Stoma Care - Stoma Care on discharge from hospital

Patient name:

Stoma type:

Prior to discharge

Prior to your discharge we will ensure you are able to empty and change your pouch yourself. If you are unable to, we will ensure carers, parents or relatives are suitably trained and feel confident.

On discharge

You will be supplied with adequate stock to last until your next stoma nurse review, whether that be at home or in our nurse led clinic. We will aim to see you within 72 hours of your discharge from hospital for 4-6 weeks.

Your first visit will be on:

Date:

Location:

Alternatively, you could attend our Nurse Led Clinic which takes place every Thursday between 12.30 - 4pm. The clinic is situated in Area 1, Main Outpatient Department, Salford Royal Hospital.

Things to look out for:

Bleeding from stoma

It is common for stomas to bleed, particularly when they are cleaned. This bleeding usually stops very quickly. However, if you notice the blood coming from within the stoma, please inform your stoma nurse or GP.

Stoma pouch leaking

This may occur if your skin is not completely dry when you apply a new pouch or if you have an uneven skin surface around your stoma. Please contact your stoma nurse as soon as possible for advice. It is important to be seen quickly so your skin does not become sore.

Sore skin

This is usually due to stool/urine leaking onto the skin and may be caused by a poorly fitted pouch. The stoma may have reduced in size therefore the template will need to be resized. Please contact your stoma nurse to do this.

Template size is too big/small

Your stoma will change shape or size over the lifetime of your stoma, please contact your stoma nurse if you feel it needs resizing.

Smell

There shouldn’t be a smell from the stoma when the pouch is in place. Odour occurs when you are changing or emptying your pouch. It may also occur if your pouch is leaking onto your clothes or the skin.

Pancaking

This is when the stool does not drop down into the pouch. It is a problem experienced by many with a colostomy. It can help to place a few drops of baby oil into the pouch to keep the sides of the pouch apart. Alternatively, you could cover the filter with one of the patches supplied in the box.

Rectal discharge

If your rectum remains, it is not uncommon for you to experience rectal discharge, this is usually mucous that is produced in the bowel to assist the passage of faeces to the rectum. It can produce an urge to sit on the toilet and this is the easiest way to pass it. If you are unable to pass it by siting on the toilet or you notice blood in the mucous, even if this only happens once, please contact your stoma nurse for review.

Loose/watery stool

If you find your stool output is higher than normal and is waterier, there are foods that can help reduce this for example, jelly babies, under ripe bananas, marshmallows and white rice/ pasta. There are also medications you could take but please consult your Surgeon/GP or Stoma Nurse before taking them.

Obtaining stoma supplies

Once you and your stoma nurse are happy with the pouches you are using, usually around week 3-4 post discharge, we will arrange for supply/delivery of these. There are 2 ways to obtain your stoma supplies. Either by local delivery service or the chemist.

Home delivery service

If you choose to use the home delivery service, your stoma nurse will register you with a local delivery service. They will deliver your stoma products free of charge to your door.

At this initial delivery they will provide you with the contact details and how to order repeat stock.
 
The home delivery service will request your prescription from your GP when you ring for more supplies. They will also cut your pouches to the required size. Please note not all GP’s use delivery services.

Chemist

If you choose to use a chemist, you may use the chemist of your choice. Many do provide free delivery to your door, but you will need to check with them.

You would just need to take your repeat prescription to them and they will order your stoma supplies. Please note they are not able to offer a cutting service, therefore you will be required to cut your own pouches.

When to order more supplies:

You should order more supplies when you have one week’s supply of stock remaining.

If you are using a home delivery service, they are able to request your prescription when you ring for more stock.

Requirements are based on the type of stoma you have i.e.

• 1 pouch per day for an ileostomy or urostomy
• 2-3 pouches per day for a colostomy

Please ensure you take a spare kit with you when out and about, to include:

• A new pouch
• Dry wipes
• Disposable waste bag
• Any accessory products which you use i.e. flange extenders.

If you plan on going on holiday, advice would be to take twice the usual amount you would use. For example, if you use 7 pouches per week, pack 14.

Please note some GP surgeries will only allow the patient to request the prescription themselves. This would then need to be forwarded to the delivery service or chemist. It can take up to 7 working days for your stock to be delivered or come into the chemist.

Your stock requirements for one month will be:

Some items may not be required monthly, for example powder or a belt. Please only order these when required.

If you find you are running out of stock early please contact your stoma nurse for review, as it may be that you are having leakages or require a different pouch.

Stoma Care Specialist Nurses contact details

We will endeavour for you to be seen by the same nurse throughout your stay in hospital and when discharged home. If for any reason they are not able to, all members of the team are fully informed of your care and your stoma care requirements.

Stoma Care Department - 0161 206 4204 or email stomacare@nca.nhs.uk
(Direct line with 24-hour answerphone service)
Office hours: 7.00am - 5.30pm, Monday to Friday (not including bank holidays)
Out of Hours: Please call your GP out of hours service or dial 111 for advice.

Useful websites

www.colostomyassociation.org.uk
www.the-ia.org.uk
www.urostomyassociation.org.uk