Colostomy Care 

Purpose: 

To keep the resident free of odor and to prevent skin excoriation. 

Policy: 

Residents with a colostomy or ileostomy will have ostomy care provided with changes in the ostomy wafer. Ostomy care will be provided by a licensed nurse. 

Procedure: 

1. Gather Equipment: 

• Gloves 

• Ostomy appliances 

• Basin 

• Washcloth 

• Towel 

• Protective agent (if applicable) 

2. Removal: 

• Remove the old colostomy bag, wafer and discard them properly. 

3. Cleansing: 

• Cleanse around the ostomy site with soap and water. 

• Rinse thoroughly and then pat the area dry. 

4. Evaluation: 

• Evaluate the area for the presence of redness, irritation, or any broken skin areas. 

• Document any abnormalities and inform the attending physician if necessary. 

5. Protection: 

• Apply a protective agent to the area if applicable and as per physician's orders. 

6. Application of New Appliance: 

• Apply the new ostomy appliance following the instructions provided by the manufacturer. 

• Ensure the appliance is secure and the area is clean and dry to prevent leakage and skin irritation. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the procedure, including the resident’s response and any observations of skin condition, in their medical record. 

• Note any changes in the condition of the skin around the ostomy site. 

• Regularly review and update techniques for colostomy care according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper colostomy care procedures to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.