Coloplast Ostomy Skin Tool

1. Coloplast Ostomy Skin Tool

2. This is a standardised way to: • Score the peristomal skin through objective observations • Categorise the peristomal skin disorders according to their cause

3. What is the tool meant to do? • This tool is designed to assess peristomal skin • The tool is designed to assess the state of the peristomal skin at that particular point in time • Assess if there has been an improvement or a degradation over time • Reduce the amount of time nurses spend on evaluating a disorder • It is not meant to to predict deterioration of a current condition or predict the occurrence of an abnormal skin condition • It is not meant to assess the extent of care needed • The tool was developed in association with the Coloplast Global Advisory Board

4. A closer look at scoring Examine the peristomal skin and evaluatethe skin based on the descriptions in three domains: • Discolouration • Erosion • Tissue overgrowth Maximum points in each domain: • Size of affected area: 3 points • Severity: 2 points Highest possible score = 15

5. Assessing the affected area and severity Then assess the severity score • Severity should only be assessed when there is an area score from 1–3 • Assess the severity according to the descriptions within the three domains First assess the area that is affected

6. Step 1: DET score

7. Step 2: The diagnostic guide

8. Scoring a skin disorder

9. Normal skin Discolouration • There is no area of discolouration, therefore, the score is 0 • As there is no discolouration, the severity must also 0As there is no discolouration observed the score will also be 0 in the rest of the domains as follows: Erosion • There is no evidence of erosion, therefore, the score is 0 • As there is no erosion, the severity must also be 0 Tissue overgrowth • There is no tissue overgrowth, therefore, the score is 0 • As there is no tissue overgrowth, the severity must also be 0 Total score= 0

10. Adhesion area Stoma Area of discolouration Domain 1: Area of discolouration The area of discolouration is 25–50% of the total adhesion area Therefore, the area score = 2 2

11. Domain 1: Severity of discolouration The area is severely discoloured Therefore, the severity = 2 2

12. Domain 2: Area of erosion The area of erosion is 25–50% of the total adhesion area Therefore, the area score = 2 2

13. Domain 2: Severity of erosion The area is not severely eroded Therefore, the severity = 1 1

14. Domain 3: Area of tissue overgrowth The area of tissue overgrowth is less than 25% of the total adhesion area Therefore, the area score = 1 1

15. Domain 3: Severity of tissue overgrowth The area is not severely overgrown Therefore the severity = 1 1

16. Total score = 9 Summary: Patient score Domain 12 + 2 = 4 Area of discolouration = 2 Severity of discolouration = 2 Domain 22 + 1 = 3 Area of erosion = 2 Severity of erosion = 1 Domain 31 + 1 = 2 Area of tissue overgrowth = 1 Severity of tissue overgrowth = 1

17. The diagnostic guide

18. How to use the diagnostic guide

19. Observations • Discolouration • Loss of • epidermis • Hyperplasia

20. The patient consultation

21. Diagnostic category

22. Please remember • Both DET score and diagnostic guide must be used every time you assess a patient • When scoring the peristomal skin you must go through the 3 domains every time

23. How to use our Grid Place the grid covering the stoma & peristomal skin area The stoma should be in the center

24. Draw the adhesive area on the grid

25. Draw the stoma on the grid • And cut out the area

26. Draw the area of skin disorder

27. Calculate area of skin disorder By counting area of adhesive and area of skin disorder