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errors and adverse effects to patients associated with health care (Patient Safety, 2014, para.
1), and quality of care as the level of attainment of health systems intrinsic goals for health
improvement and responsiveness to legitimate expectations of the population (Legido-Quigley,
et al., 2008, p.2). A great amount of care is required for a patient with an ostomy in order to
assure that the stoma remains healthy and free of infection, and the quality of care provided
ensures that the patient is kept safe.
In caring for a patient with an ostomy, the nurse should observe the site each time she
cares for it, ensuring that the stoma is moist and beefy red, with no skin breakdown around the
site and under the wafer. The nurse should take care to empty the appliance when it is one-third
of the way full, and she should replace it every three to seven days. A nurse who would provide
high quality care would make sure that this schedule is kept, and she should also be sure to
thoroughly clean the stoma and surrounding areas each time she changes it (Taylor, 2011).
Another way a nurse could provide high quality care for a patient with an ostomy would
be to take the extra step with ostomy care, and care for the patient holistically. When removing
the appliance to change it, the nurse should apply adhesive remover to the skin to reduce the pain
that can be involved with this procedure. Patients with ostomy appliances can also become selfconscious of the fact that they have this bag attached to them that contains their fecal matter. The
nurse could talk the patient through any discomfort that they have about the situation, assuring
them that they can continue to live their life the way that they did before, and their bag will not
hold them back. If the patient is concerned about a smell coming from the bag, the nurse could
provide some scented oils that the patient could put in it to mask the smell of feces. Any of these
extra measures would help to improve the quality of care that is given, and they would keep the
patient safe from any unnecessary discomfort (Living, 2011).
Jean Watson was an established nurse in the 1970s, and she discovered a theme of
nursing that applies well to the safety and quality of care for ostomy patients. Her theory
centered on holistic care that is concerned with promoting and restoring health, preventing
illness, and caring for the sick (Taylor, 2011, p. 75). This theory ties very well into quality of
care and patient safety due to the fact that if a nurse was practicing within the scope of this
theory, then she would be ensuring she provided the best care that she could in order to restore
the patient back to health and preventing them from getting worse, ensuring his patient safety.
Caring for a patient with an ostomy appliance is a perfect example of how a nurse can
provide the patient with safe, high quality care. She must keep up with the care for it, and ensure
that she is holistically caring for the patient. With the right nursing techniques implemented, a
patients life can be greatly improved after the installation of an ostomy appliance, even with
considering the fact that the patient will be having bowel movements into a bag for the rest of his
life.
References
Bradley, M. & Pupiales, M. (1997). Essential elements of ostomy care. The American Journal of
Nursing. 97 (7), 38-46. doi: 10.2307/3465459
Legido-Quigley, H., McKee, M., Nolte, E., Glinos, I. A. (2008). Assuring the quality of health
care in the European Union: A case for action. Copenhagen: World Health Organization.
Retrieved from http://www.euro.who.int/en/publications/abstracts/assuring-the-qualityof-health-care-in-the-european-union2.-a-case-for-action
Living with a colostomy. (2011, January 1). Retrieved from
http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/co
lostomyguide/colostomy-living-with-a-colostomy
Patient Safety (N. D.) In World Health Organization, Europe. Retrieved from
http://www.euro.who.int/en/health-topics/Health-systems/patient-safety/patient-safety
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Bowel elimination. In Brandon, C. (Ed.),
Fundamentals of nursing: The art and science of nursing care. (7th ed., pp. 1296-1342)
Philadelphia, PA: Lippincott and Wilkins.
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Theory, research, and evidence-based
practice. In Brandon, C. (Ed.), Fundamentals of nursing: The art and science of nursing
care. (7th ed., p. 75) Philadelphia, PA: Lippincott and Wilkins.