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

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