Gather equipment: gloves, skin prep packet, colostomy appliance measured to fit stoma properly (if new surgical stoma, it will continue to shrink with the healing process; use stoma measuring guide), skin barrier, warm water and soap, face cloth/towel, plastic bag for disposal of old equipment. Remember that bowel is very fragile; also, working near bowel increases peristalsis, and feces and flatulence may be expelled.
| Do | Do Not |
|---|---|
| 1. Remove old appliance carefully, pulling from area with least drainage to area with most drainage. | 1. Tear appliance quickly from skin. |
| 2. Wash skin area with soap and water. | 2. Wash stoma with soap; put anything dry onto stoma. |
| 3. Observe skin area for potential breakdown. | 3. Irritate skin or stoma. |
| 4. Use packet of skin prep on the skin around the stoma; allow skin prep solution to dry on skin before applying colostomy appliance. | 4. Put skin prep solution onto stoma; it will cause irritation. |
| 5. Apply skin barrier you have measured and cut to size. | 5. Make opening too large (increases risk of leakage). |
| 6. Put appliance on so that the bottom of the appliance is easily accessible for emptying (e.g., if client is out of bed most of the time, put the bottom facing the feet; if client is in bed most of the time, have bottom face the side); picture-frame the adhesive portion of the appliance with 1-inch tape. | 6. Have appliance attached so client cannot be involved in own care. |
| 7. Put a few drops of deodorant in appliance if not odor-proof. | 7. Use any materials that would irritate bowel. |
| 8. Use clamp to fasten bottom of appliance. | |
| 9. Talk to client (or communicate in best way possible for client) during and after procedure. | 9. Avoid conversation/eye contact. |
| 10. Use good hand-washing technique. | 10. Contaminate other incisions. |