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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
slide5
Case 1

Case 1: Visit 1

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 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

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 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

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

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
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
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
slide49
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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