Julie is 5 days post colectomy with ileostomy (subtotal). She has had an uneventful recovery and the consultant would like to discharge Julie home in the next 2 days.

Devise a discharge plan for Julie including:

A health education plan to teach Julie about how to change her stoma bag (think about the skills you will use when teaching her)

• Talk through procedure of changing stoma as you do it. Explain to Julie what you are doing and why.
• At first demonstrate each step of the skill then allow Julie to do it under your guidance.
• Show equipment, i.e. stoma bags
• How to prepare stoma bag and phalange to be placed on skin
• Clean skin with warm water and a soft cloth
• Use skin preparation if advised by stoma nurse
• Apply phalange and bag

Follow up appointments, with whom

• Consultant
• Stoma nurse

Community support

• Stoma nurse
• District nurse
• GP
• Pharmacist
• What products you would need to organise for Julie to take home with her 
• Phalanges
• Stoma bags
• Specific skin sprays or creams
• Stoma kit

Information on where to get further ostomy supplies from

• Stoma nurse
• Pharmacist

Showering or bathing

• To shower rather than bath as in a bath you soak and wound can go soft

Skin care

• Keep skin around site clean and dry
• Make sure the phalange is cut to correct size to prevent leakage on to skin
• Use specific creams or spray to protect the skin

Sexual relations

• To recommence when she feels able to
• Ensure bag empty so is does not fall off

Wound care and removal of sutures

• Observe wound for redness or opening up
• Keep dry and clean; maybe send dry dressings home
• Ensure clothes not rubbing on site
• District nurse referral to check wound
• Sutures to be removed at approx. 10/12 days by district nurse or at GP