Mercè Folguera-Arnau1, José M Gutiérrez-Vilaplana2, Esther González-María3, María Teresa Moreno-Casbas3, Silvia Obarrio-Fernández4, Gloria Lorente-Granados5, Elsa Viñoly Torres6, María Pilar Rodríguez-Soberado7. 1. Hospital Universitari de Santa Maria, Lleida, España. 2. Hospital Universitari Arnau de Vilanova, Lleida, España. Electronic address: bpsolleida@gmail.com. 3. Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España. 4. Hospital General Mateu Orfila, Mahón, Menorca, España. 5. Gerencia de Atención Integrada de Alcázar de San Juan, Alcázar de San Juan, Ciudad Real, España. 6. Hospital Doctor José Molina Orosa, Arrecife, Lanzarote, España. 7. Hospital de Medina del Campo, Medina del Campo, Valladolid, España.
Abstract
INTRODUCTION: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
INTRODUCTION: Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD: Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS: Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS: The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
Keywords:
Atención de Enfermería; Clinical Practice Guideline; Evaluación de resultados y procesos (atención de salud); Guía de Práctica Clínica; Nursing Care; Ostomy; Ostomía; Outcome and process assessment (health care)