Ostomy Education in Home Health

Rongna Sun, BSN, RN, CWON

MSN Student
The University of Texas at Tyler - College of Nursing and
Health Sciences
NURS 5202 Capstone II
Dr. JoAnn Blake

Overview Information
Project Title Ostomy Education in Home Health

Location AmeriCorp Healthcare Group, Inc.

Richardson, TX
Project Director Rongna Sun, BSN, RN, CWON

Evaluator Dr. JoAnn Blake

Time Period January 2017 April 2017

Date of Report April 13, 2017

 Ostomy Education in Home Health
Rongna Sun, BSN, RN, CWON
MSN Student
The University of Texas at Tyler - College of Nursing and Health Sciences
NURS 5202 Capstone II

Evidence Synthesis Statement

Background & Significance
In Medical City Plano, a 493-bed full service acute
care hospital with a level II trauma center, ostomy
surgeries have been performed on a regular basis.
Due to a short postoperative hospital stay and
limited opportunities for ostomy care teaching, home
health service has usually been set up for
continuous ostomy care and education after
discharge from the hospital. From some patients
readmitted shortly due to ostomy complications or
other issues, we learned that home health nurses
were not adequately trained on ostomy care.
Actually, none of the home health agencies, that
accepted patients from Medical City Plano, had a
certified ostomy nurse on staff. To improve ostomy
care in the community and reduce hospital
readmission rate due to ostomy complications, a
clinical question was originated: For nurses working
in the home health care setting, how would a
certified wound ostomy nurse-led structured ostomy
education compared to not having a certified wound
ostomy nurse-led structured ostomy education,
From clinical experience and literature review, the following conclusions were
drawn: 1) Ostomy patients often had complications and needed professional
support; 2) Home health nurses were not adequately trained to care for
patients with an ostomy; 3) Ostomy in-service or training promoted nurses
Lessons Learned
ostomy knowledge and confidence levels. This project was proposed to have a
This project was implemented in AmeriCorp Healthcare Group, Inc.,
certified wound ostomy nurse (CWON) design an ostomy care curriculum and
a home health and hospice care agency with two offices located in
educate home health nurses on ostomy care. It was assumed that
Richardson, TX and North Richland Hills, TX respectively. The cost
improvement in nurses knowledge and confidence levels would promote
to the organization was minimal (staff taking time to participate the
ostomy care clinical outcomes.
education sessions) compared to the benefits (increase in staff
nurses knowledge and confidence level in ostomy care). I have
Outcomes learned several lessons from implementing this project. First of all,
recruiting one or two champions from within the group and
Nurses ostomy care knowledge and confidence levels were measured using a encouraging them to take ownership of the project, was important in
questionnaire, respectively. Pre- and post-testing data were collected and ensuring the implementation process take place smoothly. Secondly,
analyzed. Overall, the results revealed that the education program improved face-to-face contact, verbal or written instructions, and allowing
nurses knowledge and confidence levels in most aspects. Compared to enough time for taking surveys would encourage more accurate and
pretest results, posttest scores increased in 11 out of 17 (65%) knowledge complete answers. Last but not least, recruiting more participants
survey questions, and eight out of 15 (53%) confidence Likert-scale questions. would allow some flexibility when incomplete data forms were
Posttest average total scores were increased for both knowledge survey and received.
confidence survey.
Ostomy knowledge survey Confidence survey results Conclusions
120.00%
pretest and posttest pretest and posttest

affect nurses knowledge and confidence levels in In conclusion, a certified wound ostomy nurse-led structured
4

100.00% 3.5

ostomy care? 80.00%

3 ostomy education did affect nurses knowledge and confidence
60.00%
2.5
levels in ostomy care. Improvement in knowledge and confidence
Project Purpose 40.00%
2

1.5
levels was seen in most questions and average total scores, even
20.00% 1
though the sample size was relatively small and incomplete forms
The short-term goal of this project was to increase 0.00%
0.5 were received. To make the change sustainable, a cycle of change
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

home health nurses knowledge on ostomy care and

0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 needs to take place. Recommendations for future project activities
pretest posttest

and assessment include: 1. evaluation at one month and six month

pretest posttest

improve their confidence level in taking care of

patients with an ostomy in the community. The long-
Knowledge and confidence surveys
pretest and posttest means
to assess the retention of knowledge and confidence levels; 2.
term goal of this project was to improve ostomy care assessment of clinical outcomes, such as patient and nurses
clinical outcomes, increasing patient and nurses confidence survey satisfaction, ER visit and hospital readmission rates due to ostomy
satisfaction, decreasing ER visit and hospital complications, and financial performance on ostomy care; 3. further
readmission rates due to ostomy complications, and research to include more participants, and to examine the
knowledge survey

improving financial performance on ostomy care. appropriate frequency of education and content of the curriculum.
0 10 20 30 40 50 60 70 80

pretest posttest
 Ostomy Education in Home Health
Rongna Sun, BSN, RN, CWON
MSN Student
The University of Texas at Tyler - College of Nursing and Health
Sciences
NURS 5202 Capstone II

With A Special Thank You:

To the administrative team and staff nurses at AmeriCorp

Healthcare Group, Inc. for their participation in this project
To Dr. JoAnn Blake for her guidance, her expertise, her
availability, and her encouragement
And to my family for their presence and support