Post on 25-Dec-2015
Quality of life – Quality of
Care
Judith Weller Venetz
Head stoma care nurseUniversity Hospital of Lausanne
andDomiciliary care nursing service, County of Vaud
Switzerland
Quality of life – Quality of Care
ET nurses DO make a difference to QOL
A day in the life of an ET nurse Role Competencies
The World Council of Enterostomal Therapists (WCET)
« A stoma is for life » Barbara
Wade
Comparison of 12 districts in the UK with an ET nursing service 12 districts without an ET nursing service.
Questions to patients at 10 weeks and 1 year post-operatively about
Self-care Appliance problems Satisfaction with appliance Extent and severity of physical symptoms Social constraints QOL
Wade B. A Stoma is for Life. Scutari Press 1989
« A stoma is for life » Barbara Wade
Ten weeks after surgery,
better outcomes if ET nurse involvment (better informed, better self care, more family involvement, fewer « accidents »)
BUT BUT having access to a ET was not significantly related to QOL,
social constraints or psychological adjustment
WHY? Is the ET less important than other factors? (age, length of
illnesss before operation, physical state, permanence of stoma, underlying pathology, sex, marital status,).
It is difficult to identify criteria solely attributable to nursing care.
« A stoma is for life » Barbara
Wade
One year post-operatively
In the ET districts, the ET nurse was seen as the major source of potential help for stoma care. The family doctor was consulted less often than in the non-ET districts.
40% of the patients in the ET districts had sought help with their stoma during the previous 6 months - against 21% of patients in the non-ET districts.
Montreux study
7910 patients
Questionnaire completed by patients just after the operation 3 months after the operation 1 year after the operation
Analysis by external statisticians
CORCE (Convatec Ostomy Resource Centre Europe) 1995.
Supplement to Eurostoma. Winter 1995/1996; vol 13
Montreux study
Factors not relevant to QOL : age sex nationality social status type of stoma underlying pathology
Montreux study The ostomate’s QOL is linked to the stoma care
he/she receives
QOL depends on three main factors : (in order of importance)
1. The quality of the relationship with the ET2. The overall care received from the whole
health care team3. The confidence in the pouching system and
independence in its use
The greater the involvement both directly and indirectly of an ET in the management of wounds, the greater the savings and the shorter the healing times.
Harris C, Shannon R An innovative Enterostomal Therapy nurse model of community wound care
delivery. A retrospective cost-effectiveness analysis.
J Wound Ostomy and Continence Nursing. 2008 ; 35(2) : 169 - 183
Wound Care
Study of 344 wounds cared for by ET nurses and 464 wounds cared for by staff nurses over an 18 month period in South Florida.
36.3% of the wounds cared for by staff nurses healed 78.5% of the wounds cared for by ET nurses healed
BUT
Average number of visits by staff nurses : less than 17 Average number of visits by ET nurses : 31.6
Arnold N, Weir D. Retrospective analysis of healing in wounds cared
for by ET nurses versus staff nurses in a home setting. J Wound Ostomy and Continence Nursing. 1994 ;21 (4): 156 - 160
Wound Care
A day in the life of an ET nurse....1
06.20 Get up early for urostomy and ileostomy patients
Clinical skills ET nursing is 51% practical and 49% the
helping relationship
A day in the life of an ET nurse....2
08.15 Colleague off sick.
Organisational skills Unexpected events…..stay zen!! Computer skills
A day in the life of an ET nurse....3
09.00 Doctors’ rounds
Teamwork skills Multidisciplinary team Individual roles but mutual collaboration
and respect
A day in the life of an ET nurse....5
10.00 Pre-operative visit with a patient and his family
Counselling/communication skills neuro-linguistic programming systemic theory sexuality religious and cultural differences
Stoma siting
A day in the life of an ET nurse....6
11.30 Meeting with a delegate from a pharmaceutical company
ethical issues (www.eucomed.org: Code of business practice. Eucomed guidelines on interactions with healthcare professionals)
stock management
nurse prescribing? – legal issues
A day in the life of an ET nurse....7
12.30 lunch meeting with your manager
Marketing skills keeping statistics writing reports assertiveness skills
A day in the life of an ET nurse....8
14.00 give a course to… nurses, doctors, pharmacists, medical students, student nurses, ambulance drivers, physiotherapists, ostomy visitors, general public… etc. etc. etc.
Offer to organise and give courses
Educational skills Presentation skills Audio-visual techniques Adult learning theory
A day in the life of an ET nurse....9
17.00 Research project questionnaire for patients clinical trial
Research skills literature search via the internet critical reading of research articles
A day in the life of an ET nurse....11
20.00 Go home
Look after yourself!
Beware of « burn-out »!! Stress management strategies
What What isis WCET? WCET?
Since 1975, WCET is Since 1975, WCET is a unique global non-profit organization a unique global non-profit organization
Ongoing education activities Ongoing education activities Scholarships NNG FoundationScholarships NNG Foundation Twinning ProjectTwinning Project Biennial congress (even years)Biennial congress (even years) JournalJournal BullBullETETinin Website Website www.wcetn.orgwww.wcetn.org And more!And more!
A w rld of expert professional nursing care for peole with ostomy, wound, and continence needs.
Who we are:
• Members • IDs • Executive Board• Central Office• Executive Director
International Delegates(ID)
Represent their country
Vote on behalf of their country members at the General Meeting held during Congress
Link between the Executive Board and their country members
The ID for Hungary is Julianna Czupi
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET MissionWCET Mission
To lead To lead thethe global advancement of global advancement of specialised professional nursing specialised professional nursing
care for people with ostomy, care for people with ostomy, wound or continence needs.wound or continence needs.
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET VisionWCET Vision
To ensure specialised nursing care is available worldwide for all people withTo ensure specialised nursing care is available worldwide for all people with a a need forneed for wound, ostomy or continence wound, ostomy or continence care.care.
To provide nurses worldwide with access to ostomy, wound or continence To provide nurses worldwide with access to ostomy, wound or continence specialty education.specialty education.
Recognition as the global organisation for ostomy, wound or continence care Recognition as the global organisation for ostomy, wound or continence care providersproviders
Identification as the Identification as the global leader in the specialty global leader in the specialty ofof ostomy, wound or ostomy, wound or continencecontinence care. care.
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Core ValuesWCET Core Values
Respect - for the dignity and individual diversity of all personsRespect - for the dignity and individual diversity of all persons
Integrity - adherence to a recognised code of ethicsIntegrity - adherence to a recognised code of ethics
Communication – fostering collaboration between members, non-members, and Communication – fostering collaboration between members, non-members, and organisationsorganisations
Holistic care - incorporating care for body, mind and spiritHolistic care - incorporating care for body, mind and spirit
ScientificScientific approach - advancement of research and evidence-based specialised approach - advancement of research and evidence-based specialised education and careeducation and care
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Education CommitteeEducation Committee
Setting guidelines for Setting guidelines for ETNEPs*ETNEPs* and WCET- and WCET-REPs*REPs* worldwideworldwide
Providing assistance to develop ETNEPs and Providing assistance to develop ETNEPs and REPsREPs
Reviewing the programmes submitted for WCET Reviewing the programmes submitted for WCET recognitionrecognition
Providing information on educational resources Providing information on educational resources relevant to ET nursing relevant to ET nursing
*ETNEP: Enterostomal Therapy Nursing Education Programme*REP: Recognised Education Programme
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Norma N. Gill Norma N. Gill FoundationFoundation CommitteeCommittee
Administration of 5 types of scholarship:Administration of 5 types of scholarship:
WCET annual membership fee scholarship (£20 = WCET annual membership fee scholarship (£20 = 5’900HUF)5’900HUF)
Congress Travel scholarshipCongress Travel scholarship
ETNEP/REP scholarshipETNEP/REP scholarship
General scholarship for onsite training in an emerging General scholarship for onsite training in an emerging countrycountry
Educational materials scholarshipEducational materials scholarshipA w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Norma N. Gill Norma N. Gill Foundation CommitteeFoundation Committee
Twinning Twinning
Project Project
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Publications and Publications and Communications Communications CommitteeCommittee
Responsible for all the WCET publications Responsible for all the WCET publications other than the other than the WCET Journal and the WCET Journal and the BullBullETETin: in:
Website Website www.wcetn.orgwww.wcetn.org
WCET brochures, country reports, etc.WCET brochures, country reports, etc.
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
Constitution CommitteeConstitution Committee
Ensures that the existing WCET Constitution Ensures that the existing WCET Constitution facilitates the ease of operation of the facilitates the ease of operation of the
organisation’s affairs organisation’s affairs complies with Charities Commission requirementscomplies with Charities Commission requirements
Reviews the existing Constitution and submits Reviews the existing Constitution and submits recommendations for amendmentsrecommendations for amendments
New constitution approved in 2008 in SloveniaNew constitution approved in 2008 in Slovenia
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Editorial WCET Editorial Advisory BoardAdvisory Board
Responsible for:Responsible for:
Publication of the JournalPublication of the Journal Acquiring articles for the Journal Acquiring articles for the Journal Reviewing and editing submitted articlesReviewing and editing submitted articles Mentoring and assisting authorsMentoring and assisting authors Editing journal supplements Editing journal supplements Promoting the WCET JournalPromoting the WCET Journal
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Editorial WCET Editorial Advisory BoardAdvisory Board
Articles in languages Articles in languages other than Englishother than English
(plus English translation) (plus English translation)
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
June 12th – 16th 2010June 12th – 16th 2010
In partnership with the In partnership with the
Wound, Ostomy and Continence Nurses’ Society (WOCN) Wound, Ostomy and Continence Nurses’ Society (WOCN)
of the USAof the USA
18th Biennial Congress 18th Biennial Congress of the WCETof the WCET
A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.
WCET Membership BenefitWCET Membership Benefit
When you join the WCET one of the When you join the WCET one of the benefits is a discount on the WCET benefits is a discount on the WCET Biennial Congress registration fee ! Biennial Congress registration fee !
Join now! The registration discount Join now! The registration discount will more than cover your joining fee!will more than cover your joining fee!
2010 WCET Congress - Phoenix, 2010 WCET Congress - Phoenix, ArizonaArizona