The importance of a holistic approach to stoma care: A case review

WCET Journal ◽  
2019 ◽  
pp. 23-32
Author(s):  
Melanie C Perez
Keyword(s):  
Ileal Conduit ◽  
Enterocutaneous Fistula ◽  
Foley Catheter ◽  
Holistic Approach ◽  
Comprehensive Care ◽  
Case Review ◽  
High Output ◽  
Stoma Care

This case review discusses the importance of providing a holistic approach to the care of a patient with two stomas and an enterocutaneous fistula. In this case, the stomas and fistula significantly affected the patient; not just physically but emotionally and socially. The different challenges that arose in pouching a high-output ileostomy, enterocutaneous fistula and ileal conduit with Foley catheter in situ are explored. It also delves into the various options for discharging a patient with complex ostomy complications requiring different needs and resources. Finally, it aims to highlight the therapeutic comprehensive care the stomal therapy nurse provided to the patient and their family.

Stoma care

2021 ◽  
pp. 507-524
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Clinical Practice ◽  
Postoperative Care ◽  
Ileal Conduit ◽  
Urinary Output ◽  
Faecal Output ◽  
Stoma Reversal ◽  
Permanent Stoma ◽  
Discharge Home ◽  
The Common ◽  
Stoma Care

The stoma care chapter explores the formation of a temporary or permanent stoma and the main types of stoma. The two main types of faecal output stoma are the colostomy and ileostomy. The urostomy or ileal conduit is a urinary output stoma. The care required for people undergoing or living with a stoma is explored and includes preoperative and postoperative care. Stoma appliances and products are described. There is information provided on dietary and discharge home from the hospital and the nursing advice needed in these situations. There are descriptions of the common complications associated with stomas and how these can be addressed as well as longer-term issues, such as living with a stoma. Reversal of a stoma is included to describe considerations related to having the stoma surgically closed. Succinct descriptions related to stomas are detailed within this chapter for use in clinical practice by the nurse.

scholarly journals An On-Line Multiway Approach to In-Situ NDI Looking at the PZL-130TCII

2014 ◽  
Vol 2013 (5) ◽  
pp. 5-11 ◽  
Author(s):  
Krzysztof Dragan ◽  
Michał Dziendzikowski ◽  
Artur Kurnyta ◽  
Adam Latoszek ◽  
Andrzej Leski ◽  
...  
Keyword(s):  
Damage Detection ◽  
Hot Spots ◽  
Lamb Waves ◽  
Holistic Approach ◽  
Growth Monitoring ◽  
Damage Growth ◽  
On Line ◽  
Detection Capabilities ◽  
Main Component

Abstract Providing a reliable and universal Structural Health Monitoring (SHM) system allowing for remote aircraft inspections and a reduction of maintenance costs is a major challenge confronting the aerospace industry today. SHM based on guided Lamb waves is one of the approaches capable of addressing the issue while satisfying all the associated requirements. This paper presents a holistic approach to the continuous real time damage growth monitoring and early damage detection in aircraft structure. The main component of the system is a piezoelectric transducers (PZT) network. It is complemented by other SHM methods: Comparative Vacuum Monitoring (CVMTM) and Resistance Gauges at selected aircraft hot spots. The paper offers the description of damage detection capabilities including the analysis of data collected from the PZL-130 Orlik aircraft full-scale fatigue test.

scholarly journals Paradigm Transition from the “Department Model” to the “Comprehensive Dental Care” Teaching Model

2021 ◽  
Author(s):  
Nadia Khalifa ◽  
Amel Ghazi Hamseh ◽  
Abdallah Michail ◽  
Manal M. Awad
Keyword(s):  
Dental Care ◽  
Clinical Training ◽  
Holistic Approach ◽  
Comprehensive Care ◽  
Training Methods ◽  
Patient Centered ◽  
Self Assessment ◽  
Oral Rehabilitation ◽  
Case Presentations ◽  
Consistent Information

Abstract Background This study aimed to assess students’ perceptions of the gains and challenges of the patient-centered comprehensive care methodology of dental clinical training. Methods Self-administered questionnaires were completed by 58 out of 93 students following the end of the academic term 2017–2018. Results Most of the students 43 (74%) understood the philosophy behind a holistic approach to patients’ dental care and employing a multidisciplinary style. Students’ self-assessment showed significant preponderance 41 (71%) (P = 0.026) concerning treatment phases and procedural abilities as well as enhancement of their oral rehabilitation case presentations 50 (86%) (P = 0.0001). Half of the students were not able understand what they needed to work on from their daily continuous clinical assessment grades. The comprehensive dental care (CDC) concept helped them gain more confidence 44 (76%) (P = 0.005) and although students benefited from the interaction with specialists and peers the main advantage was having fixed mentors throughout the year (P = 0.000). Conclusions The results, besides highlighting the benefits, also address some of the shortcomings of the comprehensive care curriculum especially when it comes to grading. Consequently, there is a need for standardized and regular calibration exercises for clinical tutors (general practitioners) and specialists to enable them to impart consistent information to clinical graduates. It is also necessary for students to receive sufficient feedback on their assessment grades to help them understand and improve upon their deficiencies.

scholarly journals Musculoskeletal care in haemophilia: the importance of the joint team approach

2015 ◽  
Vol 2 (2) ◽  
pp. 17-19
Author(s):  
Haroon Mann ◽  
Paul McLaughlin
Keyword(s):  
Disease Management ◽  
Disease Severity ◽  
Multidisciplinary Team ◽  
Holistic Approach ◽  
Musculoskeletal Disease ◽  
Comprehensive Care ◽  
Team Approach ◽  
Multidisciplinary Team Approach ◽  
Musculoskeletal Care ◽  
Painful Knee

Abstract The multidisciplinary team approach to providing comprehensive care is the cornerstone of the management of musculoskeletal issues in haemophilia. At the Royal Free the team takes a holistic approach to musculoskeletal disease management that is not just about assessment of a painful knee or having an operation. It recognises that patients sit on a spectrum of musculoskeletal disease severity that is dependent on age and the type of treatments available and the issues that may have been experienced with those treatments. The patient’s own goals sit at the heart of the team’s approach.

scholarly journals Polarized Water Driven Dynamic PN Junction-Based Direct-Current Generator

Research ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-10 ◽  
Author(s):  
Yanghua Lu ◽  
Yanfei Yan ◽  
Xutao Yu ◽  
Xu Zhou ◽  
Sirui Feng ◽  
...  
Keyword(s):  
Direct Current ◽  
Dielectric Medium ◽  
Potential Candidate ◽  
Distributed Sensors ◽  
Flow Energy ◽  
Portable Power ◽  
Current Voltage ◽  
Direct Current Voltage ◽  
High Output

There is a rising prospective in harvesting energy from the environment, as in situ energy is required for the distributed sensors in the interconnected information society, among which the water flow energy is the most potential candidate as a clean and abundant mechanical source. However, for microscale and unordered movement of water, achieving a sustainable direct-current generating device with high output to drive the load element is still challenging, which requires for further exploration. Herein, we propose a dynamic PN water junction generator with moving water sandwiched between two semiconductors, which outputs a sustainable direct-current voltage of 0.3 V and a current of 0.64 μA. The mechanism can be attributed to the dynamic polarization process of water as moving dielectric medium in the dynamic PN water junction, under the Fermi level difference of two semiconductors. We further demonstrate an encapsulated portable power-generating device with simple structure and continuous direct-current voltage output of 0.11 V, which exhibits its promising potential application in the field of wearable devices and the IoTs.

scholarly journals Outcome and management of postoperative enterocutaneous fistula

2020 ◽  
Vol 7 (12) ◽  
pp. 4112
Author(s):  
Dinesh Chandra Sharma ◽  
Gaurav Jalendra ◽  
Pugazhenthi M. ◽  
Amit Kumar
Keyword(s):  
Enterocutaneous Fistula ◽  
Electrolyte Imbalance ◽  
Electrolyte Balance ◽  
High Morbidity ◽  
First Line ◽  
Sepsis Management ◽  
Time Treatment ◽  
Fistula Healing ◽  
And Control ◽  
High Output

Background: Approximately 75% of enterocutaneous fistula (ECF) occur following surgery. Due to the high morbidity and mortality associated with ECF, prompt and effective treatment is important. This study was conducted to study the outcome and management of patients with enterocutaneous fistula.Methods: Total 40 patients developing the enterocutaneous fistula following surgery were included. All patients were treated either conservatively or operatively by various means and varying period of time. Treatment was focused on the correction of dehydration, controlling sepsis, management of electrolyte imbalance and nutritional support.Results: Overall 40 patients were included in this observational study, comprising 26 were males and 14 were females. About 97.5% of ECF were postoperative. Ileum was found to be the most common site of ECF. Also, 42.5% of fistulas were high output and 57.5% were low output. Serum albumin levels correlated significantly with fistula healing and mortality. Surgical intervention was required in 37.5% of patients.Conclusions: Conservative management with emphasis on improvement of nutrition, control of sepsis, management of fluid and electrolyte balance and control of fistula output is first line of management. Operative intervention must be done in selectively after cases after aggressive and targeted measures for improvement of nutritional status and control of infection.

Enterocutaneous fistula secondary to retained intraperitoneal fragment of a ventriculoperitoneal shunt in a 48-year-old man with spina bifida

2021 ◽  
Vol 14 (4) ◽  
pp. e240634
Author(s):  
Andrew Webster ◽  
Rishabh Singh ◽  
John Stebbing
Keyword(s):  
Spina Bifida ◽  
Enterocutaneous Fistula ◽  
Vp Shunt ◽  
Surgical Department ◽  
History Of ◽  
Delayed Complications ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

We report the case of a 48-year-old man with spina bifida and history of previous ventriculoperitoneal (VP) shunt placement for hydrocephalus. On attempted removal of the shunt 2 years prior to presentation at a neurosurgical unit, the peritoneal component was left in situ due to difficulties with removal. He presented acutely to our general surgical department with an enterocutaneous fistula precipitated by the retained fragment discharging to the right upper abdominal quadrant that required urgent surgical intervention. Although abdominal complications of VP shunts are documented, there is minimal literature as to the risks of remnant catheters being left in situ. This case demonstrates the possible risks with retained VP shunt catheters and the necessity to remove any redundant foreign bodies to prevent significant delayed complications.

Creation of High Output Enterocutaneous Fistula From Self-Mutilation

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1409
Author(s):  
Ronald Samuel ◽  
Lauren August Clark ◽  
Sheharyar Merwat
Keyword(s):  
Enterocutaneous Fistula ◽  
Self Mutilation ◽  
High Output
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