In April, RNAO released Supporting Adults Who Anticipate or Live with an Ostomy, the next edition of the 2009 best practice guideline (BPG), Ostomy Care and Management. This edition provides nurses and other members of the interprofessional team with evidence-based recommendations to support patients, enhance access to care, promote positive outcomes, and enable patients to better manage their condition.  

The guideline’s expert panel recommends that people who have or expect to have an ostomy consult with nurses who specialize in wound, ostomy and continence as members of an interprofessional team. This means that, before surgery, these specialized nurses educate and counsel patients.

The panel also recommends health service organizations standardize care for ostomy so interprofessional teams counsel patients on how to care for themselves, adapt new approaches to daily living, and deal with potential complications. The interprofessional team should also plan discharge based on the readiness of patients, then schedule home visits and telephone calls within four weeks of discharge.

The BPG includes strategies to prevent one of the the most common complications of ostomy: when one or more loops of the intestine protrude through the abdominal wall, creating a bulge around the peristomal skin, something called parastomal hernias. 

The panel recommends providers assess the quality of life in persons who have or expect to have an ostomy and focus on areas such as self-identity, sexuality and psychological well-being.

This latest guideline marks a milestone for RNAO’s BPG program, which is improving and streamlining how it formulates questions and researches recommendations so BPGs prove even more useful. Using a proven methodology called GRADE from this BPG onwards – including all next editions and new ones – each BPG panel will harness the expertise of its members to craft pointed practice recommendations for the most salient issues they want to tackle. RNAO’s guideline development methodologists then turn those into the research questions for systematic review. Expert panels tether recommendations more closely to evidence and report the strengths and limitations of each recommendation. The new approach results in fewer and sharper recommendations. In the case of this new ostomy BPG it has six rated recommendations, instead of the 26 included in the 2009 version.

For a free download, visit RNAO.ca/BPG/guidelines/ostomy.