Position Statement on Care of Ostomy Patients During Covid-19 Pandemic

Maculotti, Danila; Spena, Pier R.; Villa, Giulia

doi:10.1097/sga.0000000000000539

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…The typical clinical manifestations of this illness are fever, cough, dyspnea, and myalgia or fatigue ( Guan et al, 2020 ). Digestive symptoms such as nausea, vomiting, diarrhea, and abdominal pain usually accompany the respiratory symptoms ( Maculotti, Spena, & Villa, 2020 ; Pan, Shao, et al, 2020 ; Yang, Zheng, et al, 2020 ; Ye, Yang, Liu, Liao, & Wang, 2020 ). The incidence of gastrointestinal (GI) manifestations has ranged from 3% to 61% in patients with COVID-19 ( Gupta et al, 2020 ; Ye et al, 2020 ).…”

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confidence: 99%

Gastrointestinal Bleeding in COVID-19 Patients

Negro

Villa

Rolandi

et al. 2022

Gastroenterology Nursing

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T he COVID-19 pandemic has threatened global health and continues to cause excess mortality. Over 6 million people have died from COVID 19 so far, according to a report by the World Health Organization (2022). The typical clinical manifestations of this illness are fever, cough, dyspnea, and myalgia or fatigue (Guan et al., 2020). Digestive symptoms such as nausea, vomiting, diar-rhea, and abdominal pain usually accompany the respiratory symptoms (Maculotti,

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confidence: 99%

Gastrointestinal Bleeding in COVID-19 Patients

Negro

Villa

Rolandi

et al. 2022

Gastroenterology Nursing

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“…11 This shorter wait time is justified by inconclusive data in the available literature of a causal relationship between early tracheostomy and the development of complications such as VAP. 11,28 Avilés-Jurado et al and others have suggested in their studies that early tracheostomy is positively correlated with a decreased number of days on mechanical ventilation (adjusted hazard ratio 2.55; 95% CI, .96-22.3), although not statistically significant. 14,16…”

Section: Timingmentioning

confidence: 89%

“…11 Additionally, none of the members involved in the tracheostomy procedures This shorter wait time is justified by inconclusive data in the available literature of a causal relationship between early tracheostomy and the development of complications such as VAP. 11,28 Avilés-Jurado et al and others have suggested in their studies that early tracheostomy is positively correlated with a decreased number of days on mechanical ventilation (adjusted hazard ratio 2.55; 95% CI, .96-22.3), although not statistically significant. 14,16 In contrast to much of the current data which primarily discusses patients receiving tracheostomy between days 10 and 21, in their case series, Goldstein et al, explore postoperative morbidity and mortality in COVID-19 seropositive patients after 21 days of ventilation.…”

Section: Timingmentioning

confidence: 89%

Indications and Recommendations for Tracheostomy in Trauma Population With COVID-19 Infection: A Review of the Literature

Barbera-Mirza

Chan

Newsome

et al. 2021

The American Surgeon™

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This review explores the current body of evidence pertaining to tracheostomy placement in COVID-19 seropositive patients and summarizes the research by tracheostomy indications, timing, and procedure. Literature review was performed in accordance with the 2020 PRISMA guidelines and includes 12 papers discussing protocols for adult patients seropositive for COVID-19. The studies demonstrated high mortality rates after tracheostomy, especially in geriatric patients, and suggested a multifactorial determination of whether to perform a tracheostomy. There was inconclusive data regarding wait time between testing seropositive, tracheostomy, and weaning off of ventilation. COVID-19 generally reaches highest infectivity between days 9 and 10; furthermore, high early mortality rates seen in COVID-19 may confound mortality implicated by tracheostomy placement. Due to the aerosol-generating nature of tracheostomy placement, management and maintenance, techniques, equipment, and personnel should be carefully considered and altered for COVID-19 patients. With surgical tracheostomy, literature suggested decreased usage of electrocautery; with percutaneous tracheostomy, single-use bronchoscope should be used. The nonemergent exchange of tracheostomy should be done only after the patient tested negative for COVID-19. Placement of tracheostomy should only be considered in COVID-19 patients who are no longer transmissible, with rigorous attention to safety precautions. Understanding procedures for airway maintenance in a respiratory disease like COVID-19 is imperative, especially due to current shortages in ventilators and PPE. However, because of a lack of available data and its likelihood of change as more data emerges, we lack complete guidelines for tracheostomy placement in COVID-19 seropositive patients, and those existing will likely evolve with the disease.

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“…As a result of the spread of COVID-19, educational interventions for ostomy patients have undergone substantial revisions in the way they are provided [ 20 ]. The priority of avoiding exposure to infection risks has forced healthcare systems to switch to telehealth education.…”

Section: Introductionmentioning

confidence: 99%

“…The priority of avoiding exposure to infection risks has forced healthcare systems to switch to telehealth education. Telehealth can be considered an alternative solution to extend access to education while concomitantly maintaining the level of effectiveness of traditional strategies and keeping patients at home as much as possible [ 20 ]. Indeed, telehealth can increase access to care, and is equivalent to in-person services, at least in the specialties of mental health, dermatology, and rehabilitation [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Telehealth vs in-person education for enhancing self-care of ostomy patients (Self-Stoma): Protocol for a noninferiority, randomized, open-label, controlled trial

Iovino,

Vellone,

Campoli

et al. 2024

PLoS ONE

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Introduction Postoperative patients with ostomies experience significant changes in their lives as a result of the device implantation. Self-care is important to improve their health outcomes. Telehealth provides an opportunity to expand access to self-care education. Aim This is a multicenter, non-inferiority randomized, open-label, controlled trial to evaluate the non-inferiority of a telehealth intervention to the standard in-person approach in improving self-care behaviors. Methods and analysis Three hundred and eighty-four patients aged ≥ 18 years, with a recently placed ostomy, no stomal/peristomal complications, and documented cognitive integrity will be randomly assigned (1:1) to receive either a telehealth intervention (four remote educational sessions) or a standard educational approach (four in-person sessions) delivered in outpatient settings. Every session (remote and in-person) will occur on Days 25, 32, 40, and 60 after discharge. Follow-ups will occur 1, 3, and 6 months after the last intervention session. Primary outcome is self-care maintenance measured using the Ostomy Self-care Index (OSCI). Secondary outcomes include self-care monitoring, self-care management, self-efficacy (OSCI), quality of life (Stoma specific quality of Life), depression (Patient Health Questionnaire-9), adjustment (Ostomy Adjustment Inventory-23), stomal and peristomal complication rates, healthcare services utilization, mobility, and number of working days lost. Analyses will be performed per intention-to-treat and per protocol. Ethics and dissemination This study has been approved by the Institutional Review Board of the main center (registration number: 119/22). Following completion of the trial, dissemination meetings will be held to share the results of the study with the participants and the health-care team. Adoption of telehealth technologies for ostomy patients can improve service organization by ensuring better integration and continuity of care. If the remote intervention produces comparable effects to the in-person intervention, it would be wise to make telehealth education an alternative treatment for addressing the educational needs of uncomplicated postoperative ostomy patients. Trial registration ClinicalTrials.gov (identifier number: NCT05796544).

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Position Statement on Care of Ostomy Patients During Covid-19 Pandemic

Cited by 5 publications

References 4 publications

Gastrointestinal Bleeding in COVID-19 Patients

Gastrointestinal Bleeding in COVID-19 Patients

Indications and Recommendations for Tracheostomy in Trauma Population With COVID-19 Infection: A Review of the Literature

Telehealth vs in-person education for enhancing self-care of ostomy patients (Self-Stoma): Protocol for a noninferiority, randomized, open-label, controlled trial

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