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 healthcare provider’s order
- Parent authorization form
Procedure:
- Review student’s IHP and healthcare provider’s order
- Ensure proper documentation of parent/guardian authorization to perform this procedure
- 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
- If emptying into toilet, place a piece of toilet paper in the toilet to prevent splashing
- 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
- 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 inside the tail of the bag above the level of the pouch closure to prevent stool from leaking out when the pouch is closed
- This will prevent soiling or odor
- Toilet paper or commercial infant wipes can be used for this purpose
- If used, add pouch deodorant
- Re-clamp or reseal the pouch
- Remove gloves
- Wash hands
- If student assisted in the procedure, have the student wash their 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. Retrieved June 22, 2023, from https://www.facs.org/media/5nrphcg3/skills_checklist.pdf
Children’s Hospitals and Clinics of Minnesota. (2021). Fecal pouch emptying. Retrieved June 22, 2023, from https://www.childrensmn.org/educationmaterials/childrensmn/article/15550/fecal-pouch-emptying/
Children’s Hospital St. Louis. (2015). Ostomy home care teaching manual. Retrieved June 22, 2023, from https://www.stlouischildrens.org/sites/legacy/files/Ostomy%20Home%20Care%20Teaching%20Manual.pdf
Hollister. (2018). Caring for your child with an ostomy. Retrieved June 22, 2023, from https://www.hollister.com/-/media/files/pdfs-for-download/ostomy-care/caring-for-your-child-with-ostomy_923057-0318.ashx
Lynn, P. (2019). Emptying and changing an ostomy appliance. In Skill checklists for Taylor’s clinical nursing skills. A nursing process approach. (5th ed.). (pp. 297-298).
Porter, S.M., Page, D., Engholm. H., & Somppi, C. (2019). Students supported by medical technology. In Selekman, J. (Ed.), School nursing, a comprehensive text (3rd ed.) (pp. 721-740). Philadelphia PA.: F.A. Davis Co.
Stetzer, M.N. (2021). Essential ostomy knowledge for nurses: Promoting adaptation in children with new ostomy and their caregivers. Pediatric Nursing, 47(2), 71-78.
University of Wisconsin Hospitals. (2020). Health facts for you. Caring for your child’s ostomy. Retrieved June 23, 2023, from https://patient.uwhealth.org/healthfacts/7652
Wound, Ostomy, and Continence Nurses Society. (n.d.). Pediatric ostomy care. Best practice for clinicians. Retrieved June 22, 2023, from https://cdn.ymaws.com/member.wocn.org/resource/resmgr/document_library/PEDIATRIC_OSTOMY_CARE-_BEST_.pdf
Page last reviewed: February 12, 2025
Page last updated: February 12, 2025
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.