Cleaning and changing colostomy bag

Nursing Students CNA/MA

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I am a new CNA. it is a CNA job responsibility? because when I took CNA class I do not remember that my clinical instructor train their students to perform one. I did not know how to put one so I called the Practical Nurse to show it to me. it is very easy how to do it anyway and learning new thing is a good thing. :yes:

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Yes, this is typically a CNA's responsibility. It's simple to do, as the LPN demonstrated.

And learning is always a good thing :)

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I always changed the bag but never the wafer/phalange. It is easy to do but many people don't get trained on how to do it when in clinicals.

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As others have said it is part of the scoop of practice for the CNA. Definitly get someone to train you on taking care of a colostomy, and if you ever get the chance an urostomy. They are not difficult to take care of but the first time or two can be a little bit itimidating. Having your nurse or an experienced CNA that you are working with show you what to do. Replacing the wafer is not difficult the important thing is to make sure that the opening that goes over the stoma is cut correctly, too small you can run into issues, too large can create other problems. The other important thing is to make sure that you get a good seal between the skin and wafer, different products such as skin prep or paste can help with that. The other important piece of advice that I would mention is to make sure that you keep an eye on your colostomy bags, make sure that they are being emptied and burped as needed. It is much easier to take care of it early than to find that too much pressure built up and a leak has developed around the wafer or worse.

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Barb-H, That is a good advice!... Thank you for the input.:)

Thank you everyone

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It depents of the state. In North Carolina, CNA 1 are not allowed to change the colostomy bag or clean the stoma (CNA 1 only empty the bag without removing it from the stoma). If the facility trained you and checked you off, then NC nursing board allows CNA 1 to deal with colostomy bags. Colostomy care is a CNA 2 resposability in NC and other states. Check with your state nursing board.

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Thanks everyone

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I think it depends on the state and/or facility. The aides at my facility do not touch colostomy bags.

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It depents of the state. In North Carolina, CNA 1 are not allowed to change the colostomy bag or clean the stoma (CNA 1 only empty the bag without removing it from the stoma). If the facility trained you and checked you off, then NC nursing board allows CNA 1 to deal with colostomy bags. Colostomy care is a CNA 2 resposability in NC and other states. Check with your state nursing board.

Good point, but most BONs don't have anything to do with CNAs; they usually are under the State Health Department. Not always, but if you don't have a license that is controlled by the State BON, then you might need to check with your Health Dept instead.

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Specializes in Geriatrics, Cardiology..

You need to be nurse delegated to do this and yes it's your responsibility. ?

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Specializes in Operating Room.

In my hospital, it is out of our scope to change a colostomy bag. Why? What if there is an issue with the stoma? Is it a patient whom is not familiar with a colostomy bag yet? Do they have questions for this type of wound care? That is why we have wound care NURSES. What if you have a bag that leaked all over the wafer that needs to be taken off, cleaned, and recut? Do you know the appropriate size to cut the wafer? Do you know how to measure the stoma in order to see what is the appropriate size for cutting? If it is done incorrectly this can cause a serious discomfort for a patient. A CNA is allowed to empty the contents of the colostomy bag as well as cleaning it at my hospital, we are just not allowed to perform a complete change of an entire bag or cut wafers. I am not discouraging you by any means to do this if this is approved by your facility, but where I work this is not allowed. I would check with your Nurse Manager directly if you have doubts and he/she will be able to tell you exactly what you are responsible for, and if they are not available the next best person to ask is your charge nurse.

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I never learned during my CNA classes but I learned on the job when I had a resident who required this care.

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