OBJETIVO: Avaliar e comparar a qualidade de vida (QV) de pessoas colostomizadas que utilizam e não utilizam os métodos de controle intestinal (MCI), ou seja, a irrigação e o sistema oclusor da colostomia, considerando a hipótese de que aquelas que os utilizam têm melhor QV. Método: O estudo foi desenvolvido no Ambulatório do Hospital Heliópolis, após a aprovação do projeto pelo Comitê de Ética, usando o WHOQoL-abreviado. A amostra foi constituída de dois grupos: 50 pessoas colostomizadas usando os dois MCI e 50, sem os MCI. Resultados: A QV do Grupo com MCI foi significativamente melhor em todos os Domínios e na QV Geral do que daquelas do Grupo sem MCI. Conclusão: O estudo confirmou a hipótese de que a QV do Grupo com MCI é melhor do que a do Grupo sem MCI.
The purpose of this poster presentation is to share the process used at a 60-bed acute rehabilitation facility to address the individual needs of admitted patients regarding their needs for pressure ulcer prevention and/or treatment. Since nearly all patients admitted (spinal cord injury, brain injury, stroke, and general rehabilitation) are identified as being at risk for pressure ulcers upon admission, it is critical that the team quickly identify and implement measures to prevent breakdown and/or promote healing. Because the average length of stay in rehabilitation is only about 16 days, it is vital to focus both on the quality of care and the efficiency of its delivery. The thorough admission assessment process utilizes a rehabilitation interdisciplinary team consisting of the staff nurse and clinical nurse specialist (CNS), physician, physical therapist, occupational therapist, speech therapist, nutritionist, pharmacist, and psychologist. This admission assessment guides the decision making for type of bed, style of wheelchair and cushion, nutritional interventions, turning schedules, activity schedules, type of bowel and bladder programs and therapy interventions. The patient and family members are included in the assessment and decision-making process to facilitate their learning and follow-through. If a patient is admitted with a pressure ulcer, the rehabilitation CNS evaluates the wound and makes further recommendations for care. The chronic wound team, which includes the rehabilitation CNS, the WOC nurses and a plastic surgeon, are consulted for sharp debridement, for a non-healing ulcer evaluation and recommendations, or for a complicated wound that will need follow-up in the outpatient wound clinic after discharge from rehabilitation.STATEMENT OF CLINICAL PROBLEM: Donor site care and dressing changes often cause discomfort for the patient and create issues related to healing. Using evidence-based practice, healing time and complications can be decreased, and discomfort lessened for the patient. DESCRIPTION OF PAST MANAGEMENT: At our organization, standard of care for donor site dressing changes was iodine impregnated petroleum gauze* applied directly to the donor site in the operating room, along with heat lamp therapy. Dressing changes began several days post-op and consisted of traumatic removal of the gauze with intense pain and bleeding, disrupting healing and new cell growth. There was often confusion by nurses as to the best procedure, as they relied solely on the written physician order that was usually vague and incomplete. CURRENT CLINICAL APPROACH: The involvement of the CWOCNs included review of evidence-based practice and mentoring of the physicians. After utilizing the antimicrobial hydrofiber dressing with silver on several patients resulting in positive OUT-COMES, the physicians were convinced of the effectiveness of this dressing for donor site care. Eventually, the Donor Site Care Orders was formally created, increasing nurse satisfaction related to improved communication and continui...
Objective: Performing a literature review about four technical aspects related to the colostomy irrigation: volume of water to be infused, postoperative moment to start the method's training sessions, maintenance of a 24-hour interval between the colostomy irrigations, and time spent for the execution of the procedure, aiming to contribute for the most adequate systematization of the method. Methods: After searching in the designated sources, sixty-three articles were identified. Results: It was observed that there is no consensus among the several authors: the volume of infused water varied from 500ml to 1500ml, although, in the clinical practice, the average infused volume is 1000ml; the postoperative moment to start the training sessions varied from five days to six months; the maintenance time of a 24-hour interval between the colostomy irrigations varied from two weeks to six months; time spent in the execution of the procedure varied from 20 to 90min. Conclusion: The knowledge of these results may be an encouragement to the nurses, especially stomatherapists, to reevaluate their practice, in order to standardize the technical aspects related to the procedure, having as basis the specialized assistance. Keywords: Colostomy/irrigation; Nursing care RESUMO Objetivo: Realizar uma revisão bibliográfica sobre quatro aspectos técnicos relacionados à irrigação da colostomia: volume de água a ser infundido, momento do pós-operatório em que se deve iniciar o treinamento para uso do método, tempo de manutenção de 24 horas como intervalo entre as irrigações e tempo gasto na realização do procedimento, visando contribuir para a sistematização mais adequada do método. Métodos: Feitas as buscas nas fontes planejadas, foram identificados 63 artigos. Resultados: Observou-se a inexistência de um consenso entre os diversos autores consultados: o volume de água infundido variou de 500ml a 1500ml, embora, na prática, o volume médio infundido seja de 1000ml; o momento do pós-operatório para início do treinamento variou de cinco dias a seis meses; o tempo de manutenção do intervalo de 24 horas entre as irrigações variou de duas semanas a seis meses; o tempo dispendido na realização do procedimento variou de 20 a 90 minutos. Conclusão: O conhecimento desses resultados pode servir de estimulo aos enfermeiros, preferencialmente estomaterapeutas, para reavaliar a sua prática, a fim de padronizar os aspectos técnicos a esta relacionados, tendo como pano de fundo a assistência especializada. Descritores: Colostomia/irrigação; Cuidados de enfermagem RESUMEN Objetivo: Realizar una revisión bibliográfica sobre cuatro aspectos técnicos relacionados a la irrigación de la colostomía: volumen de agua a ser infundido, momento del post-operatorio en que se debe iniciar el entrenamiento para el uso del método, tiempo de manutención de 24 horas como intervalo entre las irrigaciones y tiempo gastado en la realización del procedimiento, visando contribuir en la sistematización más adecuada del método. Métodos: Una vez realizadas las búsque...
INTRODUÇÃOA adaptação ao estoma depende , em grande parte , do domínio que a pessoa ostomizada tem sobre o autocuidado do estoma e pele periestomal. Por isso, em todas as fases do tratamento cirúrg i co gerador de lostomia, a tríade ostomia-pele periestomal-sistemas coletores usados no cuid4 do deve ser uma constante no planejamento da assistência de enfermagem ao paciente E. mais especificamente no pós-operatório, a util iza ção do sistema coletor adequado deve estar associada ao ensino do cuidado com o estoma e pele periestomal bem como do manuseio do sistema coletor e, ainda, à execução dos procedimentos ou habilidades básicas ao cuidado pela própria pessoa ostomizada ou familiar responsável (Santo.s, 1 986 a.b). Embora estes aspectos
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