1017 / The Advantages of Preventive Stoma Marking

SPAIN
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Patient involvement
Surgical / Invasive procedures There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
Goals:
1) Make the stoma marking a few days before the surgery, so that they can get a suitable position for every patient, keeping in mind their daily life.
2) Provide the patient, relative and/or carer the knowledge and traineeship required for the care of the stoma.
3) The stoma and the skin around the stoma of the patient is evaluated during the first year. This way,complications which are often presented can be prevented, such as: dermatitis, candidiasis, peristomal tissue necrosis, etc. The patient attends to the stoma therapist consulting room regularly during the first three months.
Description of the Patient Safety Practice
 
When the surgeon programs the radical cistectomy with urinary diversion called Bricker, automatically there is an appointment at the consulting room of urological nursing: stomatherapist, around 10 days before the surgery.
At the first visit* a Personalized Care Planning will be performed , which includes:
-Initial assessment following the 14 fundamental needs of Virginia Henderson.
-Transcribe to NANDA language for the Nursing Diagnosis.
Sequence of appointments:
*First visit: before the admission, the marking of the stoma is performed, the urostomy bag is placed on the ideal position and the patient receives a Questionnaire about the stoma marking.
*Second visit: the patient delivers the completed questionnaire and he/she decides together with the Nurse, the position of the stoma.
*Third visit: it takes place before hospital discharge. The nurse confirms the final location of the stoma and she/he explains the care for it.
Monitoring on the 3, 6 and 12 months.
The number of appointments will be adapted to the needs of each patient..

***Next changes in the methodology of the PSP:
From the beginning of this practice the number of patients who have required the aid of a clinical psychologist has been monitored and it has been decided to include this support in the practice.
The system of work consists of programming automatically one visit with the patient, in the moment that the surgeon plans this type of intervention.
During the first visit the psychologist will evaluate the patient and in the second visit, which they perform the mark, location and explanation of the dispositive.
The nurse will follow the patient after the surgery. After the discharge from the hospital, the frequency of the visits will be adequated to the needs of the patient. It will start on April.

Another anticipated change, is the care (from the nurse) to the main carer, by the reinforcement of training about: the stoma and the dispositive. Emotional support is do it by the psychologist. They don’t determine the date of starting.
Attachment of relevant written information and/or photos, as appropriate
201403140130022634_WP4_Consulting room.zip
Standarise Care Plan NANDA 6 juny 2014.zip
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Not relevant
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
No
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Administrative support (secretary, clerk, receptionist etc.)
Clinical manager
Quality manager
Other or not relevant
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Relative(s)
Other
Point of time in which service user or their reprasentatives' involvement takes place
During the application of the Patient Safety Practice
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Consultation, such as asking for information
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Staff and management recognised the need for change
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Yes
Total number of person days required to implement this Patient Safety Practice
Clinical staff: 0,13
External consultants: 0
Support staff: 0
Managerial staff: 0
Others: 0
Not relevant: 0
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: 90
External consultants: 0
Support staff: 0
Managerial staff: 0
Others: 0
Not relevant: 0
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
1000
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
0
Contact information
 
Name: Pilar Baxarias
Country: SPAIN
Organisation: Fundació Puigvert
E-mail: pbaxarias@fundacio-puigvert.es
Phone: +34934169700
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