Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Practice Recommendations- Post Operative Phase
  1. Assess the stoma immediately post-operatively and the stoma/peristomal skin condition witheach appliance change using a validated classification tool to monitor for complications.
  2. Identify risk factors that influence stomal and peristomal complications.
  3. Review the client’s medication profile to ensure that maximum absorption and effectivenesswill be achieved in relation to the type of ostomy.
  4. Avoid insertion of a glycerin suppository into a colostomy in order to aid evacuation of effluent.
  5. Counselling by a Registered Dietician should be performed for clients with an ostomy who areat risk for, or who develop, nutritional complications.
  6. Prepare the client and family by teaching the minimum skill set specific to their needs priorto discharge from hospital.
  7. Discharge the client and family with home care support.
  8. Ensure that the ostomy plan of care is individualized to meet the needs of the client and family.
  9. Assessment and follow-up by an Enterostomal Therapy Nurse (ETN) are recommended for the clientand family after ostomy surgery to decrease psychological distress, promote optimal quality of lifeand prevent complications.
  10. Educate client and family members to recognize complications affecting the stoma and peristomal skin.
  11. Colostomy irrigation may be implemented as a safe and effective method for the managementof descending or sigmoid colostomies for select adult clients.