STEPS  
ADDITIONAL INFORMATION
1. Perform hand hygiene and collect supplies.
2. Identify the patient and review the procedure.
Encourage patient to participate as much as
possible or observe/assist as they complete the
procedure.
3. Create privacy and place waterproof pad under
pouch.
4. Apply non-sterile gloves. Empty and measure
urostomy contents. Discard old urostomy pouch.
5. Remove flange by gently pulling it toward the
stoma. Support the skin with your other hand. An
adhesive remover may be used. If stent is in
place, do not remove it.
6. Place rolled gauze at stoma opening. Maintain
gauze at the stoma opening continuously during
pouch measurement and change.
7. While keeping rolled gauze in contact with the
stoma, cleanse peristomal skin gently with warm
tap water using washcloth; do not scrub skin. If
you touch stoma, minor bleeding is normal. Pat
skin dry.
8. Assess stoma and peristomal skin.
9. Measure the stoma diameter using the
Hand hygiene reduces the transmission of
microorganisms.
Supplies include urostomy bag (one- or two-
piece system), measuring guide, urinary
collection bag, non-sterile gloves, scissors,
pencil, adhesive remover, skin barrier pad, wick
made from sterile gauze (rolled 2 x 2 gauze),
waterproof garbage bag, waterproof pad,
cleaning cloth, and drying cloth.
Proper identification complies with agency
policy.
Encouraging patients to participate helps them
adjust to having an ostomy.
This maintains patient dignity and the pad
protects the patient’s bed.
A full urostomy bag may spill on the patient or
bed.
Gentle removal helps prevent skin tears. An
adhesive remover may be used to decrease skin
and hair stripping.
This prevents urine from spilling on cleaned skin
and new pouching system.
Aggressive cleaning can cause bleeding. If
removing stomahesive paste from skin, use a dry
cloth first.
A stoma should be pink to red in colour, raised
above skin level, and moist.
Skin surrounding the stoma should be intact and
free from wounds, rashes, or skin breakdown.
Notify wound care nurse if concerned about
peristomal skin.
Customizing the opening of the flange is
measuring guide (tracing template) and cut out
stoma hole.
Trace diameter of the measuring guide onto the
flange and cut on the outside of the pen marking.
10. Prepare the skin and apply accessory products
as required or according to agency policy.
important to ensure proper fit and prevent
leakage.The opening should be 2 mm larger than
the stoma.
Keep the measurement guide with patient
supplies for future use.
Accessory products may include stomahesive
paste, stomahesive powder, or products used to
create a skin sealant to adhere pouching system
to skin to prevent leaking.
Wet skin will not allow for proper adhesion of
flange.