Policy Manual sample

MDT Home Health Care Agency, Inc. exposed. You may need to put some skin barrier paste on the barrier if it does not stick well to your skin. (Teach patient the procedure) Remove the old pouch and barrier. Remove your old pouch by peeling away the barrier and gently lifting the pouch while pressing down on the skin below the pouch. Be sure not to irritate the skin as you remove the barrier and pouch. If the pouch is sticking and difficult to remove, use an adhesive remover underneath the barrier. Dispose of the old pouch and barrier. (Teach patient the procedure) Clean the skin. Clean the skin and stoma with a wet washcloth or wipe. You may use soap; if you do, rinse well. Allow the skin to dry and check the skin and stoma for signs of irritation. See the Treating skin irritation section below. Measure stoma, if needed. After the surgery, the size of the stoma may change. The doctor may want to measure it and will give a measurement guide to help you do this. Put on the new pouch. Position the opening in the barrier around the stoma and apply the sticky side to the skin. Press down until all edges are sealed. If the pouch is open-ended, attach the clip. Treating skin irritation The stoma is normally pink to red. Call the doctor if the stoma: Has a pale color. Is dark red or purple. Has moderate to severe swelling. Has moderate to heavy bleeding. If the skin under the pouch is red, irritated, or itchy, may be needed to treat the skin. Follow these steps: (ask for orders) Gently remove the pouch. · Clean the skin under the pouch with a wet washcloth. · Dry the skin. · Sprinkle ostomy protective powder on the skin and then blot it off. · Reattach or replace the pouch. Ostomy accessories may include: Curved (convex) barriers, which better conform to some abdomens. Ostomy belts, which help support the pouch. Pouch covers, which conceal the pouch. Skin barrier paste, which fills in folds or skin irregularities of the abdomen to form a better seal. Skin wipes or powders, which protect the skin under the barrier and around the stoma. Home Health Agency Nursing Care & Procedures K-198