Outpatient Ostomy Triage

This is an infographic to help clinicians when treating people with ostomies and complications/problems that arise.

Supplies needed:

• Supplies are stocked and available for purchase at our pharmacies:
  • Hollister 2” ostomy ring #7805
  • Hollister Stoma paste #79300
  • Hollister Stoma powder #7906
  • Hollister One Piece cut to fit Velcro Closure #8531

            (stomas up to 2 ½”)

• • Coloplast One piece cut to fit drainable 3” Max Xpro #15981 (stomas up to 3”)
     
• The following manufacturers also have programs that will provide samples free of charge, connect patients with DME suppliers, and have access to certified ostomy RNs via phone for trouble shooting.
  • Hollister Secure Start: 1-888-808-7456
  • Coloplast Care: 1-877-858-2656
  • Convatec me+: 1-800-422-8811

Triage questions: Patient cannot keep pouch in place > 24 hours:

• Are they current with home care and have they notified their RN?
  • No: refer back to home care RN
  • Yes: refer for clinic visit
• If established with ostomy clinic, see if they can be scheduled in the next several days?
• If not current with a clinic need a referral from provider for “AMB Ostomy Services Referral” Choose “urgent”, then “Medical Management”, for site, don’t select, in box type “1st available” unless the patient has strong clinic preference.
• Do they have a DME supplier/how do they normally obtain supplies?
  • Yes: refer back to supplier
  • No: refer to pharmacy for purchase for immediate supply then provide patient with manufacturer contacts to help obtain more supplies/samples (ostomy clinic can help with this)
• Are they enrolled in a support program?
  • No: provide contact card and other manufacturer numbers (Column 1). 

Trouble shooting for Ostomy issues:

• Have they measured the stoma recently and are they cutting the opening no more than 1/8” larger than the stoma
• Are they emptying pouch before ½ full?
• Are they removing wafer gently?
  • Recommend ostomy adhesive remover wipes/spray
• Is the skin open and weepy?
  • Yes: perform crusting procedure during appliance change:

1) Sprinkle stoma powder and
     spread evenly with finger,
     dust off excess powder

2) Spray no sting barrier film
     over powder or dab with
     finger wet with water

3) Repeat above steps x2

4) Allow to dry and apply wafer

• Are they cleaning skin with warm water only? Soaps may leave residue
• Is the skin dry when applying the wafer?
• Is there a crease/fold/scar near the stoma?
  • Yes: use an ostomy ring by placing around opening cut out on back of wafer or directly onto skin around stoma