Diseases of the Colon & Rectum

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Diseases of the Colon & Rectum:
doi: 10.1097/DCR.0000000000000044
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Systematic Review of Educational Interventions for Ostomates

Phatak, Uma R. M.D.1,2; Li, Linda T. M.D.3; Karanjawala, Burzeen M.D.1; Chang, George J. M.S., M.D.4; Kao, Lillian S. M.S., M.D.1,2,5

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BACKGROUND: Stoma-related complications lead to increased hospital length of stay and readmissions. Although education of new ostomates is widely recommended, there is a lack of data regarding effective evidence-based educational interventions to prevent or decrease these complications.

OBJECTIVE: The aim of this study was to systematically review the literature for educational interventions for new ostomates designed to decrease stoma-related complications.

DATA SOURCES: PubMed was searched for studies on educational interventions for new ostomates.

STUDY SELECTION: Studies were included if they were in English, targeted adult stoma patients, and evaluated an educational intervention at the time of stoma creation.

INTERVENTION: Educational interventions were performed.

MAIN OUTCOME MEASURES: The outcomes of interest were length of stay, complications, and readmissions.

RESULTS: We found 1706 articles of which 7 met the inclusion criteria. Two were randomized controlled trials, and the rest were cohort studies. The overall quality of the studies was low. Each study used a unique intervention. However, all incorporated a specialized colorectal or ostomy nurse. Of the 5 studies that evaluated length of stay, 2 found a reduction in length of stay associated with the intervention, but 3 found no difference. Two studies found a reduction in complications, but 2 found no difference. Of the 3 studies that evaluated readmissions, none found a difference in the intervention group compared with the control group.

LIMITATIONS: This study is limited by the search of a single database and the inclusion of only English language studies.

CONCLUSION: Education is a key component of patient care; however, evidence to support an improvement in clinical outcomes is lacking. Further study is needed by the use of rigorous designs to craft a feasible educational intervention that will lead to improved patient care and outcomes.

© 2014 The American Society of Colon and Rectal Surgeons


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