Ineffective Health Care: Stoma Nursing Care Plan

Ineffective Health Care: Stoma Nursing Care Plan

<Definition>
It is difficult for patients and their families who need medical treatment due to illness or sequelae, management of symptoms, recovery of physical function, and maintenance of physical function to incorporate treatment into their daily lives, and it tends to be insufficient to lead the desired life. The condition is called “ineffective health care”.

<Differences in how to use “ineffective health maintenance” and “ineffective health management”>
“Ineffective health maintenance” is used for individuals who want to change their unhealthy lifestyle such as overeating, lack of exercise, and smoking, and is used for primary prevention to prevent the onset of illness.
“Ineffective health care” is used for patients who need education on self-management of illness or health condition.

<Nursing care plan>

Target
Acquire the knowledge and skills necessary for self-management
You can notice and deal with problems
Get the support you need to manage your stoma

Observation plan
1.ADL / IADL
2. Cognitive ability and comprehension ability
3. Diseases and treatment details
4. Medical history
5. Inspection data
6. Types of stoma
7. Stoma construction period
8. Stoma condition (color, shape, presence or absence of edema)
9. Presence or absence of complications
-Early complications: depression, shedding, bleeding, joint dissection, abscess, necrosis, etc.
-Late complications: stenosis, hernia, prolapse, fistula formation, etc.
10. Stoma and surrounding skin condition (see Skin Integration Disorder: Nursing Care Plan for Skin Disorder (Risk Condition) Around Stoma)
11. Status of ostomy system (type of face plate, mounting status, presence / absence of leakage)
12. Self-management status
-Knowledge and understanding of stoma
-Is the procedure for handling the stoma correct?
-How to deal with skin problems
13. Changes due to abdominal shape and posture
14. Meal content, intake status, water status
15. Weight, changes in weight
16. Urine properties and volume (in the case of artificial bladder)
17. Stool properties, volume, number of discards (in the case of artificial anus)
18. Thoughts and perceptions of stoma
19. Living conditions
-How to spend one day
-Eating habits (number of times, etc.)
-Presence or absence of smoking or drinking
-Home / community environment
-Profession
20. Family support, status
21. Family knowledge and understanding
22. Utilization of social support (use of public system, existence of disability certificate, etc.)

Care plan
1. Manage the stoma until self-care is established
2. Helping you choose the right ostomy system
3. Understand the patient’s understanding, values, and decision-making process
4. Be close to the patient’s thoughts and treat them with respect
5. Listen to the thoughts, concerns, and difficulties of the patient / family
6. Check the reason for the patient / family’s remarks, facial expressions and behaviors.
7. Coordinate a place to explain to the whole family so that the family can have the same care
8. Hold a pre-discharge conference in collaboration with multiple occupations
-Support patients and their families to express their needs and anxieties, and speak for them when necessary.
-Tell local supporters about the content of discharge guidance
9. Before leaving the hospital, go out or stay overnight to clarify the problem and try to solve it.

Education plan
1. Explain how to observe the stoma
2. Explain how to observe the surrounding skin
3. Explain the self-management method using the checklist.
6. Explain how to deal with constipation and diarrhea.
-Introduction of products that make it easier to exercise (stoma belts, leg bags, etc.)
-Introduction of products or meals that suppress odors
8. Explain the need for your GP
9. Explain how to use social support
10. Explain how to respond in the event of a disaster

Guidance pamphlet example (external site) Coloplast stoma care and living guide

Checklist for discharge (external site)
9 checklists for discharge


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