Practice and Training Needs of Staff Nurses Caring for Patients With Intestinal Ostomies in Primary and Secondary Hospitals in China

Abstract

PURPOSE: The purpose of this study was to describe staff nurses' intestinal ostomy care practice in primary and secondary hospitals in China and their ostomy-related training needs. SUBJECTS AND SETTING: The target population for this study was first-line staff nurses working in general surgical departments in primary and secondary care hospitals in Luzhou, located in Sichuan Province, Southwest China. Hospitals in China are divided into 3 tiers; first tier facilities are usually located in townships and have fewer than 100 inpatients beds; secondary hospitals are usually found in medium-sized cities or districts and have between 100 and 500 inpatient beds. DESIGN: Descriptive, cross-sectional. METHODS: Participants were recruited through a stratified cluster sampling method based on hospital tier and the presence of general surgical department. Data were collected via a questionnaire that comprised 3 sections; the first section queried demographic and professional practice data, the second queried practice related to patients with intestinal ostomies, and the third queried nurses' stoma-related training needs. Links to the electronic survey were distributed through e-mail. RESULTS: Three hundred and eighteen nurses were invited to participate in the survey, and 280 questionnaires were returned, yielding a response rate of 88.05%. Review of data found that 214 questionnaires were sufficiently complete to be used in our data analysis. The mean intestinal ostomy practice score was 26.61 ± 7.98, indicating less than optimal engagement in ostomy care. Lack of manpower in the workplace and heavy workload of daily nursing were identified as leading barriers to continuing education in this area of practice. CONCLUSIONS: The ostomy-related practice of first-line staff nurses in Chinese primary and secondary hospitals showed less than optimal engagement in ostomy practice. We recommend creating additional ostomy-related continuing education targeted for nurses practicing in primary and secondary tier hospitals and removal of barriers to this education in order to improve ostomy care in primary and secondary tier hospitals in China.

Confidence, skills and barriers to ostomy patient care by nursing staff in Saudi Arabia

“…This finding may be because senior nursing staff with many years' experience are often employed in management positions; thus, they have less direct contact with patients' ostomy care. 22 This study has documented that nurses gain more confidence in their knowledge and skill as they gain more years of clinical experience.…”

“…Another study found that nurses in China with more than 26 years of experience and working in high practice positions had significantly lower scores in knowledge and skill of ostomy care than nurses in bedside care or those with 15–25 years of experience. This finding may be because senior nursing staff with many years’ experience are often employed in management positions; thus, they have less direct contact with patients’ ostomy care 22 …”

“…However, nurses who had no specialized training had inadequate and significantly worse knowledge than nurses who had completed ostomy care training 6,13 . Li et al 22 evaluated staff nurses who were practicing and training to care for patients with intestinal ostomies, and noted that first‐line nursing staff had little educational training in ostomy care and less than optimal confidence in delivering ostomy care. These findings highlight the importance of specialized training for nurses to improve their ability and confidence in delivering stoma care.…”

“…6 However, nurses who had no specialized training had inadequate and significantly worse knowledge than nurses who had completed ostomy care training. 6,13 Li et al 22 In terms of education, there has been a reported benefit of nursing education at the bachelor's level or higher, including a strong association with fewer adverse outcomes for patients. 10 A previous study indicated that nurses' education level has a significant impact on their knowledge and competency for providing ostomy care.…”

Practice Implications from the WCET® International Ostomy Guideline 2020

“…Findings by Cross and colleagues 8 also support that staff nurses without specialized ostomy education felt more confident in emptying the ostomy pouch as opposed to other ostomy care skills. Duruk and Uçar 9 in Turkey and Li and colleagues 10 in China also reveal that staff nurses lack adequate knowledge about the care of patients with ostomies. Better ostomy care outcomes have been reported when patients are cared for by nurses who have had specialized ostomy education.…”