Best Practice in Caring for Patients with an Ostomy

As a Registered Nurse who knows the duties that his work demands, I have to demonstrate deeper understanding of the Health Directorate's core values of care, excellence, collaboration, and integrity in my professional nursing practice and patient care. To conform to the above mentioned values, I endeavor to appreciate that improving a patient's experience is integral in patient care. This can be achieved by doing away with fear and anxiety that protracts patients' healing process. Enhancement of the communication between my patients and I will also go a long way in hastening their recovery and their self-management.

S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.

Surgeons rely on technology, from diathermy to the operating room lights, assistance and team work. The conscientious staff should always ensure that the equipment is functioning and reliable. Hospital acquired conditions are medical complications that has a negative impact on patients during their hospital stay. Medicaid or additional services are not reliable to pay the hospital for any conditions that were developing while in the hospital. Based on surveys through several studies, expertise shows that medical conditions and errors are preventable. The beginning process of surgery usually starts with the patients preparations. Healthcare providers will remove hair that is on the body to be operated on. Patients who are diabetics must have their blood sugar monitor. Before any surgical procedure, healthcare nurses must interview the patient if they are scheduled to have surgery. The steps are getting blood withdrawn for lab work, receiving and E.K.G and information on past medical history. This type of process is to make sure the patient is healthier enough to undergo surgery. The preoperative phase which is the first stage used to perform tests; however the results of testing may come out wrong due to a malfunction in the machine. This can lead to a surgical infections and errors during prep and procedures. The goal of perioperative care is to provide

Plan: The patient will be admitted, kept NPO, and an appendectomy will be performed by Dr. Rogers in the morning.

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

Once the information is recorded a care plan based around the pre operative assessment can be created using the next step in the

During my rotation in the operating room at Community medical center, I observed the preoperative, intraoperative, and postoperative care for a patient who underwent a laparoscopic hysterectomy. I believe that an appropriate preoperative plan of care for this patient would have included a full physical exam and an interview for patient history, a pelvic exam to look over and understand the nature of the patient’s complications, blood testing including a CBC and WBC to note any signs of infection or contraindications for the procedure, and a urine test to rule out any urinary tract infections or pregnancy. It would be important to interview the patient and ask questions to determine how the patient is feeling about their procedure and to better assist with any anxiety or pain they may be dealing with preoperatively. It is important to consult with the patient well before the procedure to ensure that she knows to refrain from smoking for at least 8 weeks before the procedure because this reduces the risks of complications such as infections, issues with blood pressure, heart rate, blood flow, and respirations when under anesthesia, and promoting overall health and risks associated with smoking after the procedure. (ASAHQ) It is also important to educate the patient to consume no food or drinks after midnight the night before the scheduled procedure. (Health Communities) During my rotation I observed that the patient did indeed have labs drawn and a urine test run. Her lab

I was able to apply successfully and remove the ostomy device. I placed the device in the location where a descending colostomy bag would be placed, and inside the bag, I put a simulated fecal material to resemble what it normally would be.

In the professional setting, knowing the patient through his or her diagnosis, name, history of present illness, laboratory results or reason for staying in the hospital only contributes to the manner of physical care of the patient. However, recognizing the patient 's spiritual needs such as emotional support, mental positivity, and intellectual understanding of his or her situation gives a better assessment, as well as a trusting relationship between the nurse and the patient, as per personal experience. In the ward, it is evident that most of the staff nurses spend their time doing documentations, preparing medications, following-up laboratory requests, as well as reading through the patients ' charts to affirm the physician 's order. Throughout the duration of our shifts as student nurses, I see that the most that the staff nurses get to be conversant with the patient is when certain procedures (such as feeding through nasogastric tube, taking

Patients with a new ostomy need psychosocial support regardless of their background or culture. It is a change that affects an image. This patient needs education and ostomy care training by wound, ostomy, and continence nurses’ society (WOCN) certified nurse. Studies have shown that when patients consult a WOCN-certified nurse, there is a reduction in complications and readmission (Hendren et al., 2015, p. 381). A WOCN-certified nurse is consulted to educate Mr. S. Based on his needs, home health care will be considered upon discharge. Mr. S. also needs a follow-up appointment with a general surgeon for reversal operations evaluation. Regarding the timing of ostomy reversal surgery, studies suggest it is safe to perform reversal surgery as early as three weeks or later (Hendren et al., 2015, p.

Reflecting on the past few days of clinical have been a huge eye opener for myself. Not only was I able to practice and refresh old skills but I was also able to introduce new skills and enhance those. Although only two shifts in, I felt I was able to further develop my experience with Ostomy care. To illustrate, I was able to care for a 60-year-old man who had a newly formed ileostomy on his middle lower quadrant. Throughout the day, we would spend time emptying it, cleaning it and talking about it. Multiple times, D.Z would complain how difficult it was to maneuver, clean and just simply live with. After witnessing his frustrations more then once, it eventually made me realize just how difficult this new adjustment would be for D.Z.

Very interesting post, you may some great point. But as nurse we know how important ambulating as soon as possible post-op. According Bare, Cheever, Hinkle & Smeltzer, early ambulation has significant effect on recovery and the prevention of complications, such as, atelectasis, pneumonia, and or circulatory problems. In addition, ambulation can also help decrease pain and shorten the hospital stay. As the RN, How would you effectively help the patient manage is pain effectively and apply the necessary intervention needed to prevent any post-op complication. You mention in the post that you will consider the patient culture, should the patient be involved in the care and how would that affect the patient outcome you have set forth for the

In the surgery department, I work as a circulator, scrub nurse, and a charge nurse. Using these different approaches, ideals, and standards of care are often needed and applied to my assessments. Being compassionate, respectful and honest to patients is a required principle our hospital expects in caring for each

We must approach the patient and their family with an attitude of caring, empathy, and respect. We can explain that we would be happy to learn of the patients’ needs and concerns, and of any accommodations we can make so they will feel comfortable