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Registration Number: {{org_field_registration_no}}

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Stoma Care and Management Policy

1. Purpose This policy outlines {{org_field_name}}’s commitment to ensuring the safe and effective management of stomas for the people we support. The policy aligns with CQC regulations, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and best practices in stoma care as recommended by the National Institute for Health and Care Excellence (NICE). It ensures that stoma care is provided in a way that promotes dignity, independence, and person-centred care.

2. Scope This policy applies to all healthcare professionals, nursing staff, care assistants, and any other team members at {{org_field_name}} who are involved in providing care for individuals with a stoma. It covers the assessment, daily management, monitoring, emergency procedures, and ongoing support required for effective stoma care.

3. Principles of Stoma Care

• Dignity and Respect: Ensuring that stoma care is delivered with sensitivity and discretion.
• Person-Centred Care: Recognising that each individual has unique needs and preferences.
• Hygiene and Infection Control: Adhering to strict hygiene protocols to prevent infections.
• Competency and Training: Ensuring that all staff involved in stoma care are trained and assessed for competency.
• Monitoring and Prevention of Complications: Regularly assessing for issues such as skin irritation, leakage, or infection.

4. Stoma Types and Considerations There are different types of stomas that staff may encounter. Each requires specific care:

• Colostomy: Opening from the large intestine, producing semi-solid or solid stool.
• Ileostomy: Opening from the small intestine, producing liquid stool.
• Urostomy: Opening for urinary diversion, bypassing the bladder.
• Staff must understand the differences and adjust care procedures accordingly.

5. Stoma Assessment and Initial Care

• Upon admission, individuals with a stoma must undergo a comprehensive assessment conducted by a qualified nurse.
• A personalised stoma care plan is developed, including preferred stoma products and individual needs.
• Skin integrity around the stoma is assessed to prevent breakdown or irritation.
• People we support and their families are given the opportunity to discuss concerns, preferences, and any special requirements.

6. Daily Stoma Care Procedures

• Hand Hygiene: Staff must wash hands thoroughly and wear gloves before and after stoma care.
• Bag Emptying: Carers assist individuals in emptying the bag when it is one-third full to prevent leakage.
• Bag Changing: Stoma appliances must be changed as per the individual’s care plan or when leakage occurs.
• Cleaning the Stoma: The area around the stoma should be cleaned with warm water and patted dry; soap or alcohol-based wipes should not be used unless prescribed.
• Assessing Skin Integrity: Checking for redness, rashes, or signs of pressure damage and reporting concerns promptly.
• Ensuring Proper Fit: The stoma bag should fit securely to avoid leakage and discomfort.

7. Administering Medication via Stoma

• Some individuals may require medication through their stoma; this must only be administered under guidance from a healthcare professional.
• Liquid medications are preferred to prevent blockage.
• Any changes in absorption or effectiveness must be monitored and discussed with the GP or pharmacist.

8. Preventing and Managing Stoma Complications Common complications and management include:

• Skin Irritation: Ensure proper cleaning, use of prescribed barrier creams, and correct appliance fitting.
• Leakage: Address immediately by assessing the fit of the stoma appliance and changing it if necessary.
• Parastomal Hernia: Identify bulging near the stoma site, provide support belts, and refer for further assessment if needed.
• Blockage (for ileostomy/colostomy): Monitor for reduced output, abdominal pain, or swelling. Encourage fluids and a well-balanced diet.
• Infection: Look for redness, swelling, pain, or discharge and escalate concerns promptly to a nurse or GP.

9. Promoting Independence and Supporting the People We Support

• Individuals should be encouraged to manage their own stoma care wherever possible.
• Training sessions and stoma support groups should be offered to enhance confidence.
• Staff should respect the privacy of individuals and offer emotional support.
• Assistance should be provided in a discreet and non-intrusive manner.

10. Training and Staff Competency

• All staff providing stoma care must undergo specialist training in stoma management.
• Competency assessments must be conducted annually or as needed.
• Only trained and authorised staff are permitted to handle stoma appliances and provide direct stoma care.

11. Record-Keeping and Documentation

• Daily Log: All stoma care interventions, including bag changes and skin assessments, must be documented.
• Incident Reporting: Any adverse event, leakage, or infection must be reported to the Registered Manager immediately.
• Care Plans: Each individual must have an updated stoma care plan, reviewed regularly.

12. Family and People We Support Involvement

• Families and individuals are encouraged to take part in stoma education sessions.
• Open communication should be encouraged to address any concerns or preferences.
• Access to external stoma nurse specialists should be provided where needed.

13. Emergency Procedures

• Severe Skin Breakdown: Immediate referral to a healthcare professional.
• Blockage or No Output: Encourage fluids, light massage, and seek medical advice if symptoms persist.
• Excessive Bleeding from Stoma Site: Immediate referral to a GP or emergency services.
• Prolapsed or Retracted Stoma: Seek urgent medical attention.

14. Related Policies

• CH11-Safe Care and Treatment Policy
• CH18-Risk Management and Assessment Policy
• CH21-Medication Management and Administration Policy
• CH23-Lone Working and Staff Safety Policy
• CH27-Staff Supervision, Training, and Development Policy
• CH30-Equality, Diversity, and Inclusion Policy

15. Policy Review

• This policy will be reviewed annually or sooner if CQC regulations or best practices change.
• Amendments will be made to ensure continued compliance with regulatory and clinical guidelines.
• Regular audits will be conducted to monitor quality and effectiveness.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.