Considerations:
- Ostomy bag should be emptied when 1/3 to 1/2 full or when a leak occurs
- Be sure to take steps to ensure patient privacy when performing procedure
- Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
Supplies:
- Clean gloves
- Basin for stool collection (if not near a toilet)
- Wash clothes, diaper wipes, tissues or paper towels
- Pouch deodorant
- Student’s individualized health plan (IHP) and/or healthcare provider’s order
Procedure:
- Review student’s IHP or healthcare provider’s order
- Position student taking steps to ensure privacy
- Explain the procedure to the student at his/her level of understanding
- Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
- Wash hands
- If student will be assisting, have student wash hands
- Put on gloves
- Inspect the area around the stoma for:
- Redness
- Irritation
- Signs of leaking around the pouch or skin barrier
- Bleeding
- Inspect the stoma for signs of:
- Bulging
- Getting longer
- Darkening in color or turning bluish
- Raise the pouch so the opening faces up
- Open the pouch
- Either unclamp or unroll the integrated drainage outlet
- Lower the pouch toward toilet or collection container
- If emptying into toilet, place a piece of toilet paper in the toilet to prevent splashing
- Slide your hands down the pouch to push out the stool
- If there is a smaller or larger amount of stool output than expected follow up with parents/guardian, especially if student complains of cramping or abdominal pain or looks dehydrated
- Wipe the opening off inside and out with toilet paper
- If used, add pouch deodorant
- Re-clamp or reseal the pouch
- Remove gloves
- Wash hands
- Document assessment, intervention and procedure in student’s healthcare record
- Follow up with parents/guardian and healthcare provider, as needed
References:
American College of Surgeons. (2015). Step-by-step skills checklist and evaluation. Available at: https://www.facs.org/-/media/files/education/patient-ed/skills_checklist.ashx
Bowden, V. R., & Greenberg, C. S. (2016). Pediatric nursing procedures (eBook) (4th Edition). Philadelphia: Wolters Kluwer Health.
Children’s Hospitals and Clinics of Minnesota. (2021). Fecal pouch emptying. Available at: https://www.childrensmn.org/educationmaterials/childrensmn/article/15550/fecal-pouch-emptying/
Connecticut State Department of Education. (2012). Clinical Procedure Guidelines for Connecticut School Nurses. Available at: https://portal.ct.gov/SDE/Publications/Clinical-Procedure-Guidelines-for-Connecticut-School-Nurses
Gray, E.H., Blackinton, J. and White, G.M. (2006). Stoma Care in the School Setting. The Journal of School Nursing, 22, 74.
Porter, S., Haynie, M.D., Bierle, T., Caldwell, T. & Palfrey, J. (1997). Children and Youth Assisted by Medical Technology in Educational Settings. Guidelines for Care. Second Edition. Paul H. Brookes Publishing Co., P.O. Box 10624, Baltimore, MD 21285-0624.
Acknowledgment of Initial Reviewers:
Lori A. Duesing, MSN, RN, CPNP-AC
Advanced Practice Nurse
Department of Gastroenterology
Children’s Hospital of Wisconsin
Kathy Leack, MS, RN, CNS
Advanced Practice Nurse
Children’s Hospital of Wisconsin
Page last reviewed: October 5, 2021
Page last updated: October 5, 2021
The information and materials presented in this Website are intended for informational purposes only and are not designed to diagnose or treat a health problem or disease, or assist in diagnosis or treatment of the same. The information is not intended to substitute for, supplement or replace clinical judgment. If there are any concerns or questions about or relating to a nursing or medical procedure, contact the individual’s healthcare provider. The information provided on this Website is not intended to be a substitute for medical orders and persons without the proper education, training, supervision and/or licensure should not perform the procedures.