff were asked to put themselves in the position of the patient (metaphorically) and troubleshoot peristomal skin complications by drawing on their own knowledge in an interactive session allowing group learning from each other. Learning from those that know, brought eight consumers to the learning environment rotating through small groups of nurses using a semi-structured interview technique to answer questions in regards to living with a stoma. An inquisitive mind was all that was needed, and the room was abuzz with conversation.

Evaluation from staff brought about unexpected outcomes of increased empathy and confidence to ‘have a go’ when faced with helping a person care for their stoma.  Staff reported being more person centred as a result of participating due to a deeper understanding of what it is like to live with a stoma. Following on from the education were improved clinical outcomes which have been sustained evident through feedback from consumers and staff alike.


Biography:

Julia Kittscha has been a Clinical Nurse Consultant in Stomal Therapy for 20 years. Her current role at Wollongong Hospital in NSW Australia encompasses the acute setting, nurse led clinic, periphery hospitals and community. She is passionate about Stomal Therapy Nursing and relishes sharing her skills to empower others.

AASTN

This conference is proudly hosted by the Australian Association of Stomal Therapy Nurses: www.stomaltherapy.com

One of the Association's major objectives is the promotion of quality care for a wide range of people with specific needs. These needs may be related to ostomy construction, urinary or faecal incontinence, wounds with or without tube insertion and breast surgery.

Patients/clients across the life span are provided with preventative, acute, rehabilitative and continuing care as required. Another objective is the maintenance and improvement of professional standards in relation to Stomal Therapy Nursing Practice to the highest degree possible. Recognition of the need for and encouragement of the development of specialist expertise in the field of Stomal Therapy Nursing underpins the Standards for Stomal Therapy Nursing Practice.

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