CHS10 Undertake stoma care

Overview

This standard covers undertaking the care of a bowel/bladder stoma. This may be for individuals with new stomas or for individuals with established stomas who are unable to manage their own stoma care. Where the stoma is newly formed in the immediate post-operative period, these activities must be undertaken using an aseptic technique and following local guidelines and procedures. The standard is applicable in a variety of care settings including hospitals, care homes, the individuals own home or other community settings such as GP surgeries. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

the current European and National legislation, national guidelines, organisational policies and protocols in accordance with Clinical/Corporate Governance which affect your work practice in relation to undertaking stoma care
your responsibilities and accountability in relation to the current European and National legislation, national guidelines and local policies and protocols and Clinical/Corporate Governance
the duty to report any acts or omissions in care that could be detrimental to yourself, other individuals or your employer
the importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence
the importance of applying standard precautions to undertaking stoma care and the potential consequences of poor practice
what valid consent means and why it must be obtained and confirmed prior to actions being taken
why individuals should be supported and told about the activity/or procedure
how your personal beliefs may cause you difficulties with certain procedures and how you manage this conflict in practice
the concerns and worries which individuals or client groups may have in relation to undertaking stoma care
the importance of exercising sensitivity to the individual’s perception of the situation
the factors which will affect the level of assistance required such as age, medical condition, personal beliefs and preferences
the adverse reactions which may occur during and following stoma care activities and how to identify and deal with these
the role of the Stoma Care specialist practitioner and how they can be contacted
the reasons why a stoma may be fashioned
the anatomy in relation to the position and function of
1. colostomies
2. ileostomies
3. ileal conduits
4. nephrostomy
the effects of diet and mobility on stoma function
the potential consequences of contamination of stoma drainage systems
the equipment and materials required for undertaking stoma
the types of stoma appliances available
the suitability of stoma appliances for different types of stoma
the personal protective clothing and additional protective equipment which should be worn for the individual’s and your protection
the importance of involving the individual in the care of their stoma
the importance of providing the individual with sufficient stoma care materials to carry out stoma care themselves
why questions which are beyond your role or knowledge need to be passed onto the appropriate member of the care team
the importance of keeping accurate and up to date records
the specific records required for each clinical activity you are required to undertake
the importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff

Performance Criteria

You must be able to do the following:

apply standard precautions for infection prevention and control and take other appropriate health and safety measures
check the individual’s identity and confirm the planned activity
give the individual relevant information, support and reassurance in a manner which is sensitive to their needs and concerns
gain valid consent to carry out the stoma care activities
confirm all equipment and materials for stoma care are:
1. as prescribed/detailed in the individual’s plan of care
2. appropriate to the procedure
3. fit for purpose
carry out stoma care:
1. at an appropriate time according to the individual’s plan of care
2. using appropriate techniques
3. in line with manufacturer’s instructions
4. in a manner which optimises the patient’s comfort and dignity and minimises pain and trauma
observe and support the individual throughout the stoma care
recognise and report any condition or behaviour which may signify adverse reactions to the activity and take the appropriate action
encourage individuals to communicate any concerns about their stoma care needs and functioning
monitor and report on the individual’s pattern of stoma function, consistency of body waste and any changes that may have occurred
encourage and assist individuals to select and consume food and drink and take medication if prescribed to maintain effective stoma function
provide active support for individuals to manage their own stoma in a manner that promotes self respect, maximises privacy and is consistent with the plan of care
provide stoma care equipment at a time and place convenient to the individuals needs and circumstances
take appropriate action when the stoma care equipment appears to be inappropriate or unsuitable
give individuals the opportunity to dispose of their own used stoma care equipment and maintain their personal hygiene
ensure that equipment and soiled linen is disposed of safely, hygienically and in ways which minimise the risk of cross infection
record the outcomes of stoma care activity correctly using the method agreed in your care setting
report your findings and/or activity to the appropriate member of the care team

Additional Information

This National Occupational Standard was developed by Skills for Health.This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB5 Provision of care to meet health and wellbeing needs