Colostomy Irrigation : Current Status & Future Perspectives. Danièle CHAUMIER, ET nurse Hôpital Tenon, Paris France

Transcription

1 Colostomy Irrigation : Current Status & Future Perspectives Danièle CHAUMIER, ET nurse Hôpital Tenon, Paris France

2 Colostomy irrigation (CI) = Effective & safe method to achieve fecal continence in selected patients. Source : 1. Eva Carlsson, 2010 B. Braun Melsungen AG Page 2

3 Benefits of colostomy irrigation are well established : - feeling secure, - having an empty pouch, - less frequent pouch changes, - enhanced freedom, - enhanced bowel control, - feeling more clean, - improved self-esteem, - feeling confident in intimate situations, - diminished anxiety, - reduced odor, - cost effectiveness. Sources : 1. Eva Carlsson, Sarah Varma, 2009 B. Braun Melsungen AG Page 3

4 Benefits of colostomy irrigation well known? No! Sarah Varma - Bibliographic Review of Colostomy Irrigation Literature (2009) : Conclusions : Colostomy irrigation (CI) is safe and can play a vital role in rehabilitation, There is a need for educational development among health care professionals, There is a need for better understanding of CI and its advantages for patient QoL - and the Care provider (NHS). B. Braun Melsungen AG Page 4

5 Ayse Karadag and Zehra G. Baykara - Importance of colostomy irrigation for muslim individuals (2009) : Conclusions : CI reduces costs and prevents peristomal skin complications, For the selection of the most suitable bowel management method, the ET nurse must also take into account the patient s religious belief and cultural practices, CI helps muslim patients to perform their worship more comfortably. B. Braun Melsungen AG Page 5

6 Eva Carlsson et al. - Survey among Swedish WOC nurses and colostomists (2010) : Conclusions : CI should be taught to all suitable patients, It should be investigated why this is currently NOT being done, Women may be easier motivated than men for colostomy irrigation. 6

7 Isabel Cesaretti et al. - QoL of colostomists using or not using bowel control methods (2010) : Method : Comparison of QoL of - 50 colostomists with irrigation and use of plug system, - 50 colostomists without irrigation and no use of plug system, Conclusion : CI and use of plug system significantly increase QoL. 7

8 Marcia Grant et al. - Irrigation Practices in Long-Term Survivors of Colorectal Cancer With Colostomies (2012) : Method : Survey of 101 colostomates who - were practising CI, - had practised CI but had stpped some time ago, - may, but so far had not been practising CI, Main findings : Those participants who had never irrigated displayed a complete lack of knowledge about irrigation and its purposes, Teaching patients CI must be reviewed and improved! 8

9 Martha D. Cobb et al. - Colostomy Irrigation - Current Knowledge and Practice of WOC Nurses (2015) : Method : 1-time online survey of members of the WOC Nurses Society, Main findings : 985 out of 4191 WOC Nurses completed the online survey, Only 19% of the respondents do routinely teach CI, Conclusion : Education is urgently needed for ostomy nurses unprepared and/or unfamiliar with CI. 9

10 Nancy J. Tallman et al. - Colostomy Irrigation - Issues Most Important to WOC Nurses (2015) : Method : Additional analysis of the data collected by Cobb MD et al. (2015) from 985 WOC nurses, Main findings : Data provide an excellent and detailed overview of what WOC nurses know and believe about CI, Nurse opinions are presented by «themes» such as e.g. - Lack of professional education, - Lack of time for teaching, - Misconceptions, Conclusion : CI has clear advantages and disadvantages, Preparation of nurses to teach CI is limited by time, space, knowledge and experience. 10

11 Dea J. Kent et al. - Does Irrigation Affect Functional Outcomes and Quality of Life in Persons With a Colostomy (2015) : Method : Systematic review of randomized controlled studies and nonrandomized comparison studies, Main findings : CI reduces - the frequency of bowel evacuation - of pouch usage, - of stool passage between irrigations and of odor/flatus CI shows a tendency for increased QoL scores Conclusion : WOC nurses should educate patients with a left-sided permanent colostomy about the potential benefits and techniques of CI. 11

12 S. Pace et al. - Innovative technology for colostomy irrigation : assessing the impact on patients (2015) [1]: Method : Cohort study of 14 colostomates who were offered the possibility to try an electrical irrigation pump : IryPump (B. Braun), Patient profile : Ordinarily performing CI, Autonomous in the management of the standard irrigation technique (based on instillation by gravity), Able to express a valid opinion. 12

13 S. Pace et al. - Innovative technology for colostomy irrigation : assessing the impact on patients (2015) [2]: IryPump and IryCone+ (irrigation tube and cone tip) 13

14 S. Pace et al. - Innovative technology for colostomy irrigation : assessing the impact on patients (2015) [4]: Outcomes (1): 12 out of the 14 participants (86%) found that the device facilitates colostomy management, Reasons : Water pressure in the intestine is constant, Device more convenient because no need to hang the irrigation bag, The water flow into the intestine is easy to control, never stops and is stronger, Faeces are expelled much faster, Irrigation takes less time and requires less manual intervention, Provides more psychological comfort. 15

15 S. Pace et al. - Innovative technology for colostomy irrigation : assessing the impact on patients (2015) [5]: Outcomes (2): 5 out of the 14 participants (36%) found that the device is too bulky to be taken on trips, One participant found the irrigator tube rigid, One participant found it difficult to distinguish the numbers on the control wheel of the pump. Conclusions : The new device ensures a clear benefit to the patient in terms of - comfort, - results, The new device is easier to run, It also has the potential to save nursing time. 16

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