Ostomy Bag Pouch Change | Ostomy Care Nursing | Colostomy, Ileostomy Bag Change

Summary

In this video, the presenter, a registered nurse, demonstrates how to change an ostomy pouching system. She explains the supplies needed, including a one-piece or two-piece pouching system, skin barriers, barrier rings, and ostomy scissors. The nurse emphasizes the importance of proper hygiene, skin care, and measuring the stoma accurately. Viewers are guided through the step-by-step process of cleaning the stoma, applying the new pouching system, and providing tips for patients managing their ostomy independently. She also shares advice on odor management and proper bag maintenance.

Takeaways

• 🩺 The video demonstrates how to change an ostomy pouching system.
• 💡 You will need a pouching system, which can be one-piece or two-piece, a barrier ring, measuring card, ostomy scissors, gloves, and washcloths.
• ✂️ Ostomy scissors are special with a curved and blunt tip to achieve a circular cut on the skin barrier.
• 🧼 Perform hand hygiene, wear gloves, and place a towel on the patient to protect from leakage during the process.
• 📏 Use a measuring card to size the stoma accurately, leaving a 1/8 inch gap between the stoma and skin barrier.
• 🚫 Avoid using products like soap, lotion, powder, or alcohol around the stoma as they can irritate the skin.
• 🔄 Change the system every 3-5 days, and empty the pouch when it's one-third to halfway full.
• 👃 Be prepared for pungent odors when changing the bag. A mask or vapor rub may help with this.
• 🔍 Check for redness or skin breakdown around the stoma and adjust accordingly to prevent stool from leaking under the barrier.
• 🛠️ Ensure proper fitting of the skin barrier and smooth it out to stick well. Also, explain to patients how to burp the bag if it fills with gas.

Q & A

What are the key components of a one-piece ostomy pouching system?

A one-piece ostomy pouching system consists of a skin barrier (also called a wafer) and a pouch that are attached together.

When should a barrier ring be used with an ostomy system?

A barrier ring should be used when the patient is experiencing skin breakdown due to stool leakage under the skin barrier, providing extra protection around the stoma.

What are the two types of closure systems for ostomy bags?

Ostomy bags typically use either a clip or velcro for closure.

How frequently should the ostomy pouching system be changed?

The ostomy pouching system should be changed every three to five days.

What precautions should be taken regarding the timing of changing an ostomy pouch?

It's best to change the pouch when the gut is least active, such as in the morning before breakfast, to avoid stool coming out during the change.

What tools are used to measure the size of the stoma, and why is it necessary?

A measuring card is used to measure the size of the stoma to ensure that the hole cut in the skin barrier fits properly, preventing leakage.

Why should lotion, powders, or alcohol-based products be avoided around the stoma?

These products can interfere with the adhesive properties of the skin barrier and potentially cause skin irritation or damage.

How can a nurse manage the odor during an ostomy pouch change?

The nurse can wear a mask or apply vapor rub around their nose to mask the smell during the ostomy pouch change.

What is the process of burping an ostomy bag, and why is it necessary?

Burping the bag involves removing the clip and allowing gas to escape from the bag. This is necessary to prevent the bag from inflating with gas.

What should be done if the skin around the stoma shows signs of redness?

If there is redness around the stoma, it indicates that stool may be leaking under the skin barrier. In this case, a barrier ring should be used and the skin barrier should be cut to fit the stoma properly.