COLOSTOMY CARE

• Identify the indications for colostomy and the different types of colostomies.
• Explain the importance of colostomy care and the steps in colostomy care.
• Summarize the risks associated with a colostomy.
• Explain the importance of improving care coordination among the interprofessional team
to enhance the delivery of care for patients with a colostomy.
Procedure 4 3 2 1
1. Perform hand hygiene. To prevent spread of infection
2. Gather supplies. Supplies include flange, ostomy bag and clip,
scissors, stoma measuring guide, waterproof pad, pencil, adhesive
remover for skin, skin prep, stoma adhesive paste or powder, wet
cloth, non-sterile gloves, gauze and additional cloths.
3. Identify the patient using 2 identifiers. Encourage the patient to
participate as much as possible or observe/assist patient as they
complete the procedure. Provide Privacy
4. Explain the procedure. To guide them all throughout the procedure.
5. Place waterproof pad under pouch. The pad prevents the spilling of
effluent on patient and bedsheets
6. Apply gloves. Inspect the ostomy bag and determine the need to
change the appliance.
7. Assist the patient to stand or sit. Promotes better evacuation of stool
and avoids wrinkles on the colostomy. Unfasten belts if patients wear
one.
8. Empty the pouch and remove the ostomy skin barrier. Always empty
the pouch through the bottom to prevent spillage of contents into the
patient’s skin
9. Gently peel from top to bottom while holding the patient’s skin tout to
minimize discomfort. Always inspect the contents for color.
10. Clean and dry the stoma and the peristomal skin. by wiping with
warm water. Do not use soap. Aggressive cleaning can
cause bleeding. If removing stomahesive paste from skin, use a dry
cloth first.
11. Place a piece of cloth or tissue over the stoma as it is being cleaned.
To absorb any slippage as stoma care is being actively done.
12. Assess stoma and peristomal skin. A stoma should be pink to red in
colour, raised above skin level, and moist.
13. Measure the stoma diameter using the measuring guide (tracing
template) and cut out stoma hole. The opening should be 2
mm larger than the stoma size.
 14. Apply a skin barrier, which can be a cream and / or a wafer, covering
the skin for a two-inch radius around the stoma. If using a cream, let it
dry before putting the appliance back on
15. Put the ostomy belt back on and place deodorant inside the new
ostomy appliance, if used.
16. 16.Remove the back adhesive from the new appliance and center it
over the stoma with the end pointing down. Press the edges on the
skin and make sure there’s a good seal to prevent leakage
17. Apply the ostomy bag. Attach the clip to the bottom of the bag
18. Adjust the person’s clothing to cover the appliance and help readjust
their position so they’re comfortable.
19. Adjust the person’s clothing to cover the appliance and help readjust
their position so they’re comfortable.
20. Perform hand hygiene.
20. Document procedure. Document appearance of stoma and
peristomal skin, products used, and patient’s ability to tolerate
procedure and assistance with procedure.
Total= 84

Name ______________________________________________Score_____________________________

Year and Section ______________________________________Clinical Instructor___________________

References: BCIT, 2015b; Berman & Snyder, 2016; Perry et al., 2014.Hinkle, J. L., & Cheever, K. H.
(2018). Brunner & Suddarth’s textbook of medical-surgical nursing. Kozier, B., Erb, G., & Berman, A.
(2018). Kozier and Erb’s Fundamentals of Nursing (4th ed., pp. 10-14, 497-503). Pearson
Australia.Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A. (2017). Fundamentals of nursing. Ninth
edition. St. Louis, Mo.: Mosby Elsevier.