Soins complexes à domicile pour enfants
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Emptying the bag of the ostomy device

Indications

Frequency

 

Required materials

Refer to your child’s healthcare team if the material or the sequence of steps you have been taught is different than those described.


Step 1: Anticipation

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Summary:

Collaborate and form a team with your child. When you invest the time to form a strong team, children feel more comfortable and less anxious – this will help you complete the care with less stress – for you and your child.

Use these tips, from the start, to set the stage for a positive care procedure:

  • Create the right moment: integrate the care in a routine.
  • Alert your child to the needed care and communicate together.
  • Form a team with your child: Encourage autonomy by offering realistic choices such as the method of distraction. Stay tuned to your child. Manage pain and anxiety, using distraction and positioning for comfort.

Step 2: Preparation

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Summary:

  • Prepare the environment: Identify a routine place for care. Close windows, doors and fans. Wash and dry the work surface and gather the needed materials for the care and to distract your child.
  • Prepare your child: Get help if needed. Position your child for comfort to receive the care and start to use the selected distraction method.
  • Prepare yourself: Find the right time when you are ready to provide the care safely. Review the list of care steps. Wash your hands.

Now that you are ready to start the care procedure, take the opportunity to encourage and praise your child.

Step 3: Procedure

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Summary 3 key concepts:

  • Safety: Carefully follow the care practice steps as you have been taught.
  • Flexibility: Be ready to adjust according to your child’s reactions during the procedure. As needed, reposition or select an alternative distraction strategy. Follow your child’s pace and rhythm.
  • Collaboration: Reassure your child, verbally and non-verbally. Acknowledge your child’s emotions and reactions. Help your child differentiate between the different sensations during a procedure.

Step 4: Position your child

  • Place your child in one of the positions discussed with your healthcare team, according to age, ability to cooperate and comfort.
  • As soon as your child is able, place your child on the toilet seat.
  • If your child is older, your child may prefer sitting or standing in front or beside the toilet.
Why ?

This step makes the care easier.

Step 5: Open the bag

  • Direct the bag towards the toilet or container.
  • Put a piece of toilet paper on the surface of the water in the toilet.
  • If your child is lying down, put a towel or some other protection between your child and the bag.
  • Hold the bag, folding the bottom portion to keep the opening turned upwards.
  • For a bag with integrated closure:
    • Open the bag by unrolling the closure.
    • Put pressure with your thumb and your index finger on each side of the rigid part of the end of the bag in order to open it.

 

  • For a bag with a clasp:
    • Open the bag by removing the clasp.
    • Keep the clasp nearby.
    • Fold over the edges of the end of the bag about 2-3 cms.

 

Why ?

This step helps avoid splashing of the bag contents, and keeps the materials clean, thus making the next steps easier.

Step 6: Empty the bag

  • Unfold the bottom of the bag, pointing the tip of the bag downwards and let the contents flow into the toilet or container.
  • Help empty the stool out of the bag, by sliding your fingers down the sides of the bag to push everything out.

Step 7: Clean the opening of the bag

  • Wipe the opening of the bag with toilet paper.
  • Clean inside as far as you can with toilet paper or a damp washcloth.
  • The manufacturers do not recommend using soap to clean the inside of the bag. The soap may reduce the ability of the bag to control odors.
Why ?

This step helps diminish odors and helps keep the outside of the bag clean.

Step 8: Drain the air from the bag

Slide your fingers down the outsides of the bag to empty out as much air as possible, before closing.

Why ?

This step helps to diminish odors and leakage from the bag. It also ensures that the bag can be closed  more easily and fits better under clothing.

Step 9: Close the bag

  • Unfold the edge of the bag, then:
  • For a bag with an integrated closure:
    • Roll or fold the edge of the bag according to the manufacturer’s instructions.
    • Press firmly on the closure so that the seal is waterproof.
  • For a bag with a clasp:
    • Put the clasp in place about 3 cm from the tip of the bag.
    • Do not fold the bag more than once.
    • Gently pull on the bottom of the bag to see that it is securely attached.
Why ?

This step stops stool from leaking out of the bag.

Step 10: Check the seal of the skin barrier

  • Check the skin barrier portion of the ostomy appliance. There should be a tight seal of the skin barrier device to the skin of the stomach all around stoma.
  • Change the ostomy collection device if you notice any of the following:
    • Skin barrier is not well attached.
    • There is leakage around the skin barrier or collection bag.
    • The skin around the stoma appears irritated.
    • Your child reports pain or burning around the ostomy site.

Why ?

This step helps to identify quickly if there is any leakage around the stoma and thus prevent any skin irritation there.

Step 11: Recovery

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Summary:

The treatment is finished. Wash your hands again.

Be prepared to recognize the challenges faced and to provide positive feedback. Help your child recognize his/her strengths. Acknowledge the collaborative teamwork.

  • Listen to what your child says about the parts of the procedure that were difficult or painful.
  • Comfort your child and recognize your child’s collaboration with positive feedback.
  • Highlight your child’s  specific strengths that helped make the procedure positive.
  • Discuss with your child what might be done the same or differently the next time the care is needed.
  • Keep your promises if you have promised a reward, follow through.
  • Reward yourself too.

https://complexcareathomeforchildren.com/enterostomy-care/emptying-the-bag-of-the-ostomy-device/

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