Ostomy Care During a Pandemic

Introduction

Individuals with ostomies are already associated with complicated medical conditions. This is why people who have an ostomy and chronic medical problems, as well as an impaired immune system, should stay at home as much as possible. Living during a pandemic, an individual reflects on their health and the ability to survive if they contracted the virus. In the spring of 2020, when it was difficult to get essential items, concerns arose regarding obtaining sanitation items, ostomy supplies, and access to health care. It weighs heavy on an individual to imagine not caring for oneself without having access to essential supplies for ostomy care. This blog will discuss increasing nursing telehealth services in ostomy care and peer support groups during the Covid-19 pandemic.

 

Surging of Telehealth Services

 

During the pandemic, family and caregivers had limited or no visitation to participate in ostomy lessons. Therefore this limited the family and caregiver assistance after the patient’s discharge. In addition, during the pandemic, there was a surge in telehealth services. The format included telephone calls, virtual meeting platforms, photographs, videos, and mobile applications for virtual visits. Ostomy product companies also assist in support with their sample request programs.

 

Telehealth Support Groups

Living successfully with an ostomy requires learning and developing routine ostomy care skills. In addition, poor self-management skills lead to psychosocial maladaptation by self-isolation and poor coping skills. The ostomy in-person monthly support groups consisted of a Wound, Ostomy, Continence Nurse to support 4-6 peers providing educational curriculum and discussion for ostomy self-management support group meetings. The meetings changed to a virtual online setting with video conference platforms during the pandemic. In addition to telehealth, meetings are the growing number of social media peer support groups. Online support groups offer individuals with an ostomy the opportunity to talk to each other, share feelings and experiences to guide each other.

 

Telehealth Ostomy Care

During the pandemic, there was a decrease in direct patient care and an increase in telehealth visits. Wound, Ostomy, Continence Nurses (WOC Nurse) offer telehealth visits. Patients book their appointments through a website application and then are confirmed via email with an attached intake form. The nurse reviews the intake form describing current and past medical and surgical history. A follow-up with more questions via a secure email or text may be necessary. Visits are conducted using a secure real-life video technology platform in response to the patient’s needs. Patients connect using a mobile application and a device with a camera. The nurse has a shared screen to aid with patient and caregiver education. Patients are also provided with recommended product numbers and suggestions with an optional follow-up visit. As a follow-up, patients are given an evaluation survey form to aid in tracking outcomes.

 

Home Health Care Telehealth

Home health care nurses enter information in the electronic medical record, including photographs during each visit with the patient. The WOC nurse then reviews the medical history for each consult and completes a comprehensive evaluation with recommendations for a treatment plan. Telehealth visits provide an opportunity for WOC nurses to increase the number of referrals per day and provide a recommended treatment care plan. In addition, the WOC nurse will schedule an in-home visit with the patient for immediate needs.

 

Telehealth Barriers

There are some barriers to telehealth consults. Some patients lack the knowledge or resources needed for the telehealth visit. In addition, the individual may not have access or do not have a high-speed connection for video streaming or high-resolution pictures on their mobile device. Another problem is being able to provide the extra time needed for education due to the time provided for the consultation. Out-of-pocket expenses can delay or prevent care. However, reimbursement guidelines have changed in response to the pandemic. 

 

Conclusion

Telehealth applications do not solve all of the problems with an individual with an ostomy. However, during a pandemic, it provides an opportunity to connect with others virtually, reducing home health nurses’ workload, personal protective equipment, and exposure to the virus. 

 

Disclaimer

The views and opinions stated in this blog are exclusively those of the author and do not reflect those of iWound, its affiliates, or partner companies.

 

Future Reading and References

Wound Manag Prev. 2021 Jan;67(1):12-17. PMID: 33448938.

 

Mahoney, M. F. (2020, September/October). Telehealth, Telemedicine, and Related Technologic Platforms. Journal Wound, Ostomy, Continence Nurs., 47(5), 439-444.

 

Sims, T. W., & Wilson, K. (2020, September/October). Telehealth Management of Urostomy Postoperative Complications. Journal of Wound, Ostomy, Continence Nurs., 47(5), 456-457. doi:10.1097/WOCN.0000000000000698

 

Vural, F., & Ozer Ozlu, N. G. (2020, October 27). In the COVID-19 Pandemic Living with a Stoma and Being a Stoma Nurse. Turkish Journal of Colorectal Disease, 231-236. doi:10.4274/tjcd.galenos.2020.2020.10.3

 

Weinstein, R. S., Holcomb, M. J., Mo, J., Yonsetto, P., Bojorquez, O., Grant, M., Wendel, C. S., Tallman, N. J., Ercolano, E., Cidav, Z., Hornbrook, M. C., Sun, V., McCorkle, R., & Krouse, R. S. (2021). An Ostomy Self-management Telehealth Intervention for Cancer Survivors: Technology-Related Findings From a Randomized Controlled Trial. Journal of medical Internet research, 23(9), e26545. https://doi.org/10.2196/26545

 

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