Need tips for ileostomy LTC patient

[Elektra6, ASN, BSN, RN]

Her surgery was in August. I'm having a terrible time keeping her bag from leaking from the sides (so are the other nurses). She's running 150-250 cc's every time I drain her bag (q 1 hr sometimes). She is unable to do this herself. She is on multiple drugs to stop her from running but nothing has worked very well. We have tried almost every ostomy bag out there along with duoderm, skin prep, barriers, etc. Please help, the resident and I are very frustrated with this.

[tcdtx]

I had an ileostomy myself when I was 21 (learned a lot from that). I am currently an RN, working on my BSN to get my WOCN certification.

I had a lot of trouble with leakage in the beginning. If the stoma doesn't stick out very far, have you tried convex bags? Also, have you tried Stomahesive Paste (it works like caulking to fill in uneven skin surfaces)?

Hope this helps!

[vickynurse]

do you have a certified ostomy nurse in your area? Sounds like you need to have someone actually see her.

[NRSKarenRN, BSN, RN]

have cared for a few pts like this.

see types of accessories available to assist this pt:

example: accessories

look at suppliers you have for similar items.

a. if output is 150/cc hr then traditional drainage bag only holds 250'cc not practical for this patient. wt of bag/overfill causing movement away from stoma. adding an extension set to end of bag and attaching to bedside drainage bag would eliminate this issue.

example: night drainage container tubing

b. if flange of devise is not flush with skin, then stomaadhesive paste is appropriate. otherwise needs skin cement: clean skin well, no soaps, apply skin prep to irritated areas. fan dry well, then apply skin cement, dry well to tacky touch

example: skin care: skin bond cement: ostomy supplies

then apply appliance.

99.9% success rate with these 2 tricks.

ask for wound care/ostomy rn eval if these tricks don't help.

good luck.