Emptying Colostomy Pouch

<< DIGESTIVE


Considerations:

  • Ostomy bag should be emptied when 1/3 to ½ 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 download  skill competency

  1. Review student’s IHP or healthcare provider’s order
  2. Position student taking steps to ensure privacy
  3. Explain the procedure to the student at his/her level of understanding
  4. Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
  5. Wash hands
  6. If student will be assisting, have student wash hands
  7. Put on gloves
  8. Inspect the area around the stoma for:
    • Redness
    • Irritation
    • Signs of leaking around the pouch or skin barrier
    • Bleeding
  9. Inspect the stoma for signs of:
    • Bulging
    • Getting longer
    • Darkening in color or turning bluish
  10. Raise the pouch so the opening faces up
  11. Open the pouch
    • Either unclamp or unroll the integrated drainage outlet
  12. Lower the pouch toward toilet or collection container
  13. If emptying into toilet, place a piece of toilet paper in the toilet to prevent splashing
  14. 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
  15. Wipe the opening off inside and out with toilet paper
  16. If used, add pouch deodorant
  17. Re-clamp or reseal the pouch
  18. Remove gloves
  19. Wash hands
  20. Document assessment, intervention and procedure in student’s healthcare record
  21. Follow up with parents/guardian and healthcare provider, as needed

Resources:

ConvaTec:  Video Library
ConvaTec: Ostomy basics
Hollister: Caring for your child with an ostomy


References:

American College of Surgeons.  (2012).  Ostomy Skills: Emptying and Changing the Pouch.  Available at: http://www.facs.org/patienteducation/skills/empty-pouch.pdf

Bowden, V. R., & Greenberg, C. S. (2012). Pediatric nursing procedures (Third Edition). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Children’s Hospitals and Clinics of Minnesota.  (2010).  Fecal pouch emptying.  Available at: http://www.childrensmn.org/Manuals/PFS/HomeCare/018697.pdf

Connecticut State Department of Education. (2012). Clinical Procedure Guidelines for Connecticut School Nurses. Available at:
http://www.sde.ct.gov/sde/lib/sde/pdf/publications/clinical_guidelines/clinical_guidelines.pdf

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 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 updated: April 3, 2015