Patients who have colostomies have lost the ability to pass feces from their rectum, due to this nurses have to learn how to provide colostomy care. One of the things a nurse should know about providing colostomy care is how to change a colostomy bag. Many of the jobs assigned to nurses are not glamorous, but someone has to provide these services to help patients in need. The colostomy is a surgical process that can be irreversible or reversible depending on the unique situation of each patient. Nurses help to make a difference in the lives of patients who require the insertion of a stoma through a process known as a colostomy.
What is a Colostomy & How to Change a Colostomy Bag
A colostomy is a procedure that allows patients an alternative manner in which to rid their bodies of feces. Patients undergo a colostomy when their colon has been removed or a section of the colon requires a time to rest while it heals. The surgical procedure uses the healthy end of the colon or large intestine to form a stoma. The colon or intestine is pulled through an incision in the abdomen and held in place by a surgical suture. Patients may undergo a double barrel colostomy, loop colostomy, or end colostomy.
A colostomy bag is used to collect the flatus and feces from the patient’s stoma. The waterproof bag sticks on the patient’s abdomen so bathing and showering are not a problem. Patients can either have a stick-on type or strap-on type colostomy bag. The most commonly used type of colostomy bag is a stick-on type because it is the more comfortable of the two bags.
Steps on How to Change a Colostomy Bag
- Wash hands before beginning the procedure.
- Gather the necessary materials to change a colostomy bag. The materials include soap, stoma paste, washcloth, colostomy clamp, razor, scissors, and stick-on colostomy bag.
- Gently wash around the stoma using a warm soapy washcloth. Pat the area dry after cleaning. The washing process helps the bag stick and keeps the area around the incision sanitary.
- Using the razor, shave the hair within two inches of the stoma. This process alleviates a great deal of the pain caused from removing the sticky bag, and this process is done for sanitation reasons.
- Look inside the box containing the new colostomy bag. Use the cardboard holes on the box to size the wax according to the particular that will be stoma used. Select the one that fits snuggly around the patient’s stoma.
- Use scissors to cut away the extra wax at the end of the colostomy bag. The cardboard can be used as a guide if needed.
- Carefully remove the adhesive and place the colostomy bag around the opening of the stoma. Use a thin layer of stoma paste around the outer edges of the wax to seal out any type of moisture. Using too much stoma paste may prevent the wax from sticking properly.
- Clamp the open area near the bottom of the colostomy bag. The opening on the bottom of the bag makes cleaning and emptying easy, but it must remain clamped in between these times to prevent leaking of the contents.
Video on How to Change a Colostomy Bag
Tips on Changing a Colostomy Bag
- Always start with clean hands before changing a colostomy bag. Starting with clean hands prevents the spread of infection.
- Make sure the area around the stoma is completely dry before sticking on the bag.
- Never change a colostomy bag after a meal because the stomach does not retract back to size if the bag is reattached when the belly expands.
- Shave the area around the stoma for sanitary reasons.
- Wash hands after changing the bag.
Complications on Changing a Colostomy Bag
There are a relatively low number of complications that can arise from changing a colostomy bag. Patients can experience pain when the wax bag is removed, causing minor skin irritations on the area around the stoma. Infections can set in if the area around the stoma is not cleaned properly before apply the adhesive. The colostomy bag may leak if not properly clamped during and after the changing process.
Nursing clinical skills cover a wide range of duties and responsibilities. The changing of the colostomy bag is usually quick and easy. Nurses should always wear sterile gloves when performing this task so that they prevent the possible spread of infection in the facilities. The process of changing a colostomy bag is not one of the favorite jobs of nurses, but it is necessary to help their patients perform a body function that they are unable to do permanently or temporarily.