Abstract
Topic: Peristomal hernia (PH) is a pervasive, costly, and distressing problem for persons living with permanent ostomies. Prevalence rates vary greatly ranging from 20% to 78% of patients. Persons with PH experience difficulties with pouch adherence, leakage, increased use of supplies and reduced quality of life. At times, it may be difficult to conceal the peristomal bulge making it difficult to find properly fitting clothing. More severe problems such as bowel strangulation, perforation and obstruction can be life threatening. Risk factors for developing PH include: type of diversion, size of the opening in the abdominal rectus muscle, age, weakness of the abdominal wall musculature, excessive coughing or vomiting, steroid use, intra-abdominal tumor growth, emergency placement, smoking and obesity. PH may not be completely preventable. Nevertheless, available research suggests early introduction of a support garment and an appropriately focused exercise and proper body mechanics education program can help prevent development of a PH (North, 2014; Thompson & Trainor, 2005). In addition, research has made it clear that optimal outcomes with respect to improved quality of life and decreased prevalence of PH depend upon patient adherence to garment use, exercise and proper body mechanics recommendations. Objective: To develop an interdisciplinary hernia prevention pathway for persons undergoing permanent ostomy surgery. Purpose: to develop and implement a formalized multidisciplinary program to promote adherence to hernia prevention self-care practices, and decrease the prevalence of PH among patients undergoing permanent ostomy surgery for cancer or inflammatory bowel disease. This program, directed by a certified wound, ostomy, and continence (WOC) nurse practitioner includes risk screening, comprehensive education from a physical therapist specially trained in pelvic floor rehabilitation, and support garment recommendations. Outcome: Our interdisciplinary hernia prevention pathway demonstrates flow process, points of contact with the patient, and discipline-specific interactions expected at each point of contact.
Sigma Membership
Non-member
Lead Author Affiliation
Beaumont Hospital, Troy, Michigan, USA
Type
Poster
Format Type
Text-based Document
Study Design/Type
Quasi-Experimental Study, Other
Research Approach
Quantitative Research
Keywords:
Multidisciplinary, Peristomal Hernia, Self-Care Deficit
Recommended Citation
Bauer, Carole; Angeline, Sharon; and Syed, Sameena, "Development of a multidsiplinary team to prevent peristomal hernia" (2019). General Submissions: Presenations (Oral and Poster). 206.
https://www.sigmarepository.org/gen_sub_presentations/2017/posters/206
Conference Name
The Wound, Ostomy and Continence nursing Society 49th Annual Conference
Conference Host
Wound, Ostomy, and Continence Nurses Society
Conference Location
Salt Lake City, Utah, USA
Conference Year
2017
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Self-submission
Development of a multidsiplinary team to prevent peristomal hernia
Salt Lake City, Utah, USA
Topic: Peristomal hernia (PH) is a pervasive, costly, and distressing problem for persons living with permanent ostomies. Prevalence rates vary greatly ranging from 20% to 78% of patients. Persons with PH experience difficulties with pouch adherence, leakage, increased use of supplies and reduced quality of life. At times, it may be difficult to conceal the peristomal bulge making it difficult to find properly fitting clothing. More severe problems such as bowel strangulation, perforation and obstruction can be life threatening. Risk factors for developing PH include: type of diversion, size of the opening in the abdominal rectus muscle, age, weakness of the abdominal wall musculature, excessive coughing or vomiting, steroid use, intra-abdominal tumor growth, emergency placement, smoking and obesity. PH may not be completely preventable. Nevertheless, available research suggests early introduction of a support garment and an appropriately focused exercise and proper body mechanics education program can help prevent development of a PH (North, 2014; Thompson & Trainor, 2005). In addition, research has made it clear that optimal outcomes with respect to improved quality of life and decreased prevalence of PH depend upon patient adherence to garment use, exercise and proper body mechanics recommendations. Objective: To develop an interdisciplinary hernia prevention pathway for persons undergoing permanent ostomy surgery. Purpose: to develop and implement a formalized multidisciplinary program to promote adherence to hernia prevention self-care practices, and decrease the prevalence of PH among patients undergoing permanent ostomy surgery for cancer or inflammatory bowel disease. This program, directed by a certified wound, ostomy, and continence (WOC) nurse practitioner includes risk screening, comprehensive education from a physical therapist specially trained in pelvic floor rehabilitation, and support garment recommendations. Outcome: Our interdisciplinary hernia prevention pathway demonstrates flow process, points of contact with the patient, and discipline-specific interactions expected at each point of contact.