General Nursing (RGN)
Care of a Stoma and Changing of a Stoma Pouch
Nursing care of a patient with a stoma, including assessment of the stoma and surrounding skin and appropriate pouch management.
Purpose
- Maintain stoma function and cleanliness.
- Protect the skin around the stoma.
- Prevent leakage and infection.
- Promote patient comfort and independence.
Indications
- Patient with an established stoma.
- Pouch is full or leaking.
- Pouch requires routine replacement.
- Peristomal skin requires assessment.
Equipment
- Appropriate stoma pouch
- Clean gloves
- Waste receptacle
- Warm water and appropriate cleansing materials
- Measuring guide where required
- Skin protection products where indicated
Procedure steps
- Explain the procedure and provide privacy.
- Perform hand hygiene and put on appropriate gloves.
- Assess the stoma and surrounding skin.
- Gently remove the existing pouch.
- Dispose of the used pouch appropriately.
- Clean the stoma and surrounding skin gently.
- Measure the stoma when required.
- Prepare the new pouching system.
- Apply the pouch securely while protecting surrounding skin.
- Dispose of waste, remove gloves, perform hand hygiene and document care.
Precautions
- Avoid unnecessary trauma to the stoma.
- Observe for abnormal colour, bleeding or swelling.
- Protect peristomal skin from moisture and effluent.
- Use the appropriate pouch size.
- Report significant abnormalities.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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