Colostomy irrigation (part 2): contraindications, barriers to uptake, adherence and nurse education

Colostomy irrigation (CI) involves instillation of water via the stoma into the colon, where it stimulates peristalsis, causing expulsion of stool and water from the stoma. CI allows colostomates to regain controlled evacuation and faecal continence. The first article considered the impact of CI on colostomates' quality of life, including flatus, odour and peristomal skin health, as well as psychological wellbeing. This second article explores the potential barriers to successfully adopting CI. The uptake of CI in the UK remains relatively low. CI is contraindicated in active disease, and there is debate about whether it is suitable in colostomates with stoma-related complications and of different ages. Barriers to uptake among stoma care nurses include misconceptions about safety, physician consent and cost, as well as issues relating to commencement time and the setting and pace of postoperative education. For colostomates, barriers to adherence include short-term issues that can be resolved with nursing support, as well as the time taken to perform irrigation and changes related to older age. Many of these barriers could be overcome with robust education programmes.

Patients' experiences of using My Hip Journey an eHealth program to enhance hip replacement recovery: A qualitative study (Preprint)

BACKGROUND Patients undergoing surgery require pre- and post-operative education. eHealth programs can facilitate the delivery of information, individualised rehabilitation plans and communication with health professionals for surgical patients to promote overall patient recovery. My Hip Journey was an eHealth program designed to provide pre- and postoperative education for patients undergoing a total hip arthroplasty. OBJECTIVE The aim of this study was to explore patient experiences of using the eHealth program “My Hip Journey”. METHODS A descriptive, qualitative design was used to explore patient experiences of the eHealth program using semi-structured individual telephone interviews. An inductive thematic analysis was undertaken of the transcribed interviews. RESULTS Nine interviews were conducted. Participants found the program easy to use and three themes emerged from the analysis: (a) Information supported recovery; (b) Program motivated recovery and (c) Using technology for recovery. The participants found the eHealth program as a useful means of providing pre- and post-operative education and it built self- confidence in their recovery. CONCLUSIONS eHealth programs can prepare patients for surgical procedures and support them in their recovery and rehabilitation enabling them to feel some control of the surgical journey.

Nursing patients requiring perioperative care

Preoperative assessment: principles 762 Preoperative assessment: practice 763 Preoperative preparation 764 Preoperative education 768 Consent to treatment 770 Anaesthestic room care 772 Care in the operating theatre 774 Postoperative care: physical 776 Postoperative care: psychological 778 Postoperative pain management 780 Postoperative education 782 Care of surgical wounds ...