Quality of life – Quality of Care Judith Weller Venetz Head stoma care nurse University Hospital...

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)


ET nurses DO make a difference to QOL

« 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

Role Competencies

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


08.15 Colleague off sick.

Organisational skills Unexpected events…..stay zen!! Computer skills


09.00 Doctors’ rounds

Teamwork skills Multidisciplinary team Individual roles but mutual collaboration

and respect


09.45 Coffee break

WC break


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


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


12.30 lunch meeting with your manager

Marketing skills keeping statistics writing reports assertiveness skills


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


17.00 Research project questionnaire for patients clinical trial

Research skills literature search via the internet critical reading of research articles


18.00 Continuing education for the ET


20.00 Go home

Look after yourself!

Beware of « burn-out »!! Stress management strategies


Association work

Hungarian ET nurses’ Association

IOA

WCET

E T = Superwoman!!!

www.wcetn.org


A world of expert professional nursing carefor people with ostomy, wound and continence needs.

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.


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.


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


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


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


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.


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


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


WCET Editorial WCET Editorial Advisory BoardAdvisory Board

Articles in languages Articles in languages other than Englishother than English

(plus English translation) (plus English translation)


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


Phoenix, Arizona, USAPhoenix, Arizona, USA

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

www.wcetn.org

Join the World of WCET!Join the World of WCET!


Quality of life – Quality of Care Judith Weller Venetz Head stoma care nurse University Hospital...

Documents

Transcript of Quality of life – Quality of Care Judith Weller Venetz Head stoma care nurse University Hospital...