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Stoma Care Policy

1. Purpose

The purpose of this policy is to ensure that individuals requiring stoma care receive safe, dignified, and effective support. {{org_field_name}} is committed to providing high-quality stoma care that maintains comfort, promotes independence, and minimises health risks. This policy aligns with Care Inspectorate Scotland regulations, NHS Scotland guidelines, and Scottish Social Services Council (SSSC) Codes of Practice to ensure compliance and best practices in stoma care.

2. Scope

This policy applies to all employees, agency staff, volunteers, and healthcare professionals involved in the care and support of individuals with a stoma. It covers:

• Types of stomas and their specific care requirements.
• Effective hygiene and infection control procedures.
• Best practices in stoma appliance management and changing techniques.
• Managing complications and escalating concerns to healthcare professionals.
• Providing emotional and psychological support.
• Staff training and competency requirements.

3. Related Policies

• Infection Prevention and Control Policy
• Health and Safety Policy
• Medication Management Policy
• Dignity and Respect Policy
• Risk Assessment and Management Policy
• Confidentiality and Data Protection Policy

4. Legal and Regulatory Compliance

{{org_field_name}} ensures compliance with the following legislation and regulatory standards:

• Health and Social Care Standards (Scotland) 2018 – Ensuring person-centred and rights-based care.
• Care Inspectorate Scotland Guidelines – Maintaining high standards in regulated care services.
• Scottish Social Services Council (SSSC) Codes of Practice – Outlining responsibilities for professional care practice.
• Health Protection Scotland Infection Prevention and Control Guidance – Reducing infection risks in care settings.
• Adults with Incapacity (Scotland) Act 2000 – Protecting individuals who lack decision-making capacity.
• The Equality Act 2010 – Preventing discrimination in healthcare provision.

5. Understanding Stoma Care

5.1. Types of Stomas

A stoma is a surgically created opening in the abdomen that allows waste to exit the body. The main types of stomas include:

• Colostomy – Brings a section of the large intestine (colon) to the surface of the abdomen.
• Ileostomy – Brings the small intestine (ileum) to the surface of the abdomen.
• Urostomy – Diverts urine away from the bladder to an external pouch.

Each type of stoma requires specialised care, including appropriate appliance management and monitoring for complications.

6. Hygiene and Infection Prevention in Stoma Care

6.1. Best Practices in Infection Control

• Always perform hand hygiene before and after stoma care.
• Use personal protective equipment (PPE) when necessary, such as gloves and aprons.
• Clean the stoma site using warm water and dry with a soft cloth – avoid harsh soaps or alcohol-based wipes.
• Dispose of used stoma bags and related materials in line with waste management protocols.

7. Stoma Appliance Management

7.1. Changing Stoma Bags

• Ensure the individual is comfortable and in a well-lit, private environment.
• Remove the existing bag carefully to avoid skin irritation or damage.
• Clean the stoma site gently with warm water and pat dry.
• Apply a barrier cream or protective wipes if needed to prevent skin irritation.
• Fit the new stoma bag securely, ensuring a leak-proof seal.
• Record any observations regarding the stoma’s condition, including colour, swelling, or unusual output.

7.2. Identifying and Managing Common Stoma Issues

• Leakage – Check for poor adhesion and ensure the correct stoma bag size is used.
• Skin irritation or redness – Ensure gentle cleaning and apply protective barriers.
• Bleeding – Minor bleeding is normal, but persistent or heavy bleeding requires medical attention.
• Blockages – Watch for symptoms like abdominal pain, reduced output, and nausea; escalate concerns to a healthcare professional.

8. Supporting Emotional and Psychological Well-Being

• Individuals with a stoma may experience anxiety, embarrassment, or reduced confidence.
• Provide reassurance and emotional support, encouraging open discussions about concerns.
• Promote independence in stoma management where possible, ensuring people we support have access to educational resources.
• Offer peer support group recommendations for individuals who wish to connect with others in similar situations.

9. Risk Management and Escalation Procedures

• Staff must immediately report any signs of infection, severe pain, unusual stoma appearance, or lack of output.
• If a stoma appliance fails repeatedly, escalate the issue to a district nurse or stoma care specialist.
• Emergency support must be sought via NHS 24 (111) or emergency services (999 or 112) if an individual experiences:
  • Severe abdominal pain.
  • Complete blockage or lack of output for more than 24 hours.
  • Signs of dehydration, fever, or excessive bleeding.

10. Staff Training and Competency

• All staff involved in stoma care must receive specialist training.
• Annual competency assessments will be carried out to ensure ongoing compliance with best practices.
• Training will include:
  • Practical stoma care handling.
  • Recognising complications and infection control.
  • Maintaining dignity and providing emotional support.
  • Safe disposal of stoma waste materials.

11. Documentation and Record-Keeping

• Daily logs must record any changes in the condition of the stoma.
• Any adverse incidents, such as leakages, skin issues, or discomfort, must be documented and reported.
• Care plans must be updated following changes in stoma management or individual health status.

12. Policy Review

This policy will be reviewed annually or sooner if required due to legislative updates, Care Inspectorate feedback, or operational needs. Any amendments will be communicated to all staff.

For further details, please contact {{org_field_nominated_individual_first_name}} {{org_field_nominated_individual_last_name}}, Nominated Individual at {{org_field_name}}.

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