Transcript An instrument to measure quality of care of a stoma

Quality of life –
Quality of Care
Judith Weller Venetz
Head stoma care nurse
University Hospital of Lausanne
and
Domiciliary care nursing service, County of Vaud
Switzerland
Quality of life – Quality of Care
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ET nurses DO make a difference to QOL
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A day in the life of an ET nurse
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Role
Competencies
The World Council of Enterostomal Therapists
(WCET)
Quality of life – Quality of Care
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ET nurses DO make a difference to QOL
« A stoma is for life »
Barbara Wade
Comparison of
12 districts in the UK with an ET nursing service
12 districts without an ET nursing service.
Questions to patients at 10 weeks and 1 year post-operatively about
 Self-care
 Appliance problems
 Satisfaction with appliance
 Extent and severity of physical symptoms
 Social constraints
 QOL
Wade B. A Stoma is for Life. Scutari Press 1989
« A stoma is for life »
Barbara Wade
Ten weeks after surgery,
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better outcomes if ET nurse involvment (better informed, better self care,
more family involvement, fewer « accidents »)
BUT
BUT having access to a ET was not significantly related to QOL, social
constraints or psychological adjustment
WHY?
Is the ET less important than other factors? (age, length of illnesss before
operation, physical state, permanence of stoma, underlying pathology, sex,
marital status,).
It is difficult to identify criteria solely attributable to nursing care.
« A stoma is for life »
Barbara Wade
One year post-operatively
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In the ET districts, the ET nurse was seen as the major source of potential
help for stoma care. The family doctor was consulted less often than in the
non-ET districts.
40% of the patients in the ET districts had sought help with their stoma during
the previous 6 months - against 21% of patients in the non-ET districts.
Montreux study
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7910 patients
Questionnaire completed by patients
 just after the operation
 3 months after the operation
 1 year after the operation
Analysis by external statisticians
CORCE (Convatec Ostomy Resource Centre Europe) 1995.
Supplement to Eurostoma. Winter 1995/1996; vol 13
Montreux study
Factors not relevant to QOL :
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age
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sex
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nationality
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social status
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type of stoma
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underlying pathology
Montreux study
The ostomate’s QOL is linked to the stoma care he/she
receives
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QOL depends on three main factors :
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(in order of importance)
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The quality of the relationship with the ET
The overall care received from the whole health care
team
The confidence in the pouching system and
independence in its use
Wound Care
The greater the involvement both directly
and indirectly of an ET in the management
of wounds, the greater the savings and
the shorter the healing times.
Harris C, Shannon R
An innovative Enterostomal Therapy nurse model of community wound care delivery.
A retrospective cost-effectiveness analysis.
J Wound Ostomy and Continence Nursing. 2008 ; 35(2) : 169 - 183
Wound Care
Study of 344 wounds cared for by ET nurses and 464 wounds
cared for by staff nurses over an 18 month period in South
Florida.
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36.3% of the wounds cared for by staff nurses healed
78.5% of the wounds cared for by ET nurses healed
BUT
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Average number of visits by staff nurses : less than 17
Average number of visits by ET nurses : 31.6
Arnold N,Weir D.
Retrospective analysis of healing in wounds cared
for by ET nurses versus staff nurses in a home setting.
J Wound Ostomy and Continence Nursing. 1994 ;21 (4): 156 - 160
Quality of life – Quality of Care
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A day in the life of an ET nurse
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Role
Competencies
A day in the life of an ET
nurse....1
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06.20 Get up early
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for urostomy and ileostomy patients
Clinical skills
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ET nursing is 51% practical and 49% the helping
relationship
A day in the life of an ET
nurse....2
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08.15 Colleague off sick.
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Organisational skills
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Unexpected events…..stay zen!!
Computer skills
A day in the life of an ET
nurse....3
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09.00 Doctors’ rounds
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Teamwork skills
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Multidisciplinary team
Individual roles but mutual collaboration and respect
A day in the life of an ET
nurse....4
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09.45 Coffee break
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WC break
A day in the life of an ET
nurse....5
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10.00 Pre-operative visit with a patient and his
family
Counselling/communication skills
 neuro-linguistic programming
 systemic theory
 sexuality
religious and cultural differences
Stoma siting
A day in the life of an ET
nurse....6
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11.30 Meeting with a delegate from
a pharmaceutical company
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ethical issues (www.eucomed.org: Code of business
practice. Eucomed guidelines on interactions with healthcare
professionals)
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stock management
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nurse prescribing? – legal issues
A day in the life of an ET
nurse....7
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12.30 lunch meeting with your manager
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Marketing skills
keeping statistics
 writing reports
 assertiveness skills
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A day in the life of an ET
nurse....8
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14.00 give a course to… nurses, doctors, pharmacists, medical
students, student nurses, ambulance drivers, physiotherapists, ostomy
visitors, general public… etc. etc. etc.
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Offer to organise and give courses
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Educational skills
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Presentation skills
Audio-visual techniques
Adult learning theory
A day in the life of an ET
nurse....9
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17.00 Research project
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questionnaire for patients
clinical trial
Research skills
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literature search via the internet
critical reading of research articles
A day in the life of an ET
nurse....10
18.00 Continuing
education
for the ET
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A day in the life of an ET
nurse....11
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20.00 Go home
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Look after yourself!
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Beware of « burn-out »!!
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Stress management strategies
A day in the life of an ET
nurse....12
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Association work
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Hungarian ET nurses’ Association
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IOA
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WCET
E T = Superwoman!!!
Quality of life – Quality of Care
www.wcetn.org
A world of expert professional
nursing care
for people with ostomy, wound and
continence needs.
What is WCET?
Since 1975, WCET is
a unique global non-profit organization
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Ongoing education activities
Scholarships NNG Foundation
Twinning Project
Biennial congress (even years)
Journal
BullETin
Website www.wcetn.org
And more!
Who we are:
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Members
IDs
Executive Board
Central Office
Executive Director
rld of expert professional nursing care for peole with ostomy, wound, and continence needs.
International Delegates(ID)
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Represent their country
Vote on behalf of their country members at the General
Meeting held during Congress
Link between the Executive Board and their country
members
The ID for Hungary is Julianna Czupi
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Mission
To lead the global advancement of
specialised professional nursing care
for people with ostomy, wound or
continence needs.
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Vision
To ensure specialised nursing care is available worldwide for all
people with a need for wound, ostomy or continence care.
To provide nurses worldwide with access to ostomy, wound or
continence specialty education.
Recognition as the global organisation for ostomy, wound or
continence care providers
Identification as the global leader in the specialty of ostomy, wound
or continence care.
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Core Values
Respect - for the dignity and individual diversity of all persons
Integrity - adherence to a recognised code of ethics
Communication – fostering collaboration between members, nonmembers, and organisations
Holistic care - incorporating care for body, mind and spirit
Scientific approach - advancement of research and evidence-based
specialised education and care
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Education Committee
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Setting guidelines for ETNEPs* and WCET-REPs*
worldwide
Providing assistance to develop ETNEPs and REPs
Reviewing the programmes submitted for WCET
recognition
Providing information on educational resources
relevant to ET nursing
*ETNEP: Enterostomal Therapy Nursing Education Programme
*REP: Recognised Education Programme
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Norma N. Gill
Foundation Committee
Administration of 5 types of scholarship:
WCET annual membership fee scholarship (£20 = 5’900HUF)
Congress Travel scholarship
ETNEP/REP scholarship
General scholarship for onsite training in an emerging country
Educational materials scholarship
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Norma N. Gill
Foundation Committee
Twinning
Project
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Publications and
Communications Committee
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Responsible for all the WCET publications other than
the WCET Journal and the BullETin:
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Website www.wcetn.org
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WCET brochures, country reports, etc.
rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Constitution Committee
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Ensures that the existing WCET Constitution
 facilitates the ease of operation of the organisation’s affairs
 complies with Charities Commission requirements
Reviews the existing Constitution and submits recommendations
for amendments
New constitution approved in 2008 in Slovenia
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Editorial
Advisory Board
Responsible for:
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Publication of the Journal
Acquiring articles for the Journal
Reviewing and editing submitted articles
Mentoring and assisting authors
Editing journal supplements
Promoting the WCET Journal
rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Editorial
Advisory Board
Articles in languages
other than English
(plus English translation)
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
18th Biennial Congress
of the WCET
June 12th – 16th 2010
In partnership with the
Wound, Ostomy and Continence Nurses’
Society (WOCN)
of the USA
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Phoenix, Arizona, USA
WCET Membership Benefit
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When you join the WCET one of the
benefits is a discount on the WCET
Biennial Congress registration fee !
Join now! The registration discount will
more than cover your joining fee!
2010 WCET Congress - Phoenix, Arizona
Join the World of WCET!
www.wcetn.org
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rld of expert professional nursing care for people with ostomy, wound, and continence needs.