Quality of life of patients living with permanent or temporary stoma in Kenyatta National Hospital before and after stoma/wound and continence training in Kenya

Mrs Jane Ndungu1
1Kenyatta National Hospital, Nairobi, Kenya

Introduction:Patients living with stoma face many challenges both physical and psychological due to phyical damage, disfigurement , loss of bodily functions and changes in personal hygiene. Such challanges are a major point of concern and has the potential of affecting patients quality of life.

Patients undergoing ostomy surgeries at Kenyatta National Hospital are many but the impact on their quality of life has not been adequatly assessed .

Objectives: This study is intended to assess the quality of life among patients living with stoma at Kenyatta National hospital.

Material And Methods:The study will be conducted in the whole hospital and  study design will be quantitative and descriptive cross sectional. Population will be patients with temporary or permanent stomas both inpatient and outpatient. Permission to carry out the study will be sought from, Kenyatta National Hospital Ethics and Review Committee, and written consent obtained from individual participants.Systematic random sampling method will be used to select a sample size of 86 participants. Data will be collected using researcher administered structured questionnaire for a period of three months and analyzed using Statistical package for social studies. Inferential statistics will be used to determine association between variables and findings will be presented in tables, graphs, charts and written narratives.

Significance of the study: The study findings will help in provision of evidence based ways towards developing guidelines or strategies and policies geared towards improving the quality of care of patients living with stoma which is in line with hospitals vision and mission.


Biography:

Bio to come

It’s a confidence thing!…….. Exploring qualitative ostomy research results

Miss Angie Perrin1
1Salts Healthcare, Birmingham, United Kingdom

Aims – The aim of this study was to identify how people feel about living with a stoma and what factors affect confidence levels

Method  – Qualitative interviews were carried out amongst small cohorts of patients throughout the UK. These provided a wealth of data regarding the perceptions of individuals – how they felt about living with a stoma, what if any, problems do they experience, as well as their attitudes towards pouches including fabrics and colour choices.

Results – A significant number of patients felt confident regarding their stoma and its day-to-day management (86%). Reassuringly, 83% patients felt supported by their Stoma Care Nurse (SCN). Changes in attitudes towards life are most likely due to having a life threatening or debilitating illness rather than due to the stoma itself. However, there was also a handful of patients reported to feel isolated and do not like to leave the house (14%).

75% patients (mostly Female, young, ileostomists) were interested in colour options of pouches, the perceived benefits were identified to co-ordinate underwear and clothing making them feel more feminine and less conscious of potential leaks (in urostomists), especially on special occasions or during intimate moments.

Conclusion – The study highlights that a high proportion of patients are trying to get on with life as best they can, although many feel more people in society should be aware of stomas. They are grateful to be alive; fundamentally their stoma has greatly improved their quality of life, although for some there is a negative impact.


Biography:

I am a Registered General Nurse (RGN) and I commenced my career within surgical nursing setting in 1990, then progressed into the specialist sphere of stoma care and colorectal nursing & attained the ENB 216 (specialist stoma care course).   I later undertook a BSc Hons (Colorectal pathway) to highlight my dedication and commitment to Stoma & Colorectal Nursing and worked as the Lead Nurse for Stoma and Colorectal cancer nursing services from 2002 in one of the largest UK teaching hospitals. Later I gained my nurse endoscopist certificate to enable me to proactively develop several nurse-led clinics.   I decided to enhance my professional development academically by acquiring an MSc Nurse Practitioner, which provided the foundations onto which I developed one of the first Nurse-led clinics within Oxford Radcliffe Hospitals NHS Trust and Nurse-led ileo-anal pouch clinic in the country to offer assessment and investigation. I was instrumental in developing the complete Colorectal Nursing service in Oxford to meet the ever-changing demands of patients and the health service itself.  I led policy development and implem

ented change at a local, national and international level within stoma care.  I have extensive specialist skills and knowledge of stoma care and colorectal nursing.

I currently work for Salts Healthcare as the Clinical Lead for Innovation, I lead a small team of Nurse specialists and we have the responsibility for offering expert clinical opinion on all new development projects initiated by Salts Healthcare, as well as implementing primary research and facilitating many other aspects of Research & Development.

I am also the current Vice Chairperson for the Association of Stoma Care Nurses (ASCN) for the UK.

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.

ARE WE READY? ……Managing the complexities of dementia within stoma care

Mrs Michaela Parker1
1Salts Healthcare Ltd, Aston , United Kingdom

Dementia is a broad term used to describe a range of neurological disorders, that cause a progressive decline in a person’s function. Even though public awareness and involvement is increasing, there are still significant misunderstandings within society that may affect management of this group of patients.

In the UK, approximately 850,000 people live with this condition, with numbers predicted to rise to over 1 million by 2025 and 2 million by 2051 (Dementia UK). In Australia, dementia is the single greatest cause of disability in people over the age of 65 and the second leading cause of death (Dementia Australia). Without a medical breakthrough, this healthcare challenge is set to increase significantly on a global scale and governments worldwide are now, supporting and promoting initiatives to meet this major challenge

Ostomists with dementia require diverse and creative support. Moving forward, Stoma Care Nurses should proactively seek to form key partnerships with specialists in dementia to enhance care provision and consider the impact of this patient group on future services. Training, development and any planning of care is critical and should influence clear strategies that reflect best practice

This presentation aims to identify the key challenges that may become evident whilst supporting the care of someone living with dementia and then focus on the main areas for consideration and vital future developments.


Biography:

Michaela Parker Is currently a clinical nurse specialist in research and development for Salts Healthcare Limited

Experienced in colorectal, gastrointestinal and urology nursing in Nottingham, United Kingdom before becoming a stoma care nurse in 2004. Her stoma care role has allowed her to work in both the hospital and community settings and more recently with industry

Michaela has presented at conferences at a national and international level and lectured to a wide variety of health care professionals on the subject of stoma care. She has also published work in relation to the vulnerable adult with a stoma

A new way to treat urinary tract infections

Ms Loreto Pinnuck1
1Monash Childrens, Clayton, Australia

Urinary tract infections are the most common nosocomial infection worldwide. Catheter acquired urinary tract infection represents a significant proportion of this group. The increasing risk of antibiotic resistance and persistence of biofilms have necessitated the search to find alternative forms of both treatment and prevention of urinary tract infections.

Children with neurogenic bladder are often required to perform clean intermittent catheterisation up to five times a day. Many of these children develop multiple urinary tract infections and some also develop antibiotic resistance.

Microdox is a solution  containing hypochlorous acid (0.009%) with broad-spectrum antimicrobial activity against multi-drug resistant organisms and established biofilms. This is instilled as a bladder rinse for both symptomatic urinary tract infection treatment and prophylaxis.

Discussed will be our experience of children requiring clean intermittent catheterisation and developing recurrent urinary tract infections with a focus on the impact of using the instillation of Microdox.


Biography:

Loreto has worked for more than 30 years as a stomal therapist/wound consultant and more recently a urology clincincal nurse consultant

“On the verge of residential aged care” a continence management case history

Mrs Claire Dobson1
1SWSLHD, Peakhurst, Australia

Caring for a loved one with incontinence can be difficult. Add to the mix a client with dementia and it increasingly becomes a challenge emotionally, physically and financially. The issue often leads to clients being placed prematurely into residential aged care as carers do not have the coping tools and mechanisms to be able to manage the incontinence. Often they are unaware of local Continence services that can assist in the management of the condition and the burden of caring and the stress on the carer can be profound

However, help is available via Continence Advisory Services in most metro, regional and rural areas

I would love to present a heart-warming case history where a carer nearly placed his wife into residential aged care. With carer support, proper assessment and continence management strategies, this was avoided and a positive outcome was achieved


Biography:

UK trained RN

Worked in Urology at Westmead Hospital, Urodynamics at Royal North Shore Hospital and set up the Continence Service at Bankstown in 1992.

Bankstown Continence CNC from 1992 -1998 then private sector as Continence Educator for 9 years before returning to Bankstown as Continence CNC in 2008.

Graduate Certificate in Continence Management in 1990  Graduate Diploma in Health Science Education Sydney University 1997.

CNC role:

–              a clinical component to clients over the age of 65

–              an education component, 4th year medical students, nursing staff and community groups

–              research and Quality Improvement

–              -health promotion

Neobladder support group

Mrs Kavita Sharma1
1Perth Urology Clinic, , , 2Sjog Murdoch Hopital, ,

A neobladder support group was established in Perth with the assistance of Stomaltherapy nurse and business practice manager of the urology practice.

Neobladder patients were reporting a sense of isolation following their neobladder surgery and they had varied levels of satisfaction or dissatisfaction following the surgery.

Patients who have neo bladder surgery report ongoing problems:

  • Varied experiences with level of continence.
  • Constipation
  • Urinary tract infection
  • Mucous in urine
  • Consumption of alcohol reduces night time continence
  • Possible residual cancer
  • Varied experiences with chemotherapy
  • Erectile dysfunction

There is small numbers of patients having neo bladder surgery and no support organisation so these patients feel isolated. It was recognised that a support group was needed for this vulnerable group of patients.

At St John of God Murdoch patients had been put in contact with other neobladder patients when requested and if a willing contact was available. Support needed to be larger than a couple of individuals.

It was hoped that the support group could assist to:

  • Reduce the sense of isolation amongst neobladder patients
  • Allow sharing of information that may benefit other individuals
  • Provide support for prospective neobladder patients
  • Information from invited guests

 

The initial meeting was held in in August 2018 with patients attending who had had their surgery up to 12 years previously. 15-20 neobladder patients and family members or support person attended. The lead of the group was a neobladder patient. It is expected that the neobladder patients will take over the administration of the group in time.


Biography:

Continence Nurse/ Stoma Nurse

Urology Practice Nurse

Incontinence in Australia by numbers

Ms Donna Heggie1
1Continence Foundation Of Australia In Nsw Inc., Newington, Australia

One in three women who have ever had a baby…..

3-12% of children aged 5-17 years…..

20,000 to 60,000 of children aged 13-18 years…….

Over 4.8 million Australians over the age of 18…….

The Deloitte Access Economics report “The economic impact of incontinence in Australia” explores the current prevalence and economic impact of incontinence in Australia, and provides an outline of the future projected growth of this burden.

As quoted from the Continence Foundation of Australia website (www.continence.org.au)

This presentation will give an overview of Incontinence in Australia and who it effects in our community. Statistics and data will be quoted from the most recent research available.

Over 70% of people who seek help can be improved or cured


Biography:

Donna Heggie RN, STN, Grad Cert Clinical Teaching, Continence Management Certificate.  Centre Manager, Continence Foundation of Australia in NSW Inc.

Donna has a long nursing career specialising in Stomal Therapy and Continence/ Colorectal Nursing at Royal Prince Alfred Hospital, Sydney. Currently she manages the CFA in NSW Inc. Office in Newington. A position held since February 2015. Donna is also a member of the CFA National Bladder Bowel Collaborative Steering Committee.

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

123459

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.

Conference Managers

Please contact the team at Conference Design with any questions regarding the conference.
© 2015 - 2019 Conference Design Pty Ltd