Calling All Stoma RNs (Helpful Tips Needed!)

[RachRN11]

I've been a CWOCN for almost two years now. I work at a small hospital so I get maybe 1 stoma patient a month, if that. The bane of my existence as a stoma RN is the pesky ostomy bridge. I can't seem to apply the pouch correctly to stop leaks. Once the ostomy bridge is out, I'm good, but until then it's a battle.

One problem I think is that my pouch flanges are small and don't completely cover the ostomy bridge. My hospital uses Hollister ostomy products, the bridge is like an X and is sutured down at each of the 4 ends. The stool tunnels under the bridge and out the pouch sides.

Should I use a ring? Hydrocolloid sheet? Tape down the edges? I've tried to outline the bridge with ostomy paste and it works sometimes but not all the time.

I don't want the patients to think I have no idea what I'm doing so any suggestions would be greatly appreciated!

Thanks!

[TammyG]

I use a ring with all these patients and have never had a problem.

[woundnurse4u]

Ugh, bridges. They serve a good purpose but can be tricky. I am wondering if your leakage problem is related to the stoma not being as budded (ie flat/flush or somewhat retracted into an abdominal fold or crease).

The reason I mention this is because I am seeing this more- patients with more abdominal fat. I agree with the post that a ring might do the trick, especially if you have to deal with a less than optimal stoma.

[everel]

I've been a CWOCN for almost two years now. I work at a small hospital so I get maybe 1 stoma patient a month, if that. The bane of my existence as a stoma RN is the pesky ostomy bridge. I can't seem to apply the pouch correctly to stop leaks. Once the ostomy bridge is out, I'm good, but until then it's a battle.

One problem I think is that my pouch flanges are small and don't completely cover the ostomy bridge. My hospital uses Hollister ostomy products, the bridge is like an X and is sutured down at each of the 4 ends. The stool tunnels under the bridge and out the pouch sides.

Should I use a ring? Hydrocolloid sheet? Tape down the edges? I've tried to outline the bridge with ostomy paste and it works sometimes but not all the time.

I don't want the patients to think I have no idea what I'm doing so any suggestions would be greatly appreciated!

Thanks!

by

Rachel,

Hi! In my experience w/rods, stoma bridges, ur best luck is usually w/a one piece pouch that u can cut large enough to accomodate the bridge

and be sure to use barrier rings around the bridge and around the stoma to prevent leaks.

Leslie