Ostomy Care

Colostomy: A bowel diversion which may be necessary due to certain disease processes (e.g. cancer). The intestines are brought towards the abdominal wall, resulting in a stoma, which passes stool or effluent. A colostomy pouch is used to collect and hold the stool or effluent.

PSW Considerations:

  • Encourage the client to be involved in the procedure as much as possible to promote independence.
  • Notify the office immediately at 416-635-2860 if any of the following are observed:
    • If there is a smaller or larger amount of stool output than usual.
    • If the client complains of cramping, abdominal pain, or looks dehydrated.
    • Common signs of concerns with the client’s stoma:
      • Bulging
      • Getting larger
      • Darkening in colour or turning bluish
    • Common signs of poor skin health around the client’s stoma:
      • Redness
      • Irritation
      • Signs of leaking around the pouch or skin barrier
      • Bleeding

Required Supplies:

  • Clean gloves
  • Basin for stool collection (if the toilet is inaccessible)
  • Wash cloth
  • Soap
  • Tissues, paper towels, or sanitary wipes if available

Procedure for Emptying the Ostomy Pouch:

  1. Position the client appropriately and ensure that privacy is maintained.
  2. Explain the procedure to the client at their level of understanding.
  3. Wash hands thoroughly. Put on gloves.
  4. Inspect the area around the stoma for:
    • Redness
    • Irritation
    • Signs of leaking around the pouch or skin barrier
    • Bleeding
  5. Inspect the stoma for signs of:
    • Bulging
    • Getting larger
    • Darkening in colour or turning bluish
  6. Raise the pouch so that the opening faces up.
  7. Open the pouch.
  8. Either unclamp or unroll the integrated drainage outlet.
  9. Lower the pouch towards the toilet or collection container.
  10. If emptying into the toilet, place a piece of toilet paper in the toilet to prevent splashing.
  11. Slide your hands down the pouch to push out the stool.
  12. Wipe the opening of the pouch.
  13. Re-clamp or reseal the pouch.
  14. If the area around pouch is soiled, wipe it down with water and a cloth to clean it until the appliance can be changed.
  15. Remove gloves and wash hands thoroughly.
  16. Report any unusual findings, concerns, or changes to the client’s health to your CSS.

Video Resource

Please click on the video links below for a visual demonstration of the procedure:

References:

American College of Surgeons. (2016, February 10). Adult colostomy/ ileostomy.
https://www.facs.org/for-patients/home-skills-for-patients/ostomy/adult-colostomy-ileostomy/

American College of Surgeons. (2013, March 7). Colostomy/ ileostomy: Emptying a pouch [Video]. YouTube. https://www.youtube.com/watch?v=JrtO2KkLZsQ&ab_channel=AmericanCollegeofSurgeons

CareChannel (2019, October 4). How to empty & change an ostomy bag [Video]. YouTube.
https://www.youtube.com/watch?v=FXKM1r5L8U8&ab_channel=CareChannel

Hollister. (2023). Ostomy care: Quick educational tools.
https://www.hollister.com/en/ostomycare/educationaltools#

MedlinePlus. (2022). Changing your ostomy pouch.
https://medlineplus.gov/ency/patientinstructions/000204.htm

Potter, P., Perry, A. G., Stockert, P., Hall, A. (2019). Canadian fundamentals of  nursing (6th ed,. Astle, B. J., & Duggleby, W. Eds.). Elsevier Canada.

School Health Associates. (2021). Emptying colostomy pouch.
https://schoolhealthassociates.com/emptying-colostomy-pouch/

Wound Management & Prevention. (2010). Testing a computer-based ostomy care training resource for staff nurses. https://www.hmpgloballearningnetwork.com/site/wmp/content/testing-computer-based-ostomy-care-training-resource-staff-nurses