The NSWOC Power of 3

As healthcare spending in Canada continues to climb, pressure on healthcare administrators to deliver cost-efficient care is intensifying—and policymakers are ever-more focused on ensuring quality and system sustainability. Wound, ostomy and continence challenges are common across all Canadian healthcare settings—and their management places a financial burden on the healthcare system. Registered Nurses Specialized in Wound, Ostomy and Continence (NSWOCs) can help alleviate the financial strain facing administrators and policymakers through the provision of higher quality care, reduced costs and improved outcomes for patients.

PREVENTING OSTOMY COMPLICATIONS

Ostomy surgery alone is a life-changing procedure. But many ostomy patients experience complications that can further affect their quality of life and add to their reliance on the health system. More than 80% of people with an ostomy will experience a stomal or peristomal complication within two years of their surgery (LeBlanc, Whiteley, McNichol, Salvadalena, & Gray, 2019).

Patients with peristomal complications face a number of poor outcomes, including increased morbidity, psychosocial impairments, decreased health-related quality of life, and greater risk for hospital readmission following stoma surgery (LeBlanc et al. 2019). In one study, ostomy patients who experienced peristomal skin complications within 120 days after surgery were readmitted to hospital at a rate of 47% versus 33% for those without complications (Taneja et al., 2017).

Medical-adhesive related skin injuries, such as skin tears and skin stripping, are also common but underreported (McNichol, Lund, Rosen, & Gray, 2013). These injuries can happen when a practitioner or the patient incorrectly removes a medical device that uses adhesive. Another possible complication is dermatitis, which can occur when human waste gets trapped under the adhesive or due to certain chemicals in the adhesive.

NSWOCs help prevent such complications through effective preoperative and postoperative rehabilitative care, reducing readmission rates for new ostomy patients (Medley, 2014). NSWOCs can identify signs of peristomal skin problems early so treatment can get underway immediately. They can educate patients on what to look for so they can seek care as soon as symptoms appear. In the case of medical-adhesive related skin injuries, NSWOCs contribute to prevention by helping patients select a pouching system that’s appropriate to their needs, ostomy type and abdominal skin contours (LeBlanc et al. 2019). This also minimizes skin stripping, since patients with a well-fitting pouching system will be less prone to remove it frequently.