COLOSTOMY CARE

DEFINITION:
This is usually done among patients who suffer from obstructions in the colon, trauma related
to injuries or complication of surgical procedures, or a result of other diseases process in the
gastrointestinal tract.

PURPOSE:
Colostomy care is done to help ensure that patient’s trauma is being assessed for its status,
pouches and appliances are inspected for fit and function, and that effluent is drained to avoid
spillage of its contents that can cause skin irritation.
L
PRINCIPLES:
1. Use the right pouch and skin barrier opening.
2. Change the pouching system as needed to avoid leaks and skin irritation.
3. Clean the skin around the stoma with water.

EQUIPMENT:
-2 pairs of clean gloves -cotton balls -wrist watch
-alcohol/hand sanitizer -forceps -chart
-bandage scissors -waste receptacle -mask
-underpad/ towel -pouching system -pen
-container of warm water -measuring guide -bed pan

STEPS RATIONALE

1. Identify the client, introduce self, and explain To make sure you are doing the right procedure to the right
the procedure to the client and significant others. patient. To gain cooperation
2. Perform hand hygiene. To prevent spreading of microorganisms
3. Gather the needed equipment and bring to the
To save time and effort. To avoid leaving the patient
bedside.
4. Instruct the client to participate during the
To cooperate in adjusting the ostomy bag
procedure.
5. Provide client’s privacy. Place an under The pad prevents spilling of contents to the patient and
pad/rubber sheet under the ostomy pouch. bedsheets
6. Assist the client to a sitting or supine position Lying and sitting position may facilitate smoother pouch
on bed. application
7. Don clean gloves on both hands. Unfasten the
belt if client is wearing one. Remove ostomy bag,
To avoid cross contamination abd to be more careful when
then measure and empty contents. Place the old removing the bag.
pouching system in the designated waste
receptacle.
8. Remove the flange by gently pulling it towards
the stoma. Support the skin with your other hand.
Gentle removal helps prevent skin tears. An adhesive
Use an adhesive remover or normal saline remover may be used to decrease skin and hair stripping.
solution.
Note: If a rod is in situ, do not remove.
9. Clean the stoma gently by wiping it with warm Aggressive cleaning can cause bleeding. If removing stoma
water. Do not use soap. adhesive from skin, use a dry cloth first.
 A stoma should be pink to red in color raised above skin
level, and moist. Skin surrounding the stoma should be
10. Assess the stoma and the peristomal skin. intact and free from wounds, rashes or skin breakdown.
Notify the wound care nurse if you are concerned about
peristomal skin.
11. Measure the stoma diameter using the
measuring guide (tracing template) and cut out The opening should be 2mm larger that the stoma size.
stoma hole. Trace the diameter of the measuring - Keep the measurement guide with patient supply
guide onto the flange, and cut on the outside of the for the future use.
pen marking.
Accessory product may include stomachesive, powders, or
12. Perform skin preparation and apply accessory
products used to breath a skin sealant to adhere pouching
products as required. system to skin to prevent leaking.
13. Remove the inner backing on flange and apply To properly apply the flange
flange over the stoma. Leave the border tape on.
14. Apply pressure and hold in place for 1 minute, wait The warmth of the hand can help the appliance adhere to
till flange will warmth and mold to client’s body. the skin and prevent leakage.
15. Remove the outer border backing and press gently To prevent leakage
to create a seal.
Note: If rod is in situ, carefully move rod back
and forth, but do not
pull up on rod.
16. Apply the ostomy bag. Attach the clip to the To prevent effluent from soiling the patient bed
bottom of the bag.
17. Place palm of hand over the ostomy pouch for 2 The flange is heat activated
minutes.
18. Do after care of equipment, and place client in a To help decrease odor
comfortable position. Remove the designated waste
receptacle from client’s room.
19. Perform hand hygiene. To minimize transmission of microorganisms
20. Document procedure. For future references upon monitoring/ checking the
• Procedure done. patient.
• Date and time
• Appearance of stoma and peristomal skin.
• Medications used if any
• Clients’ reaction
• Nurse who performed the procedure.
21. Ability to answer questions:
A.
B.
Total Score
Equivalent Grade
*with patient
Final Grade
Signature of CI
Signature of Student