CASTOMized project: a new comprehensive collaborative approach between case manager and stoma care nurse

Area of Science:

• Colorectal Surgery
• Surgical Nursing
• Patient Pathways

Background:

• Enhanced Recovery After Surgery (ERAS) pathways are increasingly adopted but face challenges with ostomy management.
• Ostomy adaptation is a critical, yet often difficult, aspect of ERAS in colorectal surgery.

Purpose of the Study:

• To evaluate the effectiveness of a novel patient pathway integrated into the ERAS protocol.
• To assess the impact of advanced practice nurse involvement in ostomy patient care pathways.

Main Methods:

• Retrospective observational study of 99 patients undergoing colorectal surgery with stoma formation (Jan-Dec 2023).
• Two clinical nurse specialists integrated interventions and pathways for ostomy care.
• Reviewed patient management, adherence to ERAS, hospital stay, and post-discharge outcomes.

Main Results:

• High adherence (95.9%) to the new stoma care pathway was observed.
• Median hospital stay was 11 days (IQR 9), with 91% discharged home.
• 98% adherence to ERAS nursing care items; 15% experienced high-output stoma, with only 3% re-admission.

Conclusions:

• Integrating ostomy patient care pathways with advanced practice nurses enhances ERAS protocol effectiveness.
• The new pathway facilitated high adherence and positive outcomes for colorectal surgery patients with stomas.