Running head: SAFETY WITH OSTOMY CARE

Patient Safety Is Not Wasted:

Keeping the Patient Safe With Ostomy Care
Emily Mortensen
NURS 240

SAFETY WITH OSTOMY CARE

Patient Safety Is Not Wasted:

Keeping the Patient Safe With Ostomy Care
Nursing is a career in which the professional nurses will need to learn very personal
information about a patient, and they may need to aid the patient with tasks that he may prefer to
keep private. For times in which this occurs, the nurse will need to be careful of keeping herself
professional, and assuring patient comfort in the situation. One task that this holds true for is
aiding with care for their colostomy bag. Nursing procedures for patients with an ostomy focus
on patient safety and high quality care.
Bowel elimination is a part of everybodys life. People may not always be comfortable
with sharing the details of this task, but it is necessary in order for people to rid their bodies of
the waste products from what they ingested. If a person has a disease, such as cancer, in which
the integrity of the intestinal tract is compromised, or they find themselves unable to adequately
clear their intestines, then they shall require the installation of an ostomy bag (Bradley &
Pupiales, 1997).
An ostomy is formed when the intestinal mucosa is brought to the surface of the skin, and
a stoma is surgically created. A stoma is the portion of the mucosa that is sutured to the skin. An
appliance, a pouch connected to an adhesive wafer, covers the stoma, allowing the intestines to
drain their contents into the pouch (Taylor, et al., 2011). This procedure can be created as
temporary measure, in which the anterior wall of the intestine is cut and forms the stoma, or
permanent, in which the end of the intestine is severed and removed from the patient, and the
severed end that remains is brought up to form the stoma (Bradley & Pupiales, 1997).
Patient safety and the quality of care are concerns in all areas of nursing, and ostomy care
is no exception. The World Health Organization defines patient safety as the prevention of

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errors and adverse effects to patients associated with health care (Patient Safety, 2014, para.
1), and quality of care as the level of attainment of health systems intrinsic goals for health
improvement and responsiveness to legitimate expectations of the population (Legido-Quigley,
et al., 2008, p.2). A great amount of care is required for a patient with an ostomy in order to
assure that the stoma remains healthy and free of infection, and the quality of care provided
ensures that the patient is kept safe.
In caring for a patient with an ostomy, the nurse should observe the site each time she
cares for it, ensuring that the stoma is moist and beefy red, with no skin breakdown around the
site and under the wafer. The nurse should take care to empty the appliance when it is one-third
of the way full, and she should replace it every three to seven days. A nurse who would provide
high quality care would make sure that this schedule is kept, and she should also be sure to
thoroughly clean the stoma and surrounding areas each time she changes it (Taylor, 2011).
Another way a nurse could provide high quality care for a patient with an ostomy would
be to take the extra step with ostomy care, and care for the patient holistically. When removing
the appliance to change it, the nurse should apply adhesive remover to the skin to reduce the pain
that can be involved with this procedure. Patients with ostomy appliances can also become selfconscious of the fact that they have this bag attached to them that contains their fecal matter. The
nurse could talk the patient through any discomfort that they have about the situation, assuring
them that they can continue to live their life the way that they did before, and their bag will not
hold them back. If the patient is concerned about a smell coming from the bag, the nurse could
provide some scented oils that the patient could put in it to mask the smell of feces. Any of these
extra measures would help to improve the quality of care that is given, and they would keep the
patient safe from any unnecessary discomfort (Living, 2011).

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Jean Watson was an established nurse in the 1970s, and she discovered a theme of
nursing that applies well to the safety and quality of care for ostomy patients. Her theory
centered on holistic care that is concerned with promoting and restoring health, preventing
illness, and caring for the sick (Taylor, 2011, p. 75). This theory ties very well into quality of
care and patient safety due to the fact that if a nurse was practicing within the scope of this
theory, then she would be ensuring she provided the best care that she could in order to restore
the patient back to health and preventing them from getting worse, ensuring his patient safety.
Caring for a patient with an ostomy appliance is a perfect example of how a nurse can
provide the patient with safe, high quality care. She must keep up with the care for it, and ensure
that she is holistically caring for the patient. With the right nursing techniques implemented, a
patients life can be greatly improved after the installation of an ostomy appliance, even with
considering the fact that the patient will be having bowel movements into a bag for the rest of his
life.

SAFETY WITH OSTOMY CARE

References
Bradley, M. & Pupiales, M. (1997). Essential elements of ostomy care. The American Journal of
Nursing. 97 (7), 38-46. doi: 10.2307/3465459
Legido-Quigley, H., McKee, M., Nolte, E., Glinos, I. A. (2008). Assuring the quality of health
care in the European Union: A case for action. Copenhagen: World Health Organization.
Retrieved from http://www.euro.who.int/en/publications/abstracts/assuring-the-qualityof-health-care-in-the-european-union2.-a-case-for-action
Living with a colostomy. (2011, January 1). Retrieved from
http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/co
lostomyguide/colostomy-living-with-a-colostomy
Patient Safety (N. D.) In World Health Organization, Europe. Retrieved from
http://www.euro.who.int/en/health-topics/Health-systems/patient-safety/patient-safety
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Bowel elimination. In Brandon, C. (Ed.),
Fundamentals of nursing: The art and science of nursing care. (7th ed., pp. 1296-1342)
Philadelphia, PA: Lippincott and Wilkins.
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Theory, research, and evidence-based
practice. In Brandon, C. (Ed.), Fundamentals of nursing: The art and science of nursing
care. (7th ed., p. 75) Philadelphia, PA: Lippincott and Wilkins.