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The Ostomy Skin Tool –2 .rész workshop. The Ostomy Skin Tool Workshop and case studies ESET TANULMÁNYOK. Anna Monika Tomanek Clinical Advisor. . . . Meeting objectives CÉLKITŰZÉS. Workshop 1 – simple case EGYSZERŰ

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The ostomy skin tool workshop and case studies eset tanulm nyok

The Ostomy Skin ToolWorkshop and case studiesESET TANULMÁNYOK

Anna Monika Tomanek

Clinical Advisor


Meeting objectives c lkit z s

Meeting objectives CÉLKITŰZÉS

Workshop 1 – simple caseEGYSZERŰ

Workshop 2 - complex caseÖSSZETETT Using the Ostomy Skin Tool in practiceGYAKORLÁS


Workshops 2 cases 2 eset
Workshops: 2 cases /2 ESET

  • Plenary: Introduction to the cases BEVEZETÉS

  • Workshop: MŰHELYMUNKA

    • Review case study with histories and photographs TÖRTÉNET+FOTÓ

    • Assess the case using the Ostomy Skin Tool- DIAGNÓZIS

    • Discuss with colleagues in your group - MEGBESZÉLÉS

  • Plenary: Voting and Discussion SZAVAZÁS+ VITA


Case 1

Case 1: Visit 1


Domain 1 discolouration elsz nez d s

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁGI PONT

Domain 1: Discolouration ELSZÍNEZŐDÉS


Domain 1 discolouration elsz nez d s1

Area score TERÜLETI PONT= 1

Severity score SÚLYOSSÁGI PONT = ?

Domain 1: Discolouration ELSZÍNEZŐDÉS


Domain 1 discolouration elsz nez d s2

Area score = 1 TERÜLETI PONT

Severity score = 2 SÚLYOSSÁGI PONT

Domain 1: Discolouration ELSZÍNEZŐDÉS


Domain 2 erosion felmar d s

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 2: Erosion FELMARÓDÁS


Domain 2 erosion

Area score = 1

Severity score = ?

Domain 2: Erosion


Domain 2 erosion1

Area score = 1

Severity score = 2

Domain 2: Erosion


Domain 3 tissue overgrowth kin v sek

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 3: Tissue overgrowth KINÖVÉSEK


Domain 3 tissue overgrowth

Area score = 0

Severity score = ?

Domain 3: Tissue overgrowth


Domain 3 tissue overgrowth1

Area score = 0

Severity score = 0

Domain 3: Tissue overgrowth


Summary of case 1 total det score pont sszes t s
Summary of case 1: Total DET score PONT ÖSSZESÍTÉS

D 1 2 3

E 1 2 3

T 0 0 0

DET score 6

TOTAL = 6



Case 2 visit 1 2 eset 1 vizit
Case 2: Visit 12.ESET 1. VIZIT

  • Background information: HÁTTÉR INFO

    • Sex: Male FÉRFI

    • Age: 67 years old KORA 67 ÉV

    • Reason for stoma creation: Diverticulitis

    • Type of stoma: Colostomy

    • Average adhesive wear time: 2 days ESZKÖZT CSERÉL 2 NAPONTA


Domain 1 discolouration elsz nez d s3

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 1: Discolouration ELSZÍNEZŐDÉS

Visit 1


Domain 1 discolouration

Area score = 2

Severity score = ?

Domain 1: Discolouration

Visit 1


Domain 1 discolouration1

Area score = 2

Severity score = 1

Domain 1: Discolouration

Visit 1


Domain 2 erosion felmar d s1

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 2: Erosion FELMARÓDÁS

Visit 1


Domain 2 erosion2

Area score = 2

Severity score = ?

Domain 2: Erosion

Visit 1


Domain 2 erosion3

Area score = 2

Severity score = 1

Domain 2: Erosion

Visit 1


Domain 3 tissue overgrowth kin v sek1

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 3: Tissue overgrowth KINÖVÉSEK

Visit 1


Domain 3 tissue overgrowth2

Area score = 1

Severity score = ?

Domain 3: Tissue overgrowth

Visit 1


Domain 3 tissue overgrowth3

Area score = 1

Severity score = 2

Domain 3: Tissue overgrowth

Visit 1


Summary of case 1 at visit 1 total det score sszes t
Summary of case 1 at Visit 1: Total DET score ÖSSZESÍTŐ

D 2 1 3

E 2 1 3

T 1 2 3

DET score 9

TOTAL = 9



Domain 1 discolouration elsz nez d s4
Domain 1: Discolouration ELSZÍNEZŐDÉS

  • TERÜLETE

  • Area score = ?

  • Severity score = ? SÚLYOSSÁGA

Visit 2


Domain 1 discolouration2
Domain 1: Discolouration

  • Area score = 1

  • Severity score = ?

Visit 2


Domain 1 discolouration3
Domain 1: Discolouration

  • Area score = 1

  • Severity score = 1

Visit 2


Domain 2 erosion felmar d s2

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 2: Erosion FELMARÓDÁS

Visit 2


Domain 2 erosion4

Area score = 1

Severity score = ?

Domain 2: Erosion

Visit 2


Domain 2 erosion5

Area score = 1

Severity score = 1

Domain 2: Erosion

Visit 2


Domain 3 tissue overgrowth kin v sek2

Area score = ? TERÜLETI PONT

Severity score = ? SÚLYOSSÁG

Domain 3: Tissue overgrowth KINÖVÉSEK

Visit 2


Domain 3 tissue overgrowth4

Area score = 1

Severity score = ?

Domain 3: Tissue overgrowth

Visit 2


Domain 3 tissue overgrowth5

Area score = 1

Severity score = 1

Domain 3: Tissue overgrowth

Visit 2


Summary of case 2 at visit 2 2 eset 2 vizit total det score sses t
Summary of case 2 at Visit 2: 2.ESET 2. VIZITTotal DET score ÖSSESÍTŐ

D 1 1 2

E 1 1 2

T 1 1 2

DET score 6

TOTAL = 6


Summary of case 2 sszefoglal s 2 eset

TOTAL = 6

TOTAL = 9

Summary of case 2ÖSSZEFOGLALÁS 2. ESET

Visit 1

Visit 2


The ostomy skin tool using the ostomy skin tool in practice a gyakorlatban

The Ostomy Skin ToolUsing the Ostomy Skin Tool in practice – A GYAKORLATBAN


Patient and case study esettanulm ny
Patient and case study ESETTANULMÁNY

  • 69-year-old woman 69 ÉVES NŐBETEG

  • Emergency surgery for a bowel infection and had an ileostomy SÜRGŐSSÉGI MŰTÉT, BÉLFERTŐZÉS, ILEOSTOMA

    Case history

  • Day 14 after surgery, ostomy appliance found leaking and causing patient distress 14 MÚLVA SZIVÁRGÁS AZ ESZKÖZNÉL…

  • Using the Ostomy Skin Tool, a DET score of 4 was calculated PONTSZÁMA DET 4


Assessment 1 det score 1 vizsg lat pontsz ma
Assessment 1 DET score1.VIZSGÁLAT PONTSZÁMA


Visit 2
Visit 2

  • At the return visit 13 days later, the DET score was 2

  • 13 NAP MÚLVA PONTSZÁMA DET 2

  • The appliance was adhering; the patient was not experiencing peristomal skin discomfort and she was much happier

  • JÓL TAPAD AZ ESZKÖZ

  • By using the DET score, whichever nurse saw the patient on subsequent visits had a clear and uniform way to evaluate the peristomal skin and decide if it was improving or deteriorating, providing seamless patient care

  • BÁRKI LÁTTA EL, AZONOS MÓDON ÉRTÉKELTE A JAVULÁST


Assessment 2 det score 2 vizsg lat det pontok
Assessment 2 DET score2.VIZSGÁLAT DET PONTOK


Patient and case history eset tanulm ny

The patient: Mr M

69-year-old man with Crohn’s disease 69 ÉVES FFI CHRON B.

Abdominal perineal resection with ileostomy in 1998

No extraintestinal manifestations

Case history

Recent onset of peristomal ulcerationsSTOMA KÖRÜL FEKÉLY

Two visits to emergency department 2 SÜRGŐSSÉGI VIZIT

Presented to the clinic in “excruciating” pain FÁJDALMA 10-ES

Pain rating 10 out of 10

Patient and case history ESET TANULMÁNY


Visit 1
Visit 1

Assessment 1 DET score

Baseline ALAPADAT

Pyoderma gangrenosum (PPG)

Example of PPG


Visits 2 and 3
Visits 2 and 3

Assessment 3 DET score

Week 4. HÉT

Assessment 2 DET score

Week 2. HÉT

Pain rating 6 out of 10

FÁJDALOM INDEX 6

Pain rating 8 out of 10

FÁJDALOM INDEX 8


Justifying mr m s care bizony t s
Justifying Mr M’s care BIZONYÍTÁS

  • Administrators were concerned about the time and resources used IDŐ, KÖLTSÉG

    • Claimed Mr M was “clearly no longer a hospital patient”

  • Ostomy care nurse reviewed the case with the administrators

    • Lack of community resourcesand emergency care inappropriateFORRÁSHIÁNY

    • Used DET scores to show severity of disorder and effect of appropriate treatments and expert management DOKUMENTÁLT KEZELÉSI EREDMÉNYEK


It is not just what you know that creates Best Practice…

NEM AZ JÓ PÉLDA, AMIT TUDSZ,

CSAK AZ, AMIT MEGTESZEL!!!

It is what you do that creates Best Practice!!!

REMEMBER:

EMLÉKEZZ:

Slide Courtesy Dr. Sibbald


Thank you k sz n m

Thank youKÖSZÖNÖM

Anna Monika Tomanek

Clinical Advisor


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