Page 7 - CANADIAN URINARY DIVERSIONS POSITION STATEMENT

The role of the interprofessional team
Practitioners should strive to work within an Surgeons, NSWOC and urology nurses should
interprofessional team involving an NSWOC, seek to coordinate long-term surveillance of
urology nurse, physician, and other allied the patient to address complications early
health professionals to support the patient and promote independent living.† Enhancing
and significant others. patient recovery after urostomy surgery is
described in Table 3.
Nurses with knowledge, skills, and judgment
in ostomy care conduct the majority of Approaches examining nurse-led ostomy care
preoperative site markings. The Canadian team interventions in patients with an ileal
Society of Colon and Rectal Surgeons (CSCRS) conduit demonstrate reduced ostomy-related
and Nurses Specialized in Wound, Ostomy complications and improved self-efficacy level
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and Continence Canada (NSWOCC) position and health-related quality of life (HRQOL).
statement on preoperative stoma site marking The involvement of significant others provide
in colostomy and ileostomy acknowledged psychological support to the patient after
the benefit of nurses notifying surgeons if the surgery. Patients and significant others are
marking was difficult or placed in an unusual encouraged to attend quarterly ostomy
area. Surgeons may need to adjust the support groups.
planned diversion in the operating room after
such discussion with marking of alternative Note. Throughout the position statement “†”
stoma site options. Abridged preoperative has been chosen to represent expert opinion
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marking steps are considered in Table 2. of the task force.

Using evidence-based approaches, Enhanced
Recovery After Surgery (ERAS) engages the
patient in their care with an interprofessional
team, whose advanced knowledge develops
pathways to decrease patients’ surgical stress
response, optimize their physiologic function,
and facilitate recovery.

Position Statement Takeaways
1. Utilize the Ottawa decision tool to assist your applicable patients in choosing
between an ileal conduit and neobladder.
2. Evaluate patient urostomy self-care skills with the Urostomy Education Scale
in Table 4.
3. Refer to Table 1 for a quick reference guide to the five urinary diversions.
4. Follow the preoperative site marking steps in Table 2.
5. Adopt the enhanced recovery checklist for an ileal conduit to standardize patient
care and education shown in Appendix B.

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