Nursing Interventions for Discharge of Patients with Intestinal Ostomy

Monday, 22 July 2013

Luciana Regina Ferreira Mata, MSN1
Cissa Azevedo2
Jéssica Costa Faleiro2
Meury Aparecida Ferreira2
Sânya Pedroso Oliveira2
Emilia Campos Carvalho, PhD1
(1)Department of General and Specialized Nursing, University of São Paulo - Ribeirão Preto College of Nursing, Ribeirão Preto, Brazil
(2)Nursing curse, University of São João del Rei, Divinópolis, Brazil

Learning Objective 1: The participant will identify nursing interventions available in the literature for discharge planning of patients with intestinal ostomies.

Learning Objective 2: The participant will know the gaps in Knowledge about nursing interventions for discharge of patients with intestinal ostomy in scientific literature.

Purpose: to identify, in the literature, nursing interventions facing the preparation for hospital discharge of patients with intestinal ostomies. Methods: this is an integrative literature. The search in the bibliographic databases MEDLINE, Web of Knowledge, CINAHL, LILACS and SciELO was conducted. The selection criteria were: articles in Portuguese, English or Spanish, published from January 2000 to April 2012, and containing nursing interventions for discharge of patients with ostomy. The interventions identified were grouped by similarity in thematic categories: general conducts; care of ostomy bag; stoma care; peristomal skin care; specific care with ileostomy; care related to nutrition, hydration and elimination; psychological support; physical activity. Results: 20 articles were included in the review, which contemplated 44 interventions. Eleven studies were performed in the UK, six in Brazil and three in the United States. Regarding research designs, fourteen (70%) are update articles, four (20%) are descriptive with qualitative approach and two (10%) case studies. Most studies fourteen (70%) has evidence level seven. Among the most prominent interventions are the encouragement of self-care, mainly based on guidance for peristomal skin care and providing written information about home care. It is highlighted that, among the thematic categories, which had the largest number of interventions were: care of ostomy bag (n=11) and stoma care (n=7). On the other hand, those which showed fewer interventions were: psychological support (n = 4) and physical activity (n = 3), suggesting that interventions related to the psychological sphere, as well as support and guidelines for returning to normal activities are little explored in the scientific nursing production.  Conclusion: despite the interventions included in this study are of great impact for the planning of care, it is believed in the importance of developing new studies that address methodologies capable of identifying strong evidences to be the safe support to clinical decision making.