Early elective colostomy following spinal cord injury

Boucher, Michelle

doi:10.12968/bjon.2016.25.5.s4

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…Owing to the stigma associated with ostomy formation, many clinicians are reluctant to suggest the procedure early after a patient's injury. As an example, in 2012 the Multidisciplinary Association of Spinal Cord Injured Professionals released a 60-page guideline for the management of neurogenic bowel dysfunction in individuals with central neurological conditions 32 ; colostomy appears last on a list of 14 possible interventions, and only a small proportion of patients with SCI have a stoma 20,33 .…”

Section: Discussionmentioning

confidence: 99%

Colostomy and quality of life after spinal cord injury: systematic review

2020

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Background: Spinal cord injury (SCI) has a significant impact on the quality of life (QoL) of affected patients. The aim of this review was to determine whether colostomy formation improves QoL in patients with SCI. Methods: The Cochrane Register, MEDLINE, Embase and CINAHL were searched using medical subject headings. The search was extended to the reference lists of identified studies, ClinicalTrials.gov and the WHO International Clinical Trials Registry. All clinical trials that included spinal injury and QoL, time spent on bowel care, and patient satisfaction with stoma were assessed. Results: A total of 15 studies were found (including 488 patients with a stoma), of which 13 were retrospective cross-sectional studies and two were case-control studies, one of which was prospective research. Nine of 11 studies focusing on QoL reported that patients' QoL was improved by the stoma, whereas the remaining two studies found no difference. Time spent on bowel care was significantly reduced in all 13 studies that considered this outcome, with patients reducing the average time spent on bowel care from more than 1 h to less than 15 min per day. All 12 studies assessing patient satisfaction with their stoma reported high patient satisfaction. Conclusion: Stoma formation improves QoL, reduces time spent on bowel care, and increases independence. Stoma is an option that could be discussed and offered to patients with spinal cord injury.

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Section: Discussionmentioning

confidence: 99%

Colostomy and quality of life after spinal cord injury: systematic review

2020

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“…Moreover, ‘academic qualification’ (consensus statement 1) failed to achieve consensus, suggesting a possible lack of connection and understanding between educational level and the ability to use and contribute to the specialist evidence‐base among the CNS stoma care population, potentially limiting the development of this important pillar of practice. However, role‐modelling is important, and research undertaken by nurses with a clinical background in stoma care demonstrates the value of research to improve practitioner knowledge and understanding and patient outcomes (Boucher, 2022; Thorpe et al., 2014; Williams, 2015).…”

Section: Discussionmentioning

confidence: 99%

The role of the clinical nurse specialist in stoma care: A modified Delphi consensus

Burch,

Bird,

Thorpe

2023

Journal of Advanced Nursing

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IntroductionThe role of the clinical nurse specialist is complex but is defined differently across the world. The role of clinical nurse specialist stoma care is undefined and it is uncertain what aspects of the role are included in the general day‐to‐day working role.AimsThe aim was to gain consensus opinion to answer the research question: ‘What is the role of the clinical nurse specialist in stoma care?’DesignDelphi consensus.MethodsPrevious data gained from a scoping review and expert consultation was utilized to form role statements. At a UK conference the 13 statements and 173 sub‐categories were voted upon. Consensus was agreed if 75% of voters voted agree or strongly agree. Two stages of voting occurred with results from the first vote being shared in the second voting session.ResultsAll 13 statement and most (150/193) statement sub‐categories reached consensus, with 20 sub‐categories added during voting session one.ConclusionsThe four pillars of advanced practice were met by the 13 statements with clinical and education reaching higher consensus and agreement than leadership/management and research. The results of the consensus study provide a clearer articulation of the clinical nurse specialist stoma care role, which is complex and multifaceted which has not been described previously.Implications for PracticeConsideration of role evolution is made possible, to gain a greater expertise in the scope of practice it is necessary to include prescribing, management and research which could improve service delivery and optimize patient outcomes. There was no patient or public contribution, which in hindsight would have potentially improved the process but it was considered that patients might not recognize the full role of the nurse, understanding only aspects of the role that were patient‐centred.Patient or Public ContributionNo patients or public were involved in any aspect of this paper—in hindsight this might have been useful.

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“…24 It has been noted that a lack of uniformity in agreed colostomy complications hinders comparison of research findings. 25 Later complication categories used by others were assessed before deciding criteria for this research. 11,18,21,22 It was decided to record incidence of the following: hernia, prolapse, rectal discharge, defunctioning colitis (termed diversion colitis by some), 26 retraction, and stenosis.…”

Section: Methodsmentioning

confidence: 99%

Early Colostomy Formation Can Improve Independence Following Spinal Cord Injury and Increase Acceptability of Bowel Management

Boucher

Dukes

Bryan

et al. 2019

Topics in Spinal Cord Injury Rehabilitation

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Background: Colostomy formation can solve complications of bowel management following spinal cord injury (SCI). Newly injured patients at this spinal unit have chosen colostomy as a preferred option for bowel management. Objectives: To discover the reasons patients choose colostomy formation early following SCI and make comparison with those choosing it later, and to establish whether early colostomy is safe and advisable. Methods: Medical and nursing records of patients with SCI who chose to have a colostomy during the period 2005-2016 were examined retrospectively. Data were gathered concerning reasons for choosing a colostomy, early and later complications, the need for further surgery, and independence with bowel care before and after surgery. Patients were divided into two groups: those who chose a colostomy "early" during inpatient rehabilitation and those who chose it "later" as is traditional. Results: Reasons for choosing colostomy differed. Reducing reliance on caregiver and independence were of more importance to the early group; the later group chose colostomy to solve bowel care problems. Early complication rates in both groups were low. Longer term complications were higher in the early group, with the most common complication being rectal discharge. Parastomal hernia rates were low in both groups, as was the need for further surgery. Colostomy formation led to 20.8% of all patients gaining independence with bowel care. Conclusion: This study found colostomy to be a safe and effective option when performed early after SCI and demonstrates colostomy can be a means of gaining independence and making bowel care easier and more acceptable to the newly injured patient.

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Early elective colostomy following spinal cord injury

Cited by 6 publications

References 21 publications

Colostomy and quality of life after spinal cord injury: systematic review

Colostomy and quality of life after spinal cord injury: systematic review

The role of the clinical nurse specialist in stoma care: A modified Delphi consensus

Early Colostomy Formation Can Improve Independence Following Spinal Cord Injury and Increase Acceptability of Bowel Management

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