Emptying and Changing One-Piece Ostomy Appliance
Interruptions to the passage of faeces and/or urine can result from conditions such as trauma, tumours and obstructions. In these cases, the passage of faeces and/or urine may be diverted to a surgically created artificial opening known as a stoma. Stomas can be either permanent or temporary.
The appliance used to collect and contain stomal effluent is a stoma pouch or stoma bag. These can be a one-piece or two-piece stoma pouch; the latter consisting of a stoma pouch and flange. These pouches/flanges adhere to the skin around the stoma and remain in situ until they require changing. Some have a clip or Velcro at the base of the bag, so they can be emptied. Immediately after surgery, clear pouches are used to facilitate observation of the stoma.
Caring for a client with a stoma includes the management and selection of the correct stomal appliances as well as assessing and providing care for the stoma and the surrounding skin. It is important to detect and manage any adverse events and complications with the stoma and/or the surrounding skin early.
The stoma site needs to be assessed at least once a shift to ensure the stoma bag remains attached. It should be emptied when the bag is one-third to half-full and replaced or reinforced when it has become dislodged.
Understanding, patience and an awareness of the need to preserve the client’s dignity and self-esteem when providing stomal care are essential. Nurses also need to provide education, which encourages the client to be actively involved in caring for their own stoma. A stoma nurse is often involved in the care.