The Journal of Stomal Therapy Australia - Australian Association of ...

The Journal of
Stomal Therapy Australia
Volume 27 Number 3 September 2007
ISSN 1030-5823
Copyright © 2006 by the
Australian Association of Stomal Therapy Nurses Inc. ABN 16072891322
AASTN Code of Ethics
• The stomal therapy nurse must at all times maintain the
highest standards of nursing care and professional conduct.
• The stomal therapy nurse will provide needed services to
persons irrespective of their race, colour, creed, sex, sexual
preference, age and political or social status.
• The stomal therapy nurse must respect the beliefs, values
and customs of the individual and maintain his/her right to
privacy by maintaining confidentiality, sharing with others
only information relevant to that person’s care.
• The stomal therapy nurse will not participate in unethical
practice.
• The stomal therapy nurse must maintain competency by
keeping abreast of new developments in the theory and
practice of stoma care and related fields.
• The stomal therapy nurse will participate actively in
professional, inter-professional and community endeavours in
order to meet the highest professional standards.
• No full member shall be in the employ of a company or self
employed in the manufacture or sale of products, prostheses
or pharmaceuticals where it could be perceived that the use
or selling of products prostheses or pharmaceuticals could
disadvantage or contradict the personal preference of clients
or be construed to result in unethical conflict of interest.
Contents
President’s report 3
Editorial 4
Letter to the Editor 4
Articles
Challenges of managing a retracted stoma
on a large abdomen 5
From community to acute care: an audit
study of clients living with a stoma 8
Risk management in stomal therapy practice 16
Right product, right fit 21
Beneath the waves 26
YOU Inc President’s report 29
WCET report 31
State reports 32
Published four times a year by
a division of Cambridge Media
128 Northwood St West Leederville WA 6007
Web www.cambridgemedia.com.au
Copy Editor Paulette Thomas
Graphic Designer Sarah Horton
Advertising enquiries to
Simon Henriques, Cambridge Publishing
Tel (08) 9382 3911 Fax (08) 9382 3187
Email simonh@cambridgemedia.com.au
Disclaimer: The opinions expressed in the Journal of Stomal Therapy Australia
are those of the authors and not necessarily those of the Australian Association of
Stomal Therapy Nurses Inc., the editor or the editorial board.
Editorial Board
Lorrie Gray RN MSc(Ed) BSoc SC STN
WA Branch STNEP Coordinator
Keryln Carville RN PhD STN (Cred)
Silver Chain Nursing Association
Julia Kittscha RN STN BHSc
The St George Hospital, Sydney
Patricia Blackley RN Grad DipEd STN
Life Member AASTN and WCET
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Directory
Executive committee
President
Vice-President
Treasurer
Secretary
Leeanne White
Clinical Nurse Consultant
Stomal Therapy/Breast Care/Wound Management
Ballarat Health Services
PO Box 557
Ballarat VIC 3353
Tel: (03) 5320 4508
Fax: (03) 5320 4811
Email: leeannew@bhs.org.au
Elaine Lambie
Allamanda Private Hospital
29 Spendlove Street
Southport QLD 4215
Tel: (07) 5527 9779
Email: e.lambie@bigpond.com
Fiona Bolton
64 Carlisle Street
Ethelton SA 5015
Mob: 0414 226 779
Email: fionabolton65@optusnet.com.au
Vicki Patton
Pelvic Floor Unit
St George Public Hospital
Belgrave Street
Kogarah NSW 2217
Tel: (02) 9350 2715
Email: vicki.patton@sesiahs.health.nsw.gov.au
Membership Robyn Simcock
Coordinator PO Box 153
Floreat WA 6014
Tel: (08) 9387 7265
Mob: 0417 627 970
Email: rmsimcock@bigpond.com
Editor
Committee
Ed Sub
Committee
Website
Coordinator
diana Hayes
Stomal Therapy Department
Western Hospital
Gordon Street
Footscray VIC 3011
Home: (03) 9338 1793
Work: (03) 8345 6553
Mob: 0428 441 793
Email: diana.hayes@wh.org.au
Karen McNamara
22 Margaret Street
Waterman Bay WA 6020
Home: (08) 9447 8717
Work: (08) 9400 9297
Mob: 0431 603 230
Email: mcnamarak@ramsayhealth.com.au
Mary Ryan
RDNS (ESS)
Royal District Nursing Service
Cnr Mt Alexander Rd & Grice Cres
Essendon VIC 3040
Tel: (03) 9379 6945
Fax: (03) 9379 1456
Email: mtryan@rdns.com.au
Sharmaine Peterson
St Andrew’s Hospital
350 South Terrace
Adelaide SA 5000
Tel: (08) 8408 2164
Email: sharmainep@bigpond.com.au
Cynthia Smyth
38 Riverview Dr
Calliope QLD 4680
Tel: (07) 4975 7897
Mob: 0419 724 868
Email: cynandken@bigpond.com
Mary Ryan
Contact details as shown above
WCET ID
Public Officer
CPD and
Credentialling
Officer
Carmen Smith
17 Currawong Avenue
Glenalta SA 5052
Email: carmensmith@adam.com.au
Carol Stott
Stomal Therapy Dept Dickinson 2 North
Prince of Wales Hospital
Barker Street
Randwick NSW 2031
Tel: (02) 9382 3869
Email: carol.stott@sesiahs.health.nsw.gov.au
Sue Delanty
Launceston General Hospital
Charles Street
Launceston TAS 7250
Tel: (03) 6348 7832
Email: sue.delanty@dhhs.tas.gov.au
AASTN state representatives
ACT
NSW
NT
QLD
SA
TAS
Vic
WA
NZ
Kellie Burke
Community Nurse/Stomal Therapy Nurse
ACT Community Health
Continuing Care Program
Tel: (02) 6205 2740
Mob: 0407 947 100
Email: Kellie.Burke@act.gov.au
Carol Stott
CNC Stomal Therapy/Wound Management
Prince of Wales Hospital
High Street
Randwick NSW 2031
Tel: (02) 9382 3869
Fax: (02) 9382 3868
Email: carol.stott@sesiahs.health.nsw.gov.au
Jennifer Byrnes
Royal Darwin Hospital
Rocklands Drive
Tiwi NT 0810
Tel: (08) 8922 8888
Email: jennifer.byrnes@nt.gov.au
Helleen Purdy
St Andrew’s War Memorial Hospital
457 Wickham Terrace
Brisbane QLD 4001
Tel: (07) 3834 4589
Fax: (07) 3834 4373
Email: HPurdy@sawmh.com.au
Margie Reid
Stomal Therapy Nurse
Lyell McEwin Hospital
Haydown Road
Elizabeth Vale SA 5112
Tel: (08) 8182 9000
Fax: (08) 8282 1235
Email: margaret.reid@nwahs.sa.gov.au
Karen Campbell
North West Regional Hospital
Burnie TAS 7320
Tel: (03) 6430 6599
Fax: (03) 6430 6688
Email: karen.campbell@dhhs.tas.gov.au
Margaret Rigoni
Apt. 2/166 Holden Street
North Fitzroy VIC 3068
Tel: (03) 9481 5790
Mob: 0410 417 287
Email: margaret.rigoni@gmail.com
Carmel Boylan
Royal Perth Hospital
Tel: (08) 9224 2244 + pager 2369
Tel: (08) 9224 2369 (Direct)
Email: carmel.boylan@health.wa.gov.au
angela Harrison
387 Pipiroa Rd
Ngatea, Hauraki Plains NZ
Tel: +64 7 868 6550 ext 8816
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

President’s report
It’s our AASTN website and journal
Leeanne White RN, STN • CNC, Ballarat Health Services, Victoria
The executive is pleased to report that the website has been
upgraded. Our new website coordinator, Mary Ryan, has
enabled us to establish access and is looking forward to feedback
and suggestions. This has been challenging and complicated at
times but the outcome has been good. The executive will ensure
that details related to the website are recorded in the policy
manual so it will be accessible for future executive committees.
The website has been able to be updated with almost instant
service. We have had several enquires from other nursing
specialties regarding our association since the website upgrade.
We will need to consider the preferred format for the section on
how to find a stomal therapy nurse and this would be a good
issue for further discussion at state branch meetings.
Access to the website has enabled the AASTN Education
and Professional Development Committee to add the current
documents that support the AASTN – much to the relief of
Cynthia Smyth and her team – and Sue Delanty was very excited
about working with the website manager on this. It is a relief to
have the Standards and other documents available for members
to access. I will catch up with Cynthia and her committee in
Melbourne for the October two -day workshop.
Our journal editor Diana Hayes will be preparing another
edition soon and we encourage members to support the journal
by sending in letters on issues to generate discussion.
Planning for the 2008 Annual General Meeting has been
challenging. Thanks to Sue Delanty in Tasmania the tele-health
link will be coordinated from there, with the states linking in.
The number of sites is limited so we are unable to have more
than one site per state. Thanks to the state representatives and
members of the executive for all the correspondence related to
arranging venues and IT support. We are currently collating
the contact details and will be in communication with the state
representatives again. Planning is continuing and we will need
to have as much of the business as possible submitted and
circulated prior to the meeting.
the AASTN representatives attending. While on the subject of
appliances, I would like to mention that the ostomy associations
I liaise with do an excellent job.
Both state and federal governments have a commitment to
cancer care and we as stomal therapy nurses are in a key
position. For example, we need to be aware of the potential
impact of bowel cancer screening. Initially there may be more
temporary stomas before there is a reduction in the death rate
from colorectal cancer in the longer term. The Cancer Council
has released a bowel cancer screening forum report, available at
www.cancer.org.au – it would be great if there were more stomal
therapy nurse positions in Australia particularly in rural areas.
Finally all members of the executive have been working hard
and I can assure you that emails and telephone calld have been
frequently flying around the country.
VALUES, PURPOSE AND
VISION OF AASTN
Our values
Quality, respect, accountability,
commitment and innovation.
Our purpose
To provide support and leadership to stomal
therapy nurses in their endeavour to provide
quality nursing practice.
Our vision
Enduring recognition for excellence and innovation
in stomal therapy practice at a national and
international level.
The next Stoma Assessment Panel (SAP) meeting will be held
in Canberra on 27 September. Diana Hayes and I are among
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Editorial
Behind the scenes of the AASTN
Diana Hayes, RN STN • CNC Stomal Therapy, Western Health Victoria
The new AASTN website is beautifully and professionally
presented, and has allowed The Journal of Stomal Therapy Australia
to be available on-line. The four most recent editions will be
accessible in PDF.
There is an incredible amount of work and communication
within our association. Emails are constantly being sent across
our vast nation ensuring that the AASTN runs smoothly for
its members. We are a unique group and need to maintain the
integrity of our association by ensuring that membership is
maintained and that contact details are up to date.
Congratulations to Cheryl Prendergast who has been appointed
Clinical Nurse Consultant/Stomal Therapy for Melton Health
in Victoria. This expanding area of Victoria has lacked stomal
therapy services and it was only due to the lobbying of the
OSTWEST Support Group that this position became available.
We have an excellent selection of papers in this edition of our
journal, that have involved a huge amount of study, research and
dedication by the authors. We also have an interesting article by
a former patient of mine who has a permanent ileostomy and
scuba dives.
If you wish to submit an article for the journal and have not yet
done so, please open an account at cambridgemedia.com.au.
Letter to the Editor
Dear Diana
I am one of the fairly isolated STNs you mentioned in your
open forum section in the June 2007 edition of The Journal of
Stomal Therapy Australia. I run the continence clinic in Geraldton,
Western Australia, two days a week and during that time see
ostomates as a ‘sideline’. I did the stomal therapy course in 2002
and it was the best thing I ever did. There are over forty people
with stomas in our district and though there are two other
nurses in the area who have the applicable training, it remains a
sideline area for all of us.
The Open Forum section in the journal is something I will be
looking out for in each edition. I am very interested in nearly
all the questions in the June edition and hope responses will be
published in following editions.
I think the biggest bugbear for a few of my clients (particularly
active males) is perspiration resulting in appliance failure and
shorter than desired wear time. I would love to have some ideas
to give to these people.
Do You Want to be
Credentialled by the
AASTN?
All experienced, practising stomal therapy nurses
can apply to be credentialled
Applications close 30 June each year
Preparation data will be sent in July
Exams will be held in early September
Notification of outcome will be in November
Portfolio submission (100 points) due mid-January
Conferral of credentialled status will be awarded at the
following AGM at the AASTN Conference
More details from:
Cynthia Smyth, Chairperson
Education and Professional Development Subcommittee
(see contact details in Journal Directory)
Regards,
Dawn Hall STN
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Challenges of managing a retracted stoma on a
large abdomen
Liz Howse • Clinical Nurse Specialist/Stomal Therapy Nurse, Silver Chain Nursing Association, WA
Introduction
The following case study describes the challenges faced with
a 43-year-old male client who endured a retracted stoma on
a large abdomen. The client had a Hartmann’s procedure
with the formation of a temporary colostomy for perforated
diverticulum. Post-operative complications included stoma
retraction and stenosis and his past medical history included
obesity, hypertension, ruptured gastric banding and spinal cord
stenosis.
Management Goals and Surgical Aim
Management goals:
• Encourage epithelialisation of the denuded and ulcerated
peristomal skin.
• Prevent appliance leakage in order to preserve the peristomal
skin.
• Modify the client’s diet to encourage weight loss and regulate
output consistencies.
Figure 1 Figure 2
Abdominal Plane
The client weighed >160 kg and the sinus opening was
positioned within a large abdominal fold. In addition, the
excessive adipose tissue caused a counter-contraction force and
when the client moved from sitting to standing, or participated
in his exercise regimen of swimming and bike riding, the
increased intra-abdominal pressure resulted in increased tension
on the appliance and this was a major contributing factor to the
appliance leakage. The client had abdominal binders made to fit,
and was encouraged to wear them to support his abdomen and
prevent increased tension on the appliance.
• Support the client in adjusting and coming to terms with his
stoma.
Surgical aim:
• Stoma reversal in six – eight months following significant
weight loss.
Figure 3
Figure 4
Description of Stoma
Initially on discharge from hospital and admission to Silver
Chain the client had a necrotic stoma (Figure 1). As the necrotic
tissue autolysed and was eventually debrided we were presented
with a retracted stoma that had descended approximately 4 cm
within the sinus tract (Figure 2). The sinus opening was initially
60 x 20 mm. However, over an eight week period the sinus
opening continued to contract ultimately leaving an opening of
10 x 5 mm (Figure 3). Considerations were made at this stage
for stomal dilation under anaesthetic. However, not even a
paediatric scope was able to be used, as the risk for perforation
was too great. The sinus opening and tract were extremely
friable and there was evidence of frank bleeding.
Diet and Output Management
The client commenced on a weight reduction diet following a
review by a dietitian. Home delivered meals proved an ideal
option in the initial post-operative phase. As the sinus opening
contracted, stoma blockage became problematic and the client
presented to emergency departments on several occasions. The
client was encouraged to commence on a well-pureed diet,
increase his fluid intake and avoid foods that may result in
stoma blockage. In addition he was encouraged to take lactulose
to soften the output. This was necessary to prevent further
trauma to the tract and avoid further stoma blockages. The
effluent outputs were moderate amounts of regular, soft, semiformed
melaena-type stool.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Initial Two-Piece Appliance Management
System
Skin barriers were used to protect the peristomal skin.
Stomahesive powder was applied to the friable sinus opening
to control the bleeding. Seals were applied to create a convexity
effect in order to provide more security (Figure 4). The larger
base plate provided adhesion over a greater surface area and the
rim on the base plate provided a firm base to prevent the folding
in of abdominal creases. In addition, using a cut-to-fit appliance
accommodated the changes in sinus opening sizes (Figure
5). The aperture of the base plate was cut larger to provide a
more uniformed surface coverage. The base plate only required
changing twice weekly and the client was able to manage
bag changes as required (Figure 6). As the sinus continued to
contract the appliance system required adjustments. Leakage
became problematic resulting in extensive erythema, which
extended outward from the stoma opening. Furthermore,
there were friable superficial ulcerations throughout this area.
The contraction of the sinus resulted in further creases and
indentations, particularly evident at the lateral corners of the
sinus opening.
Figure 7 Figure 8
surface area. The one-piece appliance was more flexible and
provided better adhesion along the folds and creases (Figure 8).
The appliance aperture was again cut larger to provide a more
uniform coverage onto the skin surface. Although the appliance
required second daily changes, the ease of application enabled
the client to self-manage appliance changes.
Collaborative Management
A collaborative approach with the client, stomal therapy nurses
both within the acute and domiciliary setting, GP, colorectal
consultant and other members of the multidisciplinary team is
important when managing a client with a complex stoma. This
ensures that ideas for management options are shared, agreed
management goals are achieved and changes in the client’s
condition are communicated.
Figure 5
Figure 6
Outcome
The client’s peristomal skin recovered and he was able to selfmanage
appliance changes with no further leakages. He had
the reversal of his colostomy and although he required wound
management post-operatively for twelve weeks for a large
wound dehiscence, he has now completely healed and has
resumed his usual life routines.
One-Piece Appliance Management System
Peristomal skin was protected using barrier film. A combination
of Stomahesive powder, Stomahesive paste and cement bond
was applied to the denuded peristomal skin to create a crust
for appliance adhesion and to encourage epithelialisation of the
skin. Stomahesive paste was used to fill creases and indentations
to the lateral sinus
Opening
Seals were applied to create a convexity effect in order to provide
more security (Figure 7). A one-piece Stomadress appliance
was used as the larger base provided adhesion over a greater
STOMA APPLIANCE SCHEME
UPDATED SCHEDULES
Available from the Department of Health website
www.health.gov.au/stoma
If the page does not show immediately, use the
www.health.gov.au search system and you will find it by
typing in: stoma appliance scheme
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

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From community to acute care: an audit study of
clients living with a stoma
Susan Farquhar BN, RN, STN • Royal District Nursing Service, Melbourne
Charne Flowers BA (Hons), GDip (ApplSocStat) • Royal District Nursing Service, Melbourne
Patricia Griffin BN, RN, GDip (Public Health), Cert Stomal Therapy • Royal District Nursing Service, Melbourne
Margaret Rigoni RN, RM, STN, Enteral Therapist, Cert. Palliative Care • Royal District Nursing Service, Melbourne
Mary Ryan RN, Dip (ApplSciCommHeal), Cert Palliative Care, Cert Stomal Therapy • Royal District Nursing
Service, Melbourne
Paul Ryan RN, B.Sc, Cert Palliative Care • Royal District Nursing Service, Melbourne
Debbie Streames RN, Cert Stomal Therapy, Cert Midwifery • Royal District Nursing Service, Melbourne
Ann Watts RN, RM, GDip (Comm Health) • Royal District Nursing Service, Melbourne
Abstract
In 2005, a community nursing organisation undertook a retrospective audit study of its clients living with a stoma who had been
discharged into acute care. The purpose of the study was to identify the reason for the discharge, the presence and type of stoma
related problems experienced during the episode and the appropriate involvement of a stomal therapy (ST) clinical nurse consultant
(CNC) during the episode. Sixty client histories were audited. All had a discharge to acute care between January and June 2004. The
audit identified that the vast majority of these clients were discharged for a diverse range of medical reasons that were unrelated to
their stoma (71.7%). Skin problems and an inability to manage the stoma were the most common reasons for a stoma related acute
care discharge in the community. The most common stoma problems experienced during these episodes included skin problems
and uncontrolled leakage of the appliance. Data also indicated that ST CNC resources were being appropriately targeted to stoma
problems and discharges related to the stoma. The audit study has identified the need for clinicians to be mindful of a diverse range of
medical complications that can arise as these are the likely causes of an acute care admission. This study has flagged the management
of the stoma, skin problems, and uncontrolled leakage of appliances as areas to target staff and client education across health care
settings.
Introduction
In 2004, a Victorian based community nursing organisation
established a ST clinical leadership group (CLG) comprising
clinical leaders in ST across the agency. The community nursing
organisation is committed to enhancing the quality and standard
of ST care provided by the agency and to research and best
practice in the ST field. The CLG structure is one component of
an evidence based model implemented by the organisation in
2001, with CLGs established in a number of core clinical areas.
Upon formation, the ST CLG conducted a profiling study of
the agency’s ST clients; a project undertaken to lead to the
identification of research questions and provide baseline client
data. This profile study was completed in 2005 (unpublished)
and summarised descriptive and diagnostic information about
this client segment using data extracted from the organisation’s
electronic client record system for the 2003/2004 financial year.
The specific results of this profile study were well anticipated
by the CLG – their individual experiences tallying with the
combined data for the agency. However, there was one result
that was unexpected by the CLG; a third of discharges were
to acute care (34.4%). This figure was higher than expected by
these clinicians. The hypothesis that these discharges would be
planned discharges for stoma reversals was not supported by
further exploration of the data. A review of stoma complications
and the cause of acute care admissions among these clients
ensued.
Literature Review
There are a number of published studies that have explored and
suggested the frequency and nature of stoma complications.
Estimates of stoma complications vary, reflecting the variety of
classification systems related to stoma care and complications 1 ,
whether the data was sourced via a prospective or retrospective
audit or a survey, and whether it is dependent upon the length
of follow-up. Recent studies suggest a complication rate ranging
from 16 – 73% 1-3 though several investigations cluster around a
complication rate of a 25 – 33.3% of clients 4-6 .
The findings of these investigations also differed as to the most
frequent type of complication occurring for people with an
ostomy. In a sizable audit study of a general ostomy population,
the most prevalent complications included prolapse, necrosis,
stenosis, irritation followed by infection and, less frequently,
bleeding and retraction 4 . Other audit research has found
peristomal skin irritation to be the most common complication
6
. In 2005, a prospective audit included psychosocial disturbance
complication, which it found to be the most common stoma
problem with >66.6% of clients experiencing some disturbance
to a social, sexual or personal activity as a result of their stoma 2 .
In a prospective audit, in which skin excoriation and laparotomy
wound problems were excluded, it was parastomal hernia and
retraction which commonly occurred for both colostomy and
ileostomy clients, with small bowel obstruction also frequent for
ileostomy complications 5 .
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Survey research considered the rate of skin disorders in
abdominal stoma patients and found that 73% reported the
occurrence of a skin problem, with irritant reactions, pre-existing
skin disorders, seborrhoeic dermatitis and eczema some of the
most frequent skin disorders mentioned 3 .
The occurrence of stoma-specific complications has been
associated with a significantly higher mortality rate 5 . On the
other hand, the involvement of an enterostomal nurse was
associated with a six-fold decrease in stoma complications 4.
Though the prevalence of stoma complications has been
considered in a number of studies, albeit without great consensus
as to the rate and nature of the most common complications, no
published studies could be located that explore the reasons
associated with the need for acute care admission among
individuals living with a stoma. This gap in the literature and
the higher than expected rate of acute care discharges arising
from a profile study of clients living with a stoma and receiving
community nursing care, led to the current study.
Aims and Objectives
The audit study was commenced in 2005 with the aim to
describe the reasons for and circumstances surrounding the
discharge into acute care of community based individuals living
with a stoma, who were receiving community nursing services.
To enable a clinical judgment as to whether the acute readmission
could have been avoided and if so how, the study had a number
of stated objectives that included determining the specific
reason for the discharge into acute care, identifying whether
the discharge was related to the stoma, and reviewing the care
delivered in the community.
While confirming the appropriateness of current practice from a
local perspective, the results of this audit study remain relevant
to the wider ST community by offering a description of the
likely problems to arise for people living with a stoma and
the likely reason for admission to hospital for clients living in
the community. These results will inform preventative care to
ensure that the most common stoma problems encountered in
the community are addressed by health professionals in the
community and acute sectors in an attempt to avoid the onset
of complications.
Method
The ST client profile study identified 63 episodes during the
first six months of 2004 with an acute care discharge from the
community nursing service. A retrospective client care record
(CCR) audit of these stoma clients was conducted. A customised
audit instrument was developed for the audit study. Members
of the ST CLG each contributed to the study by conducting a
proportion of the audits. A series of workshops involving all
of the auditors was conducted to optimise the inter-auditor
reliability.
The audit forms were data entered into SPSS 14.0. The analysis
relied primarily on descriptive statistics though some nonparametric
tests were employed when comparing client groups
on categorical outcome measures. The CLG discussed the results
and the recommendations were collaboratively agreed upon.
Results
An audit of 60 of the 63 episodes identified to have a discharge
into acute care was completed. Three records were not located
within the auditing time frame and so were excluded. The
results are presented as they pertain to the reason for the
discharge, other stoma related problems during the episode, and
staff type and involvement in ST episodes. Valid responses to the
questions are reported.
Approximately 33.3% of clients had a stoma as their primary
diagnosis (23.7% bowel; 8.5% bladder). The remaining clients
had a stoma as a secondary diagnosis, though a matter for
ongoing investigation by the group was the sizable proportion
of clients with a diagnosis not considered by the ST specialists
to be within their scope of care; namely 30% with suprapubic
catheters. Though the suprapubic catheter represents a surgical
opening for the removal of body waste, this care is overseen
by continence specialists within the agency. A series of nursing
activity codes that have served to improve recording of stoma
care interventions were in place at the time of the audit, but had
not been introduced in time for their inclusion in the episodes,
which were audited.
Reasons for discharge
The vast proportion of discharges into acute care for clients
with a stoma was unplanned (81.7%). The discharge was
rarely identified as being in relation to the client’s stoma or
for a planned reversal and 71.7% of episodes were discharged
for other medical reasons. Though small cell sizes prohibited
statistical analysis of this data, the figures shown in Table 1 do
suggest that a greater number of discharges relating to stoma
matters were planned, compared to the proportion of planned
discharges for other medical conditions.
Planned Unplanned Total
discharge Discharge
Planned reversal % 25.0 - 5.0
of stoma (n=) (3) (0) (3)
Other stoma % 25.0 8.3 11.7
related issue (n=) (3) (4) (7)
Other surgery % 8.3 12.5 11.7
related issue (n=) (1) (6) (7)
Other medical % 41.7 79.2 71.7
condition (n=) (5) (38) (43)
TOTAL % 100.0 100.0 100.0
(n=) (12) (48) (60)
* Valid responses – multiple responses per episode may be
recorded
Table 1. Cross tabulation of the reason for discharge and whether the
discharge was planned or unplanned
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Reference: 1. Postsurgical infections are reduced with specialized nutrition support. Waitberg.
D et al, World Journal of Surgery, (2006) 30:1-13.
Novartis Consumer Health Australasia Pty. Ltd. Australia 327-333 Police Road, Level 2, East Building,
Mulgrave VIC 3170 Australia: 1800 671 628 New Zealand: 0800 607 662 23152

Only 11.7% of clients were discharged into acute care for a stoma
related problem. For these clients, the stoma related problems
that created the greatest need for an acute discharge were an
inability to manage the stoma and skin problems (see Table 2).
Count of % of responses
responses
Cerebral vascular accident 2 4.7
Count of
responses
% of responses
Dehydration 2 4.7
Renal failure 1 2.3
Prolapse 1 10.0
Skin problems 3 30.0
Uncontrolled leakage
of appliance 1 10.0
Inability to manage stoma 4 40.0
Infection 1 10.0
TOTAL 10* 100.0
* Valid responses – multiple responses per episode may be
recorded
Table 2. Stoma problems related to discharge
The specific surgery related problems associated with the
discharge into acute care for seven clients are shown in Table 3.
A variety of surgery related issues were identified.
Table 4 presents the other medical problems related to the
discharge into acute care. There was considerable diversity in
responses identified as ‘other medical problems’, the majority of
which did not fit into the pre-existing categories in the audit tool
and required considerable recoding into meaningful categories.
One third of medical problems remained in the ‘other’ options
as they were unique conditions that did not warrant a category
and did not fit with other items into a more general category.
Count of
responses
% of responses
Wound infection 2 20.0
Wound dehiscence 1 10.0
Bowel obstruction 1 10.0
Sepsis 1 10.0
Development of a fistula 1 10.0
Other surgical problems 4 40.0
TOTAL 10* 100.0
* Valid responses – multiple responses per episode may be
recorded
Table 3. Surgical problems related to discharge
Wound 4 9.3
Peg tube management 1 2.3
IDC/ SPC continence
management 5 11.6
Neurological disorder 1 2.3
Respiratory disorder 5 11.6
Cardiovascular disorder 3 7.0
Renal disorders/ UTI 4 9.3
Diabetes 1 2.3
Other medical problem 14 32.6
TOTAL 43 100.0
* Valid responses – multiple responses per episode may be
recorded
Table 4. Other medical problems related to discharge
Some of the more common medical problems included
problems ‘indwelling catheter and suprapubic catheter (IDC/
SPC) continence management’ and ‘respiratory disorder’ (both
11.6%). A further 9.3% of episodes recorded the discharge into
acute care as being for a ‘wound related matter’ and ‘renal
disorder or UTI’.
Stoma problems experienced during the episode
In addition to recording whether the discharge was related to
the client’s stoma, the audit also reviewed if and what stoma
problems were experienced during the episode.
Of the episodes recorded 36.0% experienced a stoma problem.
Where stoma problems were reported, 58.8/5 were skin
related and 41.2% were related to uncontrolled leakage of the
appliance.
Involvement of ST CNCs in the episode
ST CNCs saw 32.1% of clients during their episode and 93.1% of
clients with a stoma who were discharged into acute care were
discharged by a field (generalist) nurse, with only four clients
discharged by a CNC.
Episodes in which the ST CNC saw the client were more likely
to be episodes where a stoma problem was observed [χ 2 (1) =
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 11

ConvaTec
Ostomy Care
O F
A U S T R A L I A N
S T O M A L
A S S O C I ATI O N
T H E R A P Y
I N C
N U R S E S
The $5000 Elinor Kyte Research Grant
Do you require funding for research?
ConvaTec Ostomy Care is dedicated to enhancing quality of life through providing superior products
with innovative technologies, support and services for clinicians and ostomates. In association with
the Australian Association of Stomal Therapy Nurses Inc, we are proud to provide sponsorship to
the value of $5000 for a research project related to stomal therapy practice.
If you are currently working on a project that requires funding or have an idea but don’t know where
to start, ConvaTec can help.
All AASTN members and NZNOSTS members are eligible to apply and application is easy.
For information please contact your ConvaTec Territory Manager or our award winning ConvaTec
Support Centre on 1800 335 276.

The Elinor Kyte Research Grant
Australian Association of Stomal Therapy Nurses Inc.
Sponsored by ConvaTec ®
For a research project related to stomal therapy practice
The grant (value)
$5000 to fund a research proposal into aspects of stoma management /
care that improves the quality of life of people with stomas (not product
specific).
This grant will be awarded annually to one project as nominated by the
selection committee.
ConvaTec will provide the following ancillary supports (if required):
• Professional liaisons.
• Secretarial support directly related to the research (via ConvaTec
Marketing Department Staff).
• Literature search.
• Assistance with presentation preparation (via ConvaTec).
• Registration at the following year’s AASTN Conference to present findings
of completed research.
Judging panel
• AASTN Executive Members – President, Secretary, Editor
• Marketing Manager ConvaTec
• Member of Education Subcommittee
• Guest member of specific expertise if required e.g. epidemiologist
Selection criteria
Research relating to enhancing the lives of people with stomas as
demonstrated by one of the below.
• Professional issues that further the quality of life of people with stomas.
• Education programme development of professional staff (i.e. nurses or
doctors) that furthers the care of people with stomas.
• Research that focuses on improving quality of life aspects of a person
with a stoma.
• Impact on the rehabilitation process of the client or development of stomal
therapy practice.
For full details contact an AASTN executive (listed on page 2 of this issue),
your ConvaTec Territory Manager or ConvaTec Support Centre on
1800 335 276.
Eligibility criteria
• The applicant must be a practising Full Member of the AASTN or NZNOSTS.
• The grant is NOT to be used as part of the current university study or with
any other research grant from other Corporate Sponsors.
• Research is to be completed within 12 months.
• Beneficiary to present outline of proposal at National Conference Annual
General Meeting.
• Completed research to be submitted to AASTN and/or WCET Journals for
publication.
• Applications must be submitted on the official application form which is
available from the Secretary AASTN or a ConvaTec representative.
• Applications should be submitted to the AASTN Secretary before
31 December for consideration for the following year’s funding.
• Prior approval from employer if utilising data collected from workplace
or ethics approval may be required (Ethics Committee letter attached to
application).
Notification of grant approval
• The judging panel will review the applications. If required outside expertise
will be sought in assisting with the final decision.
• The successful applicant will be notified in writing by February of the
following year with a formal presentation occurring at the following AASTN
Annual General Meeting.
Dispersal of the grant
• ConvaTec will present a cheque to the Executive Treasurer annually, for
dispersal as directed by AASTN Executive.
• The AASTN National Executive will require three monthly written progress
reports of the project.
• Funds will be released in increments, which will be related to the progress
of research; the incremental dispersement will not exceed $2,500.
• ConvaTec will provide registration of the beneficiary to National
Conference in the year the paper is presented providing the material is
presented within two years of its completion.
• The decision of the judging panel will be final.
Elinor Margaret Kyte
Elinor (Elle) Kyte was born 12 March 1930 and began her training as a nurse at the Royal Melbourne Hospital in 1953. Kyte’s interest in stomal therapy
began with the care of her first ostomy patient. This encounter occurred whilst she was working at St Andrew’s Private Hospital in Melbourne in 1959. The
patient’s surgeon was Mr Edward Stuart Reginald (ESR) Hughes, who many came to regard as the ‘Father of Stomal Therapy’ in Australia – Sir Edward
was knighted in 1977 for his services to surgery. Kyte’s commitment to the care of this ostomy patient was recognised by Hughes and he offered her a
position in his professional rooms – a position she took up in 1960. Thus, began a professional journey for Kyte which caused her to become Australia’s
first stomal therapy nurse.
In 1967 Kyte co-authored with Hughes All About an Ileostomy and, in 1969, All About a Colostomy, which was co-authored with Hughes and Cuthbertson.
In 1969 she was the first author on an article titled A post-operative colostomy and ileostomy appliance published in the prestigious Medical Journal of
Australia, and again in 1970 she was listed as the first author with Hughes on an article titled Peristomal skin protection with Orahesive.
This latter report revealed the revolutionary success Kyte and Hughes had achieved with the use of Orahesive bandage as a peristomal skin barrier.
Kyte had first applied the Orahesive bandage to the severely denuded perifistular skin of a young woman on 18 April 1969. The woman’s pain relief and
skin healing was so dramatic that Kyte had no qualms in applying it to the same woman’s peristomal skin ulceration on 9 May 1969. The peristomal results were found to be equally
as good as the perifistular healing.
As the adage goes – the rest is history. The manufacturers, E R Squibb and Sons Pty Ltd, adapted the size of Orahesive bandage from a three to four inch square so that it would fit
under flanges and changed the prefix in the name to Stomahesive in 1970. Kyte’s discovery not only revolutionised worldwide ostomy care, but impacted on wound management
in general.
Kyte’s other significant achievements for advancing stomal therapy nursing included an invitation in 1969 to present a paper at the Royal Society of Medicine’s International Conference
on Proctology in London, she was instrumental in the establishment of the Australian Association of Stomal Therapists in 1971 (renamed the AASTN in 1984) and was elected the first
President of this body and a Life Member in 1984. Kyte’s achievements position her as a nurse leader ahead of her times and rightly affords her the title of the ‘Mother of Stomal Therapy’
in Australia.
Editor
ConvaTec. A Division of Bristol-Myers Squibb Australia Pty Limited. ABN 33 004 333 322. Level 1, 352 Wellington Road, Mulgrave Vic 3170,
Australia. PO Box 63, Mulgrave, Vic 3170. Phone: (03) 8562 1300 Facsimile: (03) 8562 1343. ConvaTec. A Division of Bristol-Myers Squibb
(NZ) Company. AK 86171. Worldwide Tower, Level 8, 8-10 Whitaker Place, Auckland, New Zealand. PO Box 62663, Kalmia Street, Auckland.
Phone: (09) 306 8833 Facsimile: (09) 306 8831.

22.045, p

Risk management in stomal therapy practice
Nola Polmear RN, RM, CHN, STN (Cred) Onc, BCN, BA, MSocSci • Stomal Therapy Department, Royal Hobart
Hospital
*This paper won the 2006-2007 Coloplast National Education Fund senior section
Risk management was developed as an organisational strategy
to deal with problems that might occur, particularly with regard
to technology and the advent of the new millennium or ‘YK2’.
In healthcare it is strongly aligned to the quality improvement
cycle and quality outcomes for patients.
The purpose of this paper is to explain what risk management is
all about, using an example that stomal therapy nurses (STNs)
are familiar with in their practice. That is, the risk that a patient
will proceed to the operating theatre for an impending stoma
without pre-operative siting. Siting is used to demonstrate how
the risk management process can work, to demonstrate the
fluidity of the process, and to act as an incentive to STNs to use
risk management strategies in their practice.
The risk management process has five tiers with communication
and consultation being imperative to the process:
1. Establishing the context of the risk – setting the scene.
2. Identifying risks – what, when, where, why?
3. Analysing risks – consequences and likelihood.
4. Evaluating risks – comparing against standards and setting
priorities.
5. Treating risks – assessing, planning, implementing and
evaluating.
With final consideration given to ongoing monitor and review 1 .
“Risk management … is a holistic management process applicable
in all kinds of organisations, at all levels and to individuals.” 2
Risk management may be applied to specific projects or to
manage specifically recognised areas of risk. It is part of a process
linked with quality improvement and should be continuous and
ongoing. Clinical risk management
...is based on the effective identification, analysis and management
of potential and actual corporate, clinical and organisational risks
and adverse events which are inherent in the provision of health care
services to the community 3 .”
The importance of risk management for STNs lies in the essence
of their clinical practice, that is, the successful restoration of
patients to the community following ostomy surgery. STNs
need to be conscientious in thought and effort in the review
of their practice and the identification and management of
risks that may impinge on the successful rehabilitation of their
patients. Imbued in risk management is the requirement to
search for and deal with organisational problems, their causative
or contributory factors and ways to appropriately reduce the
likelihood of recurrence or consequences of the risk.
We need to move beyond anecdotal clinical experience to be
more explicit when bridging the gap between commonality of
experience and therapeutic interventions that are as accurate,
as safe and as efficacious as possible 4 . The objective of the
Australian Association of Stomal Therapy Nurses Inc (AASTN)
is that STNs “reflect the promotion of quality of care for a wide
range of people with specific needs ” 5 .
Standard 1 – Professional Role and Self Development, states
“The STN fulfils the obligation of the professional role through:
reflective practice, evaluation, practice based assessment tools,
continuous professional development and credentialling” 6 . The
concept is further reflected in the notion that STNs, as advanced
registered nurses, are able to conceptualise their practice and
“use theory, research evidence, observations and experience to
think about practice in a way that considers factors other than
the immediate event or circumstances” 4 . The risk management
process is one... “of continuous improvement that is best
embedded into existing practices” 7 .
Establish the Context
Establishing the context in which the risk management process is
to take place entails a description of internal and external users
of stomal therapy services, developing standards by which to
judge the function and management process, and the structure
on which the project is to be based 1 .
Already established is the commitment of STNs to the provision
of expert care and to function as advanced registered nurse
practitioners. The AASTN Standards of Stomal Therapy Practice
are the embodiment of the STN function and position within the
nursing profession and the healthcare system. STNs provide a
service to their patients; internal to this agency are other nurses,
medical staff, and allied healthcare professionals; external to this
agency are the patients and the wider community.
An STN of many years experience, Pat Blackley states that
satisfactory quality of life for stomal therapy patients is very
much dependent on a new ostomate’s ability to “regain an
acceptable style of living after discharge from hospital” 8 .
Blackley draws our attention to the International Ostomy
Association (IOA) Charter of Rights for people experiencing
ostomy surgery. The Charter states “... all should have a right
to a satisfactory quality of life after their surgery and that this
Charter shall be realised in all the countries of the world” 8 .
Both the AASTN Standards of Stomal Therapy Practice for
STNs Practice and the IOA Charter of Rights for ostomates are
a communication of the need to provide and extract expert care,
and to seek out and prevent risks that may have an adverse
16 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

effect on successful rehabilitation; together they provide the
ground rules for this specialty of healthcare.
Context is established by consultation and communication on
the met and unmet needs of the ostomate. In conjunction with
the goals of the risk management process they provide the
framework for evaluation.
The goals of risk management are:
• Eliminate adverse incidents as far as is practicable.
• Minimise the consequences of risk.
• Manage exposure to risk.
• Improve performance.
• Achieve the levels of compliance and governance required 9 .
Identifying Risks
Risk identification – the what, where, when and why events can
occur – can greatly influence risk management. Methods used to
aid risk identification include:
• Brainstorming.
• Scenario analysis.
• Task analysis.
• Review of past data.
• Audits and physical inspection.
• Key performance indicators.
• Morbidity and mortality reviews.
• Complaints data.
• Clinical incident management and reporting 10 .
General risks associated with post-operative patient recovery
have long been identified and precautionary measures put in
place to treat them, for example thrombosis, wound breakdown
and chest infection. Specific risks to an ostomate could be:
• Progression to theatre without the patient being sited for
impending stoma.
• Delay in stoma assessment and commencement of postoperative
stoma care where STNs are not notified at the
earliest possible time about new cases.
• Stoma construction problems, for example necrosis, retraction
or stenosis.
• Poor bowel care regimen for ostomates commenced on
opioids that could result in constipation or impaction.
• Unsuitable diet served to ostomates post-operatively with
distressing effects such as odour or excessive flatus, or higher
impact such as bowel obstruction.
• Appliance failure.
• Peristomal skin breakdown.
For the purposes of this paper siting has been selected to
exemplify the risk management process. The possibility that
a patient will progress to the operating theatre without being
sited for an impending stoma has been identified as a major risk
to successful rehabilitation of the patient. The IOA Charter of
Rights states:
“People experiencing ostomy surgery shall ... Have a well
constructed stoma placed at an appropriate site and with full
and proper consideration of the comfort of the patient” 8 .
According to Blackley “a well sited stoma is the key to successful
rehabilitation …. (the patient) must be able to resume a normal
life style secure in the knowledge that activities of daily living
will not be interrupted” 11 .
The desirable outcome of stoma siting is the prevention of
problems that can affect successful rehabilitation. In optimal
conditions the patient should approved of the site and the stoma
should be sited so that the patient can easily see the site; can
independently fit the appliance; can wear the appliance for an
appropriate length of time without leakage, odour or effect on
the stoma; the appliance is not visible under normal clothing; the
appliance is comfortable to wear on the preselected site 12 .
Analyse Risks
What is the risk at the Royal Hobart Hospital (RHH) that a
patient will proceed to the operating theatre without being
adequately sited for an impending stoma?
Selecting a suitable risk analysis tool and calculating the level
of clinical risk would expose the likelihood of the risk occurring
(in this case the unsited patient proceeding to theatre) and the
impact and consequences of worst case scenarios, and identify
existing controls. Communication and consultation with key
stakeholders is paramount to the process 13 .
In 1995, colorectal surgeon Mr John Oakley commenced practice
as a consultant at RHH, having previously been a partner at the
prestigious Cleveland Clinic, USA. At his suggestion, and in
answer to the ongoing problem of difficult to manage stomas,
each year for three years a six-monthly audit was conducted
on every patient undergoing bowel stoma formation (the use
of an audit is endorsed as a successful tool in the measurement
of compliance, governance and exposure to risk 9 ). The format
of the audit entailed the use of post-operative photography
to expose problems associated with unsited stomas and the
consequences to ostomate rehabilitation.
Evaluate Risks
The IOA Charter of Rights states that in an ideal situation every
new ostomate would have “... a well constructed stoma placed
in an appropriate site” 8 . The RHH audit process facilitated an
evaluation of the level of risk that patients would proceed to
theatre without siting and also revealed the extent and nature
of the risk in terms of adverse outcomes and the need to set
priorities for these patients. In the first year of the survey 23
patients were unsited from a total 62 patients; in the second
year 22 of 54; and in the third year 28 of 54. The major reasons
given for an unsited adult patient were laparotomy out of hours;
sited but site not used; and emergency surgery due to bleeding
post-bowel resection. The audit revealed not only that a large
number of unsited stomas had been fashioned but that many of
the stomas were poorly constructed 14 .
Some of the unsited stomas were located in skin folds and/or
the patient was unable to see the stoma. In conjunction with
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 17

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poor construction of the stoma patients were unable to remain
independent with their stoma care, discharge was delayed
and costs increased in outlay for additional ostomy products.
Importantly, ostomates who were sited pre-operatively had no
problems with their stoma site.
On completion of the third audit the results of the study were
summarised and presented to the RHH Division of Surgery
medical staff. Mr Oakley commented on the surgical problems
that he recognised and gave advice.
Mr Oakley also advised consultant surgeons and surgical registrars
that all patients admitted for emergency bowel surgery should be
sited for possible stoma formation. The siting should be done in
preference by an STN or, in the absence of an STN, an otherwise
experienced nurse; surgeons should site their own patients preanaesthetic
and, if necessary, on the operating table 14 .
The audit process demonstrated what was acceptable in terms
of patient outcomes and unacceptable major risks of poorly
sited or constructed stomas with consequential adverse effects
on patient rehabilitation.
Treat Risks
At the time of the stoma audit, stoma construction did improve
and siting was remembered. However, in the absence of ongoing
attention to the problem, standards relapsed and the likelihood
of an unsited, poorly constructed stoma again became an issue.
In fully adopting the clinical risk management process STNs
need to develop and implement specific, cost-effective strategies
and action plans for increasing potential benefits and reducing
potential costs 15 .
Like any nurse, STNs are familiar with the nursing process, using
assessment, planning, implementation and evaluation to organise
patient care. The same process works well to treat risks, along with
analysis and evaluation to identify and treat residual risk 1 . A good
example of evaluation and identification of residual risk is the
Audit Nursing Risk Assessment Tool developed by the Pressure
Ulcer Prevention Project Officer at the Austin Hospital, Victoria.
The aim of this audit was to review the usage of the Austin
Health nursing risk assessment tool, a form used on each ward
to evaluate pressure ulcer prevention. The information collected
was used to assist in evaluating the effectiveness, utilisation and
clinical appropriateness of the form 16 .
Simply using the post-operative stoma photography audit with
peer review has insufficiently addressed the risk that patients
will progress to theatre without siting. Controlling risk is better
addressed by developing and implementing policies, standards,
procedures and making physical changes. If STNs do not have
the organisational authority or power to bring about change
from within their practice, it is recommended that there is a
shift of responsibility to another party or higher authority 1 ,
using the chain of command to bring about warranted and
effective change. Listing suggested changes to ensure the siting
procedure was performed would include:
• A stomal therapy orientation package given to all new staff
joining the general surgical team – doctors, nurses, allied
healthcare professionals.
• All medical staff participating in basic surgical training
– registrars, residents, interns attend a mandatory lecture on
the necessity of siting. This practice to be sanctioned by the
Medical Director – Division of Surgery.
• STN education program be advocated at every possible
opportunity to ensure the availability of suitably qualified
staff to provide a service after hours and at weekends, and
that their availability be widely advertised amongst nursing
and medical staff.
• That pre-operative siting be added to the operating theatre
checklist and an audit conducted on compliance with the
checklist.
• Risk management policy and procedure document be written
for the AASTN Education and Professional Sub-committee
to approve and post on the AASTN website.
Once further controls have been instigated the pictorial audit
can be repeated to re-evaluate risk stabilisation.
CONCLUSION
The intention of this paper is to promote risk management
as a meaningful adjunct to quality improvement and realise
positive outcomes for patients following ostomy surgery. Using
the example of pre-operative siting demonstrates the need to
constantly evaluate and re-evaluate procedures, and to measure
and justify the effectiveness of our stomal therapy practice.
REFERENCES
1. Risk Management Guidelines – Companion to AS/NZS 4360:2004
(Handbook). Standards Australia/Standards New Zealand.
Wellington New Zealand. 2004:17.
2. ibid, Risk Management Guidelines:VII.
3. Desk Top Guide to Clinical Risk Management – Toolkit for Managing
Risk in Health Care. Dept of Health Western Australia. 2005:3.
4. Australian Nursing Federation (ANF). Revised Competency
Standards for the Advanced Registered Nurse. Draft, undated:1.
5. Australian Association of Stomal Therapy Nurses Inc (AASTN).
Standards of Stomal Therapy Practice. Draft, 2005:3.
6. ibid, AASTN:7.
7. op cit, Risk Management Guidelines:13.
8. Blackley P. Practical Stoma Wound and Continence Management.
Victoria:Research Publications Pty Ltd. 1998:1.
9. Health Risk Management – Policy and Framework. Western Australia
Public Health System. Feb 2005:3
10. op cit, Desk Top Guide:8.
11. op cit, Blackley:108.
12. op cit, Blackley:112.
13. op cit, Desk Top Guide:11.
14. Hicks S. A Site to be Seen – Striving for Excellence. The Journal of
Stomal Therapy Australia, Sept 2002; 22(3):18.
15. op cit, Desk Top Guide:17.
16. Allen A. Audit Nursing Risk Assessment Tool, M15.21. Austin
Health , Victoria. September 2005.
20 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Right product, right fit
Leonie Cartlidge-Gann
The Person With A Stoma
Ms H, a 64-year-old woman with a loop ileostomy formed
in 1995 for irritable bowel disease (IBS) was referred to me
by the community health social worker for stomal therapy
management due to leakage of effluent underneath her existing
Ileostomy appliance system. Her surgical history included the
formation of a temporary colostomy on three separate occasions
for her IBS.
A loop ileostomy is a temporary stoma formed from the last
section of the small intestine and drains continuously, producing
effluent containing digestive enzymes, which can be corrosive
to the skin 1 . With the formation of an ileostomy, the colon is
bypassed and the body loses its ability to absorb water, salt,
potassium and sodium, leading to fluids and electrolytes being
lost through the stoma 2 . Salt output via an ileostomy is high,
being around one teaspoon per day 2 .
Ms H had a high output Ileostomy draining 2 – 4 litres per day
with the effluent varying from liquid to a mushy consistency and
she displayed clinical signs and symptoms of dehydration and
electrolyte imbalances – severe thirst and muscle cramping.
Shah states that with high volume output ileostomies.. ‘the
electrolyte content of the effluent is replaced volume for volume
with normal saline to approximate the sodium and chloride
content of small intestinal fluid’ 3 .
Ms H refused to seek hospital treatment to help correct fluid
and electrolyte imbalances, due to past negative experiences
when hospitalised, preferring to liaise with her GP for treatment
and be referred to the community health dietitian for dietary
advice. The community health nurse also provided Ms H
with information on potassium and sodium rich foods and
rehydration fluids, such as Gatorade to help replenish sodium
and potassium levels in the body 4 .
Two or three times a day, unpredictable explosive bowel actions
caused dislodgement of the pouching system and usually whilst
on outings. As a result, Ms H felt embarrassed, depressed,
anxious, and suicidal, leading to her becoming socially isolated.
Hence, the community health social worker was providing
support and counselling in an attempt to alleviate some of these
feelings. Feelings of low self-esteem led to Ms H turning to food
for comfort, and she was consuming large amounts of sugary
and high saturated fat type foods.
Ms H reported gaining 19 kg in the last fourteen years and this
was also a contributing factor to her having irregular peristomal
contours.
Description of Peristomal Skin, Abdominal
Plane & Stoma
Ms H had a large, soft, flaccid abdomen and a parastomal hernia.
A moat was evident around the stoma with deep dipping of the
peristomal skin between 3, 6 and 9 o’clock positions observed.
The angle at which the stoma emptied, pointed to a 9 o’clock
position. Hence, peristomal skin breakdown and skin irritation
from leakage of effluent underneath the wafer had occurred
between 8 and 12 o’clock positions. The stoma was red and
moist with a bud formation, and measured 25 x 25 mm with a
good degree of stomal protrusion.
The Clinical Challenge
The clinical challenges identified were 5 :
• To reduce the leakage of effluent underneath the wafer and
protect the skin from corrosive type effluent.
• To create a level pouching surface.
• To improve the adhesion between the skin and pouching
system.
• To minimise dislodgement of the pouching system caused by
explosive bowel actions.
• To extend the wear time of the pouching system.
• To promote self-esteem through developing a secure
pouching system.
• To promote healing of the peristomal skin.
• To encourage compliance with dietary and fluid
modifications.
Considerations In Choosing An Appliance
Over the years Ms H had tried several different types of ileostomy
appliance but found them ineffective for various reasons;
pouches not large enough to contain the high output, wafers
too rigid or inflexible causing discomfort, skin sensitivities to
some products, and the poor adhesive quality of most wafers
shortening wear time.
The required pouching system had to prevent dislodgement
from the skin, prevent undermining of effluent underneath the
wafer, have an extended wear time and minimise the risk of a
wafer causing an allergic skin reaction.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 21

Back in Control,
with confidence.
For many years the Dansac slim-line
barrier has optimised the adhesion
area to give patients greater
confidence. Now Dansac gives your
patients a greater sense of freedom
and comfort, we have created the
new Dansac Novalife 1 piece closed.
Designed to fit better to their body,
providing both comfort and freedom
of movement, making it possible to
dress as they did before and feel
like they are back in control,
w i t h g r e a t e r c o n f i d e n c e .
dansac
For further detailed information
or free samples phone: 1800 331 766
DSK 1012

Reasons For Choosing The Convex Appliance
• ConvaTec’s Surfit - Plus Durahesive® convexity appliance
system was chosen as the unique turtle necking effect of
the wafer ensured a snug fit and secure seal around the
stoma, minimising peristomal skin exposure and promoting
peristomal skin healing.
• Pre-cut size was chosen for ease of use and to further simplify
stoma management.
• The design of the flexible Durahesive convexity wafer
provided appropriate contouring to the abdomen and created
a secure seal.
• The large surface area of the hydrocolloid wafer with the
taped edges reinforced skin adhesion and added security.
• ConvaTec’s high output pouch effectively contained the
large amounts of effluent, preventing the pouch filling too
quickly and thus allowing Ms H plenty of time to reach a
toilet to empty it.
• The tap on the ConvaTec high output drainable pouch
allowed an overnight drainage bag to be attached, which in
turn minimised sleep disturbances by not having to empty
the pouch.
• When changing the wafer, adhesive removers ensure
atraumatic removal of the wafer.
• Before applying a new wafer, a protective film wipe was
applied to improve barrier adhesion, prevent risk of allergic
skin reactions occurring from the wafer and to act as a
moisture barrier.
• Ms H was encouraged to wear an ostomy belt and hernia
support pants for increased security 5 .
References
1. Lyon CC, Smith AJ. 2001, Abdominal Stomas and Their Skin Disorders
– An Atlas of Diagnosis and Management. UK:Martin Dunitz, 2001.
2. United Ostomy Associations of America Inc. Accessed 13 August
2006 www.uoa.org.
3. Shah S. Management of ileostomy and other GI fluid losses, New York:
Kings County Hospital, 2005.
4. University of Michigan, Dehydration Prevention Teaching.
Accessed 10 August 2006 www.med.umich.edu/1libr/aha/
dehydration%20handout.pdf.
5. Hampton BG, Bryant RA. 1992, Ostomies and Continent Diversions
Nursing Management. USA:Mosby Year Book, 1992:31-100.
• The superior adhesive properties of the Durahesive wafer
ensured an extended wear time allowing appliance changes
to reduce to once daily instead of several times daily, creating
a more manageable routine of stoma care for Ms H.
The Outcome
• The ConvaTec Sur-fit convexity appliance provided
a secure pouching system preventing skin irritation and
erosion from the pooling of effluent on the peristomal skin.
• No leakage problems were evident and the peristomal
skin was protected
• The effectiveness of ConvaTec’s Sur-fit appliance system
helped to boost Ms H’s self-esteem, enabling her to develop a
trusting relationship with her stomal therapy nurse and thus
creating a positive learning environment with developing
confidence to self-manage her ileostomy care.
Photo 1 Assessment of stoma and peristomal skin prior to selecting
appropriate appliance.
Hints And Tips
• To create a level pouching system by filling in the moat
to achieve the correct degree of convexity around the
peristomal skin, barrier seals (Eakin Cohesive® Seal) and
paste (Stomahesive® Paste) were applied on the back of the
wafer.
Photo 2 Assessment of abdominal
contours to determine most appropriate
appliance required.
• Prior to applying a new wafer, powder (Stomahesive) was
applied to the broken peristomal skin areas to minimise
further skin damage and to promote healing of the peristomal
skin.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 23

Colorectal Surgical Society of Australia
and New Zealand (CSSANZ)
Scholarship for Stomal Therapy Nurses
Purpose
To foster and further develop the relationship between
the Australian Association of Stomal Therapy Nurses
Inc (AASTN Inc) and CSSANZ. The CSSANZ will
present a scholarship for a novice stomal therapy
nurse (stomal therapy nursing education program
completed within the previous three years) to attend
their annual Spring Meeting. This is an annual award
and will be presented at the AASTN Inc Annual General Meeting.
Photo 3 View of peristomal skin breakdown from an existing ill-fitting
appliance.
Award value
This scholarship will cover registration to the annual CSSANZ Spring
Meeting, economy class airfare and $500 towards accommodation.
Eligibility Criteria
Applicants must:
• Be a full member of the AASTN Inc.
• Be currently registered in the state where they are working and
utilising their stomal therapy nursing skills.
• Have completed an AASTN Inc recognised stomal therapy
nursing education program within the previous three years.
• Be able to attend the Spring Meeting in or outside Australia.
Process
Submit an article suitable for publication in The Journal of Stomal
Therapy Australia (JSTA). The article may be in the form of, but not
limited to:
• A clinical case study
• Research project
• Book review not previously published in JSTA
• Educational poster or teaching tool
• Professional issue pertinent to either specialty
Photo 4 ConvaTec Sur-fit Durahesive two-piece convexity appliance with
high output drainable pouch
The article, plus a completed official application form with a copy
of current nursing registration, must reach the national executive
secretary by 15 May in the relevant year. Contact details for the
secretary can be found in the current JSTA. Application forms are
available from the AASTN Inc executive secretary and AASTN Inc
website www.stomaltherapy.com.
All applications will be reviewed by the judging panel. A decision
will be available and all applicants notified within six weeks. The
judging panel will consist of:
• The Editor, JSTA (or delegate)
• Committee member of the AASTN Inc Education and Professional
Development Subcommittee.
• Nominated member of the CSSANZ
Late applications will not be considered. The scholarship award is
not transferable.
Photo 5 Showing snug fit and secure seal using ConvaTec Sur-fit
Durahesive.
Selection Criteria
The decision of the judges is final and based on the following
criteria:
• Presentation
• Originality
• Appropriateness to stomal therapy nursing and colorectal
surgery
• Demonstrated integration of theory and practice
• Suitability for publication following the JSTA Guidelines for
Authors found in current JSTA.
24 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

NEW
See what Gelling Foam
can do for your patients
New Versiva ® XC
Gelling Foam Dressing,
the only dressing
with The Gelling Foam
advantage, redefining
patient care.
• Designed to protect periwound skin and reduce the risk
of maceration.
• Comforts patients over time whilst the dressing is in situ
and upon removal 1 .
• Offers more for wound management than just a moist
wound environment.
• Gel cushions in a way that only a Gelling Foam dressing can 2 .
Call your local ConvaTec Territory Manager or the ConvaTec Support Centre for further information:
Australia: 1800 335 276 or New Zealand: 0800 441 763
References: 1. A phase II non-comparative study of non-adhesive Versiva ® XC on leg ulcers (N=46). CW-501-04-U331. April 29, 2005. Data on file, ConvaTec.
2. Bishop S. Versiva ® XC Gelling Foam Dressing cushioning and protection claims R&D justification. June 2005. Data on file, ConvaTec.
®/TM The following are trade marks of E.R. Squibb & Sons, L.L.C.: Versiva XC and Hydrofiber. ConvaTec is an authorised user.
©2007 E.R. Squibb & Sons, L.L.C. January 2007. GB-07-354.1
ConvaTec. A Division of Bristol-Myers Squibb Australia Pty Limited. ABN 33 004 333 322. Level 1, 352 Wellington Road, Mulgrave Vic 3170, Australia.
PO Box 63, Mulgrave, Vic 3170. Phone: (03) 8562 1300 Facsimile: (03) 8562 1343. ConvaTec. A Division of Bristol-Myers Squibb (NZ) Limited.
AK 86171. Worldwide Tower, Level 8, 8-10 Whitaker Place, Auckland 1010 New Zealand. PO Box 62663, Kalmia Street, Auckland 1544 New Zealand.
Phone: (09) 306 8833 Facsimile: (09) 306 8831.
www.convatec.com
SEPT 07
ADW005

Beneath the waves
Grant McLaren • Ileostomate since 24 December 2001
After six weeks I was back to work (in Chile at 3,200 m above
sea level) and after nine months I was re-acquainting myself
with running, climbing in the Andes and riding my Harley
around quaint little South American villages and pueblos. I
was extremely fortunate to be strongly on the mend, but one
favourite pastime was still to be conquered – scuba diving!
Prior to the operation, I had been just short of titled ‘fanatical’
as I would dive every weekend in the icy cold depths of the
Humboldt Current that sweeps up the west coast of Chile. I
missed it and longed for the camaraderie of my dive buddies.
The question was out there – when?
Probably like most ostomates, I thought that the world as I knew
it was coming to an end when I had ‘X’ marked on my lower
abdomen and was dutifully told that at that site I was going
to have my small intestine pulled through a perforation in my
body.
It was my first sensation of surreality. At this shattering meeting
with my specialist I was a distant observer trying to fathom
the whole scenario, whilst also physically present. The ‘real’
me was grappling with questions around recovery time, family
and work. The ‘observing’ me was more pragmatic, thinking of
other alternatives, second opinions or even ‘putting it off for a
while’. But the two of me came crashing back together when I
woke after the operation to find the most ugly thing on the face
of the earth hanging out of my lower abdomen – I went into
panic mode.
What about intimacy, longevity, doing all the zany things of
my past – losing friends? The questions repeatedly hammered
through my mind until out of the gloom appeared my STN – a
ray of optimism, care and professionalism. With smiling aplomb,
she managed to dispel all of my immediate fears. We tackled and
nailed all the points of domestic trepidation in quick time and I
was quickly into ‘suck it up and get on with it’ mode – not least
thanks to her motivation and the unwavering support of my
family. Then I was onto solving the puzzle of which parts of my
former life I could return to.
On my twelve-month visit to the specialist I broached the
subject and was given a cautious ‘thumbs up’ to give it a try at
increments of 5 m depth at a time. So, with my long-term dive
buddy we worked out a plan and I instructed him, “...if I bob
up to the surface and my ileostomy bag has blown up and we
are surrounded by flotsam and jetsam then you should swim
for your life!”. Down we went, metre by metre until I was at a
depth of 32 m. All went well and the return to the surface was
uneventful – I was back in the briny depths and loving it!
To date, I have amassed a total of 400+ dives – 50 of those since
my operation; I have since been to the Red Sea, the Galapagos
and Yucatan Peninsula, diving long/short, deep/shallow,
tepid/icy, thick wet suit/Lycra body suit, salt/fresh water, off
rubber duckies/the back of cruise charters/the shore. In every
combination I have had no problems.
I continue to use a standard lead weight, belt. This can be
somewhat uncomfortable, especially when wearing a thin
dive suit and after successive dives – I have decided that
my next buoyancy compensation device (BCD) will have an
integrated weight system.This will also minimise the weight
being manually handled before and after the dive. Care not to
over-exert around the stoma area is required when trying to lift,
say, a 10 kg weight belt from the water into a dinghy, especially
if there is no help in the dinghy. I leave cords tied around a
dinghy/duckie, so that I can tether the belt, BCD and tank, then
retrieve them once in the boat.
The art of climbing back into a dinghy/duckie has to be
somewhat modified so that the stoma is neither dragged across
the gunwale, nor over-exertion transferred to the stoma area.
This can be overcome with a deft twist and roll motion, all of
which makes one look like a harpooned seal floundering on
26 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

ConvaTec
Ostomy Care
Dedicated to enhancing
quality of life
ConvaTec Ostomy Product Accessories
Stomahesive Paste –
Skin protection for a secure seal, preventing
leakage, and for fistula management.
Stomahesive Protective Powder –
a barrier for raw and weeping skin.
Orabase Protective Ointment –
a protective paste that adheres to
weeping skin surfaces.
ConvaCare –
Barrier Wipes provide adhesive control and optimal skin
protection, while Adhesive Remover Wipes help to gently
remove appliances without skin stripping.
ConvaTec Support Centre
Partners in Ostomy Care and Wound Therapeutics
Call your local ConvaTec Territory Manager or ConvaTec Support Centre for further information:
Australia: 1800 335 276 or New Zealand: 0800 441 763
ConvaTec. A Division of Bristol-Myers Squibb Australia Pty Limited. ABN 33 004 333 322. Level 1, 352 Wellington Road, Mulgrave Vic 3170,
Australia. PO Box 63, Mulgrave, Vic 3170. Phone: (03) 8562 1300 Facsimile: (03) 8562 1343. ConvaTec. A Division of Bristol-Myers Squibb (NZ) Limited.
AK 86171. Worldwide Tower, Level 8, 8-10 Whitaker Place, Auckland 1010 New Zealand. PO Box 62663, Kalmia Street, Auckland 1544 New Zealand.
Phone: (09) 306 8833 Facsimile: (09) 306 8831.
SEPT 07
ADO009

one’s back in the bottom of the vessel – to the raucous delight
of dive mates.
Having my stoma and bag visible to my dive friends was
awkward at first, but once they observed that I am capable of
doing everything myself they are unquestionably understanding,
and in true Aussie spirit are there to help if needed. This may
not be the same when diving with strangers, but that scenario
is more often encountered on larger charters – in larger groups
being discreet and not attracting attention can sometimes be
easier. In the tropics, when I dive with a ‘stinger suit’ (lycra), I
use a pliable, skin-coloured, gut belt to gently hold and hide the
stoma area.
Handling my dive gear is a point for careful attention. On
charters I usually have some assistance, but when with my
mates I lug tote bags, tanks and weight belts. All of these are
heavy and require caution against over-exertion, especially with
a light build.
I generally understand the rhythm of my stoma and can predict
when after eating I will next see its output. I plan meal times
where possible and this helps to generally ensure not to arrive
back at the boat looking like a 3 kg puffer fish is trapped under
my wet suit! This is not a physical problem (my one-piece bags
always stay adhered), just one of a bevy of Aussie mates ‘taking
the mickey’.
In summary I hope this information gives new ostomates, who
may be either former or would-be new divers, the courage and
reassurance to scuba dive. Importantly, check with your STN
and/or specialist first, as ostomates vary infinitesimally, but
there are certainly some who are not precluded from diving – I
truly hope that you are one of them – there is a beautiful world
to explore beneath the waves and that is a tonic in itself.
DEVELOPMENT OF STN
DATABASE TOOL
In conjunction with the AASTN Education &
Professional Development Committee, ConvaTec
is currently developing a database tool for use by
stomal therapy nurses.
* Goal: To develop a national standard data
collection tool for stomal therapy nursing.
* Expected Outcomes: A standardised national
tool for stomal therapy nurses to collect data
to support nursing interventions and
promote best practice.
The database was launched in March 2007 at the
AASTN 36 th Annual Conference in Wollongong,
NSW.
Bowel Group for Kids Incorporated
Caring for children with congenital Hirschsprung’s disease
or ano-rectal malformations
2007 Conference ‘Beyond the Horizon’
When: Saturday 20 October 2007
Time: 10.00 am – 3.30 pm
Where: Sydney Children’s Hospital
Lecture Theatre, Level One
High Street, Randwick NSW 2031
Keynote Address – Duncan Armstrong
Genetics & Research – Prof David Croaker
Workshops for parents (and children, depending on
numbers)
Videoconferencing to all eastern seaboard Australian states
and New Zealand
Web: www.bgk.org.au
Email: conf@bgk.org.au
Tel: Julie on 02 9499 8642
28 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

YOU Inc President’s report
March 2006 – Feb 2007
Margaret Allan • President, YOU Inc
Young Ostomates United Inc (YOU) was established in 1989 to
cater for the specific needs and concerns of young ostomates. We
operate from Melbourne, Victoria, Australia, but often handle
enquiries from other places in Australia and even from overseas
via our website.
As in previous years, the YOU group had several gatherings and
meetings during 2006 for the benefit of the members. The year
started with our Annual General Meeting when I assumed the
role of president, and at which a calendar of events for the year
was outlined.
In June 2006, YOU hosted an open forum with Northern
Hospital Ostomy Support Group, providing the opportunity for
all members to come along and share and discuss concerns and
issues relating to a stoma. Approximately forty people of all ages
gathered on the day and lots of discussion ensued. The initial
forum was followed by refreshments, which gave people the
opportunity to talk more informally in small groups.
This was followed in August by a session of ‘YOU Talk’. We hold
this style of meeting from time in an effort to provide a smaller,
more private environment for young people to express and
discuss issues that they are not comfortable voicing in a larger
group. We have found the YOU Talk format to be very valuable
over the years and this one was no different. A wide range of
topics was discussed, like relationships, partners, travelling,
living away from home, the work environment etc. The feedback
on the day was very positive and many of the members gained a
great deal of support and encouragement from the experience.
Again in conjunction with the Northern Hospital Ostomy
Support Group, YOU hosted a community awareness event for
World Ostomy Day on 7 October 2006. This was preceded on
Friday 6 October by an information display in Block Arcade in
the Melbourne CBD where a range of resources and information
relating to stomas, inflammatory bowel disease and cancer were
available. The stand was manned by volunteers and generated a
lot of interest from the community.
On Saturday 7 October, 90 – 100 YOU members and friends
gathered in Brunswick to hear a range of guest speakers
providing information on medical and stomal therapy ostomy
issues from both a local and global perspective. The YOU group
held a fashion parade to demonstrate that ‘ostomate’ does not
necessarily mean ‘fashion victim’; it is possible to be current,
trendy and stylish with a stoma. This helped to allay the fears
of many new members who thought they would need to replace
their whole wardrobe and never be able to wear jeans again!
The World Ostomy Day community awareness presentation was
a very big undertaking for both support groups and demanded
much organisation by the committee formed especially for
the purpose. The feedback on the day and after the event was
extremely supportive and encouraging, with comments like
‘outstanding’ and ‘most impressive and best organised’.
The value of these gatherings cannot be quantified, but whenever
YOU meets socially or more formally for meetings etc, the benefit
to the members is undeniable. At the more formal gatherings it
is often after the formalities that people gather to chat in small
groups where they are comfortable discussing personal issues
and concerns. Many new members gain a great deal from talking
openly with more experienced ostomates about matters that
might not be easily discussed with friends or family – they often
leave smiling and with a lighter step, having discovered that
there is a great deal of life to be lived with a stoma.
In 2006 Coloplast established a competition for each region of
the world to submit a story on their achievements on World
Ostomy Day to win US$2,500.00. So of course we entered! A
narrative was compiled, together with a series of photographs
taken at our community awareness day.
In February 2007 we received notification of $1,000 in funding from
the Department of Human Services (DHS) in Victoria, via their
Health Self-Help Funding Program. The DHS recognises the vital
role self-help groups play in both the health system and community,
and funding is provided to assist groups such as YOU in their
endeavours to support and exchange information with members.
The DHS funding is most welcome and we are currently assessing
the reprinting of many of our YOU brochures and pamphlets,
the cost of which cannot always be met from membership fees
alone. This material is a widely distributed resource that is often
requested by medical, stomal and other health professionals. We
are also planning to produce a more professional journal that
will be distributed to new members as a means of providing
support and encouragement during a challenging time. Our
newest resource ‘Fashion Tips’ (developed in conjunction with
the fashion parade held on World Ostomy Day) will also be
produced in a more professional format for distribution.
YOU also has a well-established visiting service that has been
operating since inception of the support group. The service
aims to ‘match’ people undergoing surgery with well-adjusted
ostomates with a similar background, ie ileostomy, colostomy,
married, single, male, female etc. At times it is not possible to
conduct a personal visit, so much of our ‘visiting’ occurs via
telephone. Fortunately, this fulfils a the function of providing
support and information to the new ostomate and we have
received wonderful feedback from this service. Often the contact
is ongoing, with the internet also being used as a means of
keeping in touch.
Once again it was a big twelve months for the YOU group!
The membership base has grown and attendance at each of
our meetings has increased. A lot of work goes on behind the
scenes of a volunteer organisation such as this and we on the
YOU committee are constantly encouraged by the positive
feedback we receive, with the genuine appreciation and thanks
for the support and services we provide. We hope that in 2007
we can continue to update and expand our resources, share our
knowledge with others, and support both new and existing
members as they travel the path of life as an ostomate.
To contact YOU, visit our website www.vicnet.net.au/~youinc
or contact Helen on (03) 9796 6623.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 29

YOU Inc President’s report
March 2006 – Feb 2007
Margaret Allan • President, YOU Inc
Young Ostomates United Inc (YOU) was established in 1989 to
cater for the specific needs and concerns of young ostomates. We
operate from Melbourne, Victoria, Australia, but often handle
enquiries from other places in Australia and even from overseas
via our website.
As in previous years, the YOU group had several gatherings and
meetings during 2006 for the benefit of the members. The year
started with our Annual General Meeting when I assumed the
role of president, and at which a calendar of events for the year
was outlined.
In June 2006, YOU hosted an open forum with Northern
Hospital Ostomy Support Group, providing the opportunity for
all members to come along and share and discuss concerns and
issues relating to a stoma. Approximately forty people of all ages
gathered on the day and lots of discussion ensued. The initial
forum was followed by refreshments, which gave people the
opportunity to talk more informally in small groups.
This was followed in August by a session of ‘YOU Talk’. We hold
this style of meeting from time in an effort to provide a smaller,
more private environment for young people to express and
discuss issues that they are not comfortable voicing in a larger
group. We have found the YOU Talk format to be very valuable
over the years and this one was no different. A wide range of
topics was discussed, like relationships, partners, travelling,
living away from home, the work environment etc. The feedback
on the day was very positive and many of the members gained a
great deal of support and encouragement from the experience.
Again in conjunction with the Northern Hospital Ostomy
Support Group, YOU hosted a community awareness event for
World Ostomy Day on 7 October 2006. This was preceded on
Friday 6 October by an information display in Block Arcade in
the Melbourne CBD where a range of resources and information
relating to stomas, inflammatory bowel disease and cancer were
available. The stand was manned by volunteers and generated a
lot of interest from the community.
On Saturday 7 October, 90 – 100 YOU members and friends
gathered in Brunswick to hear a range of guest speakers
providing information on medical and stomal therapy ostomy
issues from both a local and global perspective. The YOU group
held a fashion parade to demonstrate that ‘ostomate’ does not
necessarily mean ‘fashion victim’; it is possible to be current,
trendy and stylish with a stoma. This helped to allay the fears
of many new members who thought they would need to replace
their whole wardrobe and never be able to wear jeans again!
The World Ostomy Day community awareness presentation was
a very big undertaking for both support groups and demanded
much organisation by the committee formed especially for
the purpose. The feedback on the day and after the event was
extremely supportive and encouraging, with comments like
‘outstanding’ and ‘most impressive and best organised’.
The value of these gatherings cannot be quantified, but whenever
YOU meets socially or more formally for meetings etc, the benefit
to the members is undeniable. At the more formal gatherings it
is often after the formalities that people gather to chat in small
groups where they are comfortable discussing personal issues
and concerns. Many new members gain a great deal from talking
openly with more experienced ostomates about matters that
might not be easily discussed with friends or family – they often
leave smiling and with a lighter step, having discovered that
there is a great deal of life to be lived with a stoma.
In 2006 Coloplast established a competition for each region of
the world to submit a story on their achievements on World
Ostomy Day to win US$2,500.00. So of course we entered! A
narrative was compiled, together with a series of photographs
taken at our community awareness day.
In February 2007 we received notification of $1,000 in funding from
the Department of Human Services (DHS) in Victoria, via their
Health Self-Help Funding Program. The DHS recognises the vital
role self-help groups play in both the health system and community,
and funding is provided to assist groups such as YOU in their
endeavours to support and exchange information with members.
The DHS funding is most welcome and we are currently assessing
the reprinting of many of our YOU brochures and pamphlets,
the cost of which cannot always be met from membership fees
alone. This material is a widely distributed resource that is often
requested by medical, stomal and other health professionals. We
are also planning to produce a more professional journal that
will be distributed to new members as a means of providing
support and encouragement during a challenging time. Our
newest resource ‘Fashion Tips’ (developed in conjunction with
the fashion parade held on World Ostomy Day) will also be
produced in a more professional format for distribution.
YOU also has a well-established visiting service that has been
operating since inception of the support group. The service
aims to ‘match’ people undergoing surgery with well-adjusted
ostomates with a similar background, ie ileostomy, colostomy,
married, single, male, female etc. At times it is not possible to
conduct a personal visit, so much of our ‘visiting’ occurs via
telephone. Fortunately, this fulfils a the function of providing
support and information to the new ostomate and we have
received wonderful feedback from this service. Often the contact
is ongoing, with the internet also being used as a means of
keeping in touch.
Once again it was a big twelve months for the YOU group!
The membership base has grown and attendance at each of
our meetings has increased. A lot of work goes on behind the
scenes of a volunteer organisation such as this and we on the
YOU committee are constantly encouraged by the positive
feedback we receive, with the genuine appreciation and thanks
for the support and services we provide. We hope that in 2007
we can continue to update and expand our resources, share our
knowledge with others, and support both new and existing
members as they travel the path of life as an ostomate.
To contact YOU, visit our website www.vicnet.net.au/~youinc
or contact Helen on (03) 9796 6623.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 29

WCET report
Carmen George RN Dip App Sci Nsg, Grad Dip Adult Ed, STN (Cred) • World Council of Enterostomal Therapists
International Delegate, South Australia
July 2007 and I have just returned to Adelaide from Jakarta,
Indonesia, where for three months I was joint coordinator of the
inaugural Indonesian Enterostomal Therapy Nursing Course.
The course accepted twenty students from across Java and
one from Sumatra. Many of the students made a significant
commitment to travel considerable distances to Jakarta, leaving
their families for over ten weeks. A prerequisite was that all
students accepted for the course would be able to speak, read
and write English, but no language testing had been done
and there was wide variation in their English language ability,
making the first two weeks very interesting as we settled into
the theoretical component of the course.
An enormous amount of work was done by the Indonesian
Enterostomal Therapy Nurses Association (InEtna) in
establishing the course. Collaboration with the University of
Indonesia through the Indonesian Nursing Care Centre proved
very valuable in gaining course recognition from Indonesia’s
major nursing association, the Indonesian National Nurses
Association (Persatuan Perawat Nasional Indonesia – PPNI), and
in negotiating clinical placements for the students. A business
unit was formed with two of the Indonesian enterostomal
therapy nurses (ETNs) and an administrator, to manage finances
through the collection of donations and sponsorship and the
granting of ‘scholarships’ to the students from the funds raised.
The twinning of Australia and Indonesia through the World
Council of Enterostomal Therapists (WCET) has been highly
successful. I particularly thank all those stomal therapy nurses
(STNs) who donated money, textbooks, WCET memberships
etc to the course and offer very special thanks to Heather Hill,
Sharmaine Peterson and Sandra Bradley who each came to
Indonesia for two weeks, donating their time and considerable
costs to this wonderful venture – their input was crucial.
The world now has twenty-one newly qualified ETNs, but the job
is not finished, as some of them are working in complete isolation
from other ETNs. I would really like to match the twenty-one
graduates with one Australian STN each, who would be willing
to support them in some way. I do not envisage this as a financial
commitment but more as an ‘on line’ support role. If you are
interested in providing support I will be happy to match you with
one of the new graduates, so please contact me.
To other business: The second Asia Pacific Congress being held
in Mumbai in November, is a great opportunity to participate
in regional professional development. We have a much to learn
from our colleagues in the developing countries of this region
and much to contribute.
I would like to remind members to regularly check the WCET
website for updates.
Finally, my role as international delegate to the WCET ends
following the congress in June 2008. If you are interested in this
great job please let me know!
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 31

State reports
Australian Capital Territory
It has been a time of great change in the world of stomal therapy
in the ACT.
Sharon Gibbins has left the cold climes of Canberra and moved
to the sunshine ‘up north’. We wish her all the best in her new
adventures.
Clare Love has moved from Canberra Hospital to community
health and continues to exercise her skills helping the ostomates
in their homes.
Judith Barker has completed her qualifications and is now a
nurse practitioner. She continues to share her time and skills
between the hospital and community settings.
Karen Williams has taken a sea change and moved to the south
coast.
All of these changes have resulted in a re-evaluation of stomal
therapy services in the ACT. There are currently no qualified
STNs working in the major public hospital in Canberra and
this has resulted in a number of quality improvement activities
to best utilise the available services. Watch this space for the
outcomes!
We have had some new associate members join the AASTN, so
we are encouraging them to further their skills and gain formal
qualifications in the exciting world of stomal therapy.
Kellie Burke
New South Wales
The NSW branch continues to meet every second month with
an educational session before each meeting. Instead of having
all the meetings (except December) on Tuesday evenings we
have trialled Wednesday evenings to see if attendance improves.
The next meeting will be held on Wednesday 3 October. The
December meeting is on Friday 7 December to be followed by
Christmas Dinner in a local restaurant in Newtown. All of the
NSW branch meetings are held at Royal Prince Alfred Hospital
commencing at 17:45. For further information about meetings
contact Carol Stott 0402018790.
At the August meeting Dr Julia Thompson spoke about her
recent tour of Southeast Asia lecturing on stomal complications
and colostomy irrigation, and there was general discussion on
the credentialling process. We must encourage as many people
as possible to go through credentialling. Acting as preceptors for
students undergoing STN courses is integral to the role of the
STN and extremely rewarding. Information about credentialling
will be sent out to all NSW branch members with the meeting
minutes, to encourage the credentialling process.
Sadly, Tony Rafferty, president of the Colostomy Association for
almost thirty years, died on 31 July 2007, shortly after retiring
from the association in June. Anne Marie Lyons and Carol
Stott attended the funeral, representing the NSW branch of the
AASTN. Anne Marie additionally represented Concord Hospital
where Tony was a patient over many years. Our sympathy is
extended to Tony’s family.
Carol Stott
Queensland
Stomal Therapy week
Gold Coast
On 2 June an afternoon seminar was held on the Gold Coast for
the first time, to celebrate Stomal Therapy Week, with ostomates
travelling from as far away as Lismore to the Gold Coast Ostomy
Association venue. This Northern Rivers group travelled by
bus and made a day of it, incorporating the seminar with
shopping. The seminar was scheduled to facilitate maximum
attendance (including company reps) and we were thrilled to
have attendance boosted to a total of eighty-five!
Bill Tyrell spoke on his experiences as a country STN, as
president of the AASTN, and on workshops he has conducted
for community and hospital based nurses in the Northern Rivers
region. Elaine Lambie spoke on the challenges experienced by
STNs and nurses generally with changes to hospital management.
Dr Scott McClintock, spoke on ileal conduits and his talk was
most appreciated, it being many years since a urologist has
spoken to this group. Sheryl Waye presented ‘Handy Hints’
and, as always, was well received by the ostomates. The seminar
finished with Bill, Sheryl and Elaine presiding over ‘Question
Time’.
We were also very fortunate to have a ‘pre-launch’ of Nicola
Hamilton’s book Climbing the Ladder of Life. Nicola is an
ileostomate of some ten years and the book is about her
experiences. Nicola’s story is told simply and very openly and
will certainly be an encouragement to others. Climbing the Ladder
of Life will be available in bookshops and via the internet.
Brisbane
The AASTNQ annual educational seminar for ostomates was
held on Brisbane’s Northside on Saturday 16 June as part of
Stomal Therapy Awareness Week and attracted an audience of
ninety-seven. The program included presentations on nutrition,
urostomy care, types of ostomy surgery and an enlightening
presentation on living with a stoma from a young woman’s
perspective.
The trade display was as popular as ever, as was the sumptuous
afternoon tea sponsored by the reps. The Queensland Stoma
Association assisted with the hire costs of the venue and setting
up and arranging audiovisuals. AASTNQ members Maxine
Wench, Petra Prokop, Brenda Sando and Lucy Daniels generously
donated their time to support Shirley Jones with running the
afternoon. Feedback was very positive with overwhelming
support for another seminar next year.
32 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Nurses on the move
We welcome Penny deWinter who has moved from Royal
Adelaide Hospital to Logan Hospital, to take up a position as
stomal therapist and wound manager.
Shirley Jones has resigned from the Royal Brisbane Hospital
to a new position as clinical stomal therapist and wound
management nurse at Northside Health Service District.
Pat Sinasac has resigned from the Mater Public Hospital,
Brisbane and is moving to Toronto, Canada, where she has
enrolled in the International Interprofessional Wound Care
Course at the University of Toronto, under Prof Gary Sibbald.
What a wonderful opportunity!
Diane Cunningham has taken a year’s leave from The Northside
Health Service District to follow her heart and live in Dubai.
Regional news
Caroline Bates from Holy Spirit Northside Hospital has just
completed her graduate certificate in stomal therapy and in July,
shortly after completing the course, she delivered a beautiful
baby girl, Jessica Paige.
Congratulations to Linda Durham from the Mater Public
Hospital in Brisbane who has completed her graduate certificate
in stomal therapy.
The Wide Bay Ostomates Association is moving in the near
future from Bundaberg Base Hospital to off-campus premises
in Bundaberg.
In June, Elaine Lambie became a grandmother to Jaiden.
Cheers,
Helleen Purdy
The $5 from each registration is being donated to a fistula
hospital.
The Royal Adelaide Hospital is again running their stomal
therapy course in 2007. Due to popular demand, another ostomy
resource module was held in late July (the first for the year was
in March) prior to the intermediate module beginning in August.
Several STNs are assisting with the workshops. Congratulations
to course coordinator.
Carmen Smith has recently returned from Indonesia after
facilitating the implementation of a stomal therapy course.
Judging by Carmen’s emails, this was a particularly challenging
but rewarding experience. She was assisted by Sandra Bradley
and Sharmaine Peterson. The AASTN SA Branch donated $500
towards facilitating clinical placements. We look forward to
hearing all about Carmen’s latest adventure.
At our April meeting we celebrated Jill Johnston’s 60th birthday
and our May meeting was attended by guest speaker Dr
Andrew Hunter who presented a very informative session on
colonic stenting.
We are currently planning a quiz night to be held as a fundraiser
in October. Our last was a great success and we are hoping that
this year’s is even better!
I would like to thank outgoing committee member Sue McKay
for her hard work over the last three years as both president and
state representative. Thanks also to our secretary Claire White
and ongoing thanks to Barb Lewis our valued treasurer.
Cheers,
Margie Reid
South Australia
Hello to all from South Australia! This is my first report as state
representative for South Australia.
New committee members are:
President: Wendy Humphreys
Secretary: Lisa Kimpton
Treasurer: Barb Lewis
State Rep: Margie Reid
On 16 June, during Stomal Therapy Week, the SA branch held
a very successful and well attended professional development
program, with excellent education sessions and workshops.
Highlights were from Dr Titus on BOTOX® therapy for urinary
incontinence and there wasn’t a dry eye in the house after a
moving presentation by Charmaine Otto on the plight of obstetric
women with fistulae in Ethiopia. Workshops included those
on developing PowerPoint® presentations, mucocutaneous
separation, aperients and clean intermittent self-catheterisation.
Tasmania
Hello to all from Tasmania! There have been a few changes in
Tassie since the last journal report.
Nola Polmear has resigned from the shared stomal therapy
position at the Royal Hobart Hospital and has commenced
working solely as a breast nurse in the community. The stomal
therapy position is being filled by others in the short-term and
will be filled permanently in due course.
After many years of hard work, Nola has also resigned from the
Education and Professional Development Committee and the
Tasmanian branch extends its thanks and best wishes to Nola in
her new professional endeavours. Nola has been a guiding and
inspirational light to all of us here in Tasmania and we would
like to take this opportunity to publicly thank her for all her
efforts and “Fabulous” inspirational ideas over the years. Nola
will be sorely missed from the committee but will continue to be
an active member of the state branch.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 33

Sue Delanty remains on the Educational and Professional
Development Committee to continue Tasmania’s input into this
important area.
Karen Campbell has resigned her post as a stomal therapy and
breast care nurse in the north-west of Tasmania and relocated
to Royal Hobart Hospital as the gynaecology and oncolocy
cancer care coordinator. Karen will continue in the role of state
president and representative for the state branch. Currently
Tracey Beattie is doing a sterling job as the stomal therapy and
breast care nurse in the north-west and the position will be filled
permanently in the near future.
A paediatric stomas and continence study day was held on Friday
10 August 2007 in the south of the state with attendees from all
over Tasmania and interstate enjoying an extensive program
that included Prof Paddy Dewan speaking on pathophysiology
and surgical/medical procedures and Judy Wells, STN at the
Royal Children’s Hospital, Melbourne, speaking on stomal
therapy management and procedures.
Regards,
Karen Campbell
Paediatric Stomas and Continence – Tasmania Study Day
On Friday 10 August 2007, a fabulous study day on paediatric
stomas and continence was held in Hobart. The day was
organised by the AASTN Tasmania in recognition of the need
for education in this area of stomal therapy, and that it would
be an opportunity to network with like-minded healthcare
professionals, with the possibility of forming a children’s focus
group.
Those attending included locals from Hobart to Launceston
and Burnie on the north-west coast – in fact, almost every
STN employed in Tasmania – and STNs from South Australia,
Victoria and the ACT, as well as other interested Tasmanian RNs
and a smattering of healthcare professionals from disciplines
like dietetics and occupational therapy.
The day was completed by a great trade display (all major
companies represented and their presence genuinely appreciated)
and a sumptuous lunch, catering to all in true Tassie style.
Thanks again to all participants, registrants and company reps
for making it such a memorable day.
Nola Polmear RN, RM CHN, STN Onc, BCN, BA, MSocSci
Victoria
At our AGM held earlier this year, a new committee was
elected:
Helen Nodrum
Margaret Rigoni
Cheryl Prendergast
Celia Haberl
Wendy Sansom
Caroline Harrison
Jenny Davenport
Christine Curley
Lisa Wilson
Gianna Carter
President
Vice-President/State Representative
Secretary
Treasurer
State Education Rep
State Education Rep
Committee member
Committee member
Committee member
Country liaison member
We acknowledge and wish well our friends who have taken up
national executive positions –
Leeanne White
Diana Hayes
Mary Ryan
National President
Journal Editor
Acting Website Coordinator/
Committee member
As you can see the Victorian branch is alive, well and very active
and we will assure the national executive of our full support and
assistance, especially leading up to the AGM in March 2008.
Prof Paddy Dewan, Western Health, Victoria, and Judy Wells,
Stomal Therapy/Continence Nurse, Royal Children’s Hospital,
Melbourne, Victoria, spearheaded the program. Both were
eloquent and well-versed speakers on their varied approaches
to aspects of stomal therapy and continence care. They each
entertained the 45-strong audience for two hours and provided
a wealth of information gathered over many years of experience
working in this very special field of clinical practice.
The main program was complemented by speakers who gave
practical information and advice about the support services
available in Tasmania, such as Wetaway, the Royal Hobart
Hospital (RHH) children’s continence clinic, and the RHH PEG
clinic. Carolynne Partridge RN STN, and parent, gave a heartfelt
presentation advising all healthcare professionals to be honest
in their dealings with parents, particularly when giving ‘bad
news’.
34 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)

Meeting for education
In Victoria we have many new STNs taking up vacated positions
and our meetings aim to provide education. To achieve this we
have changed our meeting format and are meeting more often at
different venues on different nights of the working week.
In March, at our AGM, Jenny Davenport gave a talk on stoma
complications. In May, ConvaTec provided the meeting with an
update on the new START data base program and also provided
the supper – our thanks to Jennifer Knoeteze. In July, Lisa
Connolly spoke on the ‘Complexities of Convexity’, an area of
education we agreed that we all needed! The evening sparked
excellent debate and questions. Our thanks to Hollister, Wendy
and Denise, for providing supper on that night.
In August our meeting was a ‘beauty’ with a mini-conference
held at the Royal Melbourne Hospital, starting at 4.00 pm,
when we were very fortunate to have two colorectal surgeons
speaking – Mr Ian Jones on pre- and post-op fast-track feeding,
and Mr Ian Hayeson laparoscopic formation of stomas. Ms Lisa
Barker, a senior dietician, spoke on evidence based post-op
nutrition therapy.
A strong commitment is to increase our presence and support of
country members and two study days have been scheduled in
this year’s agenda.
Our first conference day was held in Wangaratta, in June,
with a jam-packed program that commenced at 1.00 pm and
concluded at 6.00 pm. Forty-three registrants attended from
surrounding districts and twenty Stomal Therapists and trade
company representatives made the trip from Melbourne.
Coloplast, Dansac, Hollister, Omnigon, ConvaTec and Future
Environmental Services provided the trade displays.
The program ranged from PEG tubes through skincare, basic
stoma care, stoma complications and ileostomy dysfunction to
medications that affect stoma output, urostomy care, and the
effects of chemo/radiation therapy, concluding with a few case
studies.
At the conclusion of the day we held a Victoria Branch meeting
and stayed on for dinner at the conference venue. About fifteen
stayed overnight and the next day enjoyed a lunch just out of
town before heading home.
The enthusiasm, support and energy of all on this day was just
tremendous, and bodes well for our ongoing success as a branch.
Our special thanks to Lynne Nicholson in Wangaratta who was
the catalyst in organising this successful day.
This program from this country study day will be repeated in
Sale on Saturday 13 October starting at 9.30 am and concluding
2.00 pm – once again we are fortunate to have enthusiastic
members in the area and Anne Payne will be our liaison for this
day.
JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3) 35

News updates
A new super clinic has been established in the Melton area for
outpatient/clinic services. Our congratulations and best wishes
go to Cheryl Prendergast on being the successful applicant to set
up and provide the stomal therapy services side of this venture.
She will work Monday am and Tuesdays and Fridays. Referrals
can be made by either GP or treating hospital STN – telephone
9747 7803
Annette Coombs has moved from her position as STN at
Peninsula Private to St John of God Nepean Rehab in Mornington,
and Jeanine Bark (Collard) takes up the role of STN at Peninsula
Private.
It was previously reported that we have not been able to run
a stomal therapy course at Mayfield for the last two years.
I am happy to report that, as I write, very positive talks are
proceeding with Mayfield and a new course coordinator with
a view to revising how the course is offered, making it more
affordable, and streamlining the content. Our plan is to have
it ready by October for presentation to the national education
meeting and available for registration by December, with a
March 2008 starting date. More on this in our next report!
Recently we reluctantly accepted the resignation of Liz Spencer
as an active member of the branch – Liz and Bob are joining the
‘grey train’ to travel around Aussie. Liz has been a 100% active
member of the branch since 1978; a mentor to many of us and
a rock when we have needed stabilising. Liz has travelled from
country to city, attended most of our branch meetings and nearly
every annual national get-together that I can remember since at
least 1984. She is a great friend to many of us and I am sure we
will keep Liz in the branch loop for years to come.
Congratulations to the Hobart branch on their Paediatric Study
Day held in August. Three members from Victoria attended this
very worthwhile day.
We are relieved and very happy to see that the stomal therapy
website is up and running again. I encourage all members to log
on for updates on what is happening in stomal therapy. We are
using the website as a means of letting all branch members know
what we are up too – www.stomaltherapy.com.au.
Our next meeting is on 2 October at 5.30 pm at Cabrini
Hospital, 183 Wattletree Road, Malvern, with a talk on fistula
management.
Our country study day is on 13 October in Sale.
Helen Nodrum
Western Australia
Following our committee meeting in May, we had a very
informative clinical update comprising two presentations. The
first was by Deborah Gordon, CEO of the Continence Advisory
Service in WA, who spoke of the mission of the service to
provide education and training, advice and information, product
advice and access, health promotion and a helpline to people
with bladder/bowel issues, their families, carers, healthcare
professionals and special needs groups. The second speaker was
Irena Nurkic, Acting Senior Physiotherapist, Women’s Health
and Continence, Royal Perth Hospital, who outlined the location
and function of the pelvic floor muscles (PFM) and how they
work to maintain continence and evacuation of the bowel. She
discussed PFM assessment, and exercises and physiotherapy
for bowel dysfunction, and the effects of low anterior bowel
resection on bowel function.
The Stomal Therapy Department at Royal Perth Hospital held
its annual Ostomate Seminar Day on 4 May, with forty-nine
ostomates in attendance. The selection of speakers comprised
STNs, dietician and two surgical registrars and topics covered
included parastomal hernias, reversal procedure and bowel
habit post-reversal, sexuality, the do’s and don’ts of food,
appliance selection, problem solving and the changes to the
appliance scheme. This was a great opportunity for ostomates
to discuss issues related to stoma management and to liaise
with STNs and allied health professionals. Our thanks to the
trade reps who supported the day and were available to discuss
products.
We continue to hold monthly committee meetings and are most
fortunate that our country representative Kate Reid has been
able to attend many of those.
We bid farewell to Tanya Norman who has returned to the UK
with her family. Tanya was a valuable member of our committee
and a past state representative. We wish her well in her future
– no doubt she and her two lovely children will appreciate being
surrounded by close family.
Carmel Boylan
Northern Territory
We continue to enjoy a pleasant winter with cool nights at 15 – 20
degrees Celsius and glorious days around 30 degrees – you have
to visit at this time of year to appreciate it! Our STN membership
and stoma formation remain constant.
Our main focus is the AWMA conference in 2008 and we
are hoping to see a huge attendance by our stomal therapy
counterparts. The conference will be held in the dry season
(May) with beautiful weather like that mentioned above. Since
2008 will be the first year that we do not have an AASTN
conference, we trust that this will free up a lot of STNs to attend
so that we can maintain annual networking with old and new
colleagues alike.
Hope to see you there.
Cheers
Jenni Byrnes
36 JOURNAL OF STOMAL THERAPY AUSTRALIA 2007 27(3)