How to Change an Ostomy Pouching System

Introduction

• Speaker: Cereth, a registered nurse
• Topic: Demonstration on changing an ostomy pouching system
• Previous video covered colostomies and ileostomies

Supplies Needed

• Pouching System
  • One-piece system: skin barrier (wafer) attached to pouch
  • Two-piece system: separate skin barrier and pouch that snap together
• Barrier Ring (optional)
  • Provides extra protection if the patient has skin breakdown
• Clip
  • Used to close some bags (others might use Velcro)
• Measuring Card
  • For measuring the stoma size
• Pen
• Ostomy Scissors
  • Curved with blunt tip for smooth cuts
• Gloves
• Washcloths
  • For cleaning and drying the stoma

Procedure for Changing the Ostomy Pouch

Preparation

1. Perform hand hygiene.
2. Don gloves.
3. Protect the patient’s gown and skin using a towel.
4. Change the system every 3-5 days; empty the pouch when 1/3 to 1/2 full.
5. Involve the patient to encourage independence.
6. Consider using a mask or vapor rub for odor if sensitive.

Removing the Old System

• Remove the adhesive gently.
• Use adhesive remover if necessary.
• Discard the old system properly.

Cleaning and Inspecting the Stoma

• Use warm water, avoid soaps or products containing lotion, powders, or alcohol.
• Check for skin breakdown or redness.
• Clean and dry the stoma thoroughly.
• Trim hair if necessary to improve adhesion and comfort.

Measuring and Preparing the New System

1. Measure the Stoma
   • Use a measuring card for accuracy.
   • Allow approximately 1/8 inch around the stoma.
2. Prepare Skin Barrier
   • Trace and cut the barrier using ostomy scissors.
   • Ensure no jagged edges.

Applying the New System

1. Pre-close the Bag
   • Snap or Velcro closed to prevent leaks.
2. Apply Skin Barrier
   • Remove backing, place a barrier ring if needed.
   • Affix the skin barrier over the stoma ensuring firm adhesion.

Additional Tips

• Gas Management
  • Check for gas buildup in the bag and burp if necessary.
  • Some bags may have filters.
• Patient Education
  • Encourage patients to check the bag regularly and manage gas appropriately.
• Nurse Responsibility
  • Regularly inspect the bag under the gown to ensure it is functioning properly.

Conclusion

• Demonstrated steps for changing an ostomy pouching system.
• Encourage watching more educational videos by subscribing to the channel.