Assessment and management of stomal complications: a framework for clinical decision making.
Assessment and management of stoma complications are often the responsibility of nurses across the continuum of care. These complications can occur at different times based on their etiology - immediately postoperatively or even several years after surgery - and often require modifications in a person's daily stoma management. This article presents a conceptual framework to help categorize types of stoma complications based on either etiology or location and offers management options to facilitate quality care. The five major categories of complications include Poor Siting, Stoma Proper, Peri-Intestinal Area, Mucocutaneous Junction, and Iatrogenic. Most of these suggested approaches to care are the recommendations of certified ostomy nurses based on their educational training, expert opinion, and successful experiences. Although these recommendations have often solved the specific problems and greatly improved the quality of life for the person with stomal complications, much research is still needed to confirm and/or improve these nursing approaches.
Barr
Jane Ellen
JE
Mercy Medical Center, 1000 North Village Avenue, Rockville Center, NY 11570, USA. jeb617@aol.com.
D000465:Algorithms; D019985:Benchmarking; D003251:Constriction, Pathologic / Q000209:etiology / Q000451:nursing; D003663:Decision Trees; D004322:Drainage / Q000295:instrumentation / Q000379:methods / Q000451:nursing; D004487:Edema / Q000209:etiology / Q000451:nursing; D046449:Hernia, Abdominal / Q000209:etiology / Q000451:nursing; D006801:Humans; D022125:Lacerations / Q000209:etiology / Q000451:nursing; D009336:Necrosis; D009730:Nursing Assessment / Q000379:methods*; D011182:Postoperative Care / Q000379:methods* / Q000451:nursing / Q000523:psychology; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000451:nursing; D011391:Prolapse; D011788:Quality of Life; D012307:Risk Factors; D017592:Skin Care / Q000379:methods* / Q000451:nursing / Q000523:psychology; D054047:Surgical Stomas / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000451:nursing