Full Name:

…………………………………..……
NURSING CARE PLAN No 26 Address: Addressograph
OSTOMY CARE
Please use in conjunction of Careplan 1 ………………………………….……
HCR..............................................
……………………………………….……
Care Plan No 26 OSTOMY CARE ……
Issue Date: April 2020
Problem Goals Review Date: April 2023
……………………………………….……
……
………………………………..…..
has a ………………………………’s stoma will heal and function HCR
without complication.
No: ……………… DOB: ___ /
___ / _______
• colostomy
……………………………and parents will be educated on caring for his/her stoma.
• ileostomy
• urostomy
• other:
Commencement, Discontinued,
Date, Signature, Date, time,
No NURSING INTERVENTION Time, Grade Signature,
Grade
1 Nursing Intervention: Pre-operatively
Ensure………………………and parents meet with the Colorectal Nurse Specialist pre
operatively to discuss the following:
• care of the stoma
• Education re. complications
• products
• altered body image
• life with a stoma
• Support.

The site will be marked following discussion with the patient, Colorectal Nurse and the
Surgical Team

STOMA SITE MARKED: YES ………………. NO ……………….

Administer bowel prep as ordered by the Surgical Team……………………..…
…………………………………………………………………………………………………………..……………………..…..

…………………………………………………………………………………………………………..……………………..…..

…………………………………………………………………………………………………………..……………………..…..

Consider the need for Intravenous fluids when fasting

Nursing Intervention Post-operatively
2
(use in conjunction with post-op Careplan)
Observe and document stoma for:
• Colour (pink, dusky?)
• Size (is it prolapsed, retracted?)
• Output (is the stoma acting?)
• Please contact Surgical Team immediately if any abnormalities noted.

Ensure a post-operative stoma bag is in-situ.

This is a clear bag to allow the stoma to be observed. Cover filter with sticker provided
so to observe for flatus.

Allow to eat and drink as instructed in the post-operative notes. Liaise with dietician re:
particular diet education.

Department of Nursing
 Full Name:
…………………………………..……
NURSING CARE PLAN No 26 Address: Addressograph
OSTOMY CARE
Please use in conjunction of Careplan 1 ………………………………….……
HCR..............................................
……………………………………….……
……Commencement Discontinued,
, Date, Date, time,
3 Nursing Intervention: Care of the stoma Signature, Time, Signature,
……………………………………….……
Grade Grade
Removal of appliance: ……

 If using drainable bag, empty contents of the bag, measure output as HCR No: ……………… DOB: ___ /
___ / _______
required.
 Remove old appliance by peeling gently away from skin using an adhesive
remover spray / wipes.
 Examine the skin for signs of irritation from leakage.
 Dispose of used material in appropriate waste bin.
Cleaning the stoma and skin:
 Cleanse stoma and surrounding skin with unsterile gauze and warm tap water.
 Dry the skin carefully and gently (otherwise adhesive will not stick). Additional
care:

Preparing and attaching new appliance:

Chosen appliance:
 Use a measuring guide to check diameter of stoma and make a template from
cutting guide.
 Ensure the hole of the adhesive is cut no more than 2mm larger than the stoma.
Too large a hole will lead to leakage of effluent and so cause skin irritation. Too
small a hole will cause mechanical stress to the stoma and oedema will develop.
 Use Cohesive (Doughnut) Seal, this must be placed directly beside the stoma,
covering all the way around the stoma. Do not use seal on a flat stoma.
 Ensure adhesive has full contact with skin, begin closest to the stoma by
pressing the adhesive to the skin and work your way out to the edges of the
appliance.
 Apply bag on to base plate if using a two-piece system.

Appliance / Product Guide:

 One-piece product, wear for up to 2 days.
 Two-piece product, wear for more than 2 days.
 Use of one or two piece depends on patient’s preference and output.
 Open bag used for ileostomy (effluent more fluid like).
 Closed bag used for colostomy (effluent more formed).

Document nursing care, skin condition and appliances used.

4 Nursing Intervention: Discharge
 Liaise with the Colorectal Nurse Specialist re. discharge advice, appliances and
follow up.
 Use Stoma Teaching Tool and discharge plan.

Created by Nursing Department

Issue Date: April 2020 / Review Date: April 2023

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Department of Nursing