Quality of life Quality of Care

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Quality of life Quality of Care

• Judith Weller Venetz
• Head stoma care nurse
• University Hospital of Lausanne
• and
• Domiciliary care nursing service, County of Vaud
• Switzerland

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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)

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Quality of life Quality of Care

• ET nurses DO make a difference to QOL

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 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

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 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.

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 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.

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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

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Montreux study

• Factors not relevant to QOL
• age
• sex
• nationality
• social status
• type of stoma
• underlying pathology

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Montreux study

• The ostomates QOL is linked to the stoma care
  he/she receives
• QOL depends on three main factors
• (in order of importance)
• The quality of the relationship with the ET
• The overall care received from the whole health
  care team
• The confidence in the pouching system and
  independence in its use

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Wound Care

• 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

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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

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Quality of life Quality of Care

• A day in the life of an ET nurse
• Role
• Competencies

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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

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A day in the life of an ET nurse....2

• 08.15 Colleague off sick.
• Organisational skills
• Unexpected events..stay zen!!
• Computer skills

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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

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A day in the life of an ET nurse....4

• 09.45 Coffee break
• WC break

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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

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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

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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

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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

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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

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A day in the life of an ET nurse....10

• 18.00 Continuing
• education
• for the ET

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A day in the life of an ET nurse....11

• 20.00 Go home
• Look after yourself!
• Beware of  burn-out !!
• Stress management strategies

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A day in the life of an ET nurse....12

• Association work
• Hungarian ET nurses Association
• IOA
• WCET

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E T Superwoman!!!
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Quality of life Quality of Care

www.wcetn.org
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A world of expert professional nursing carefor
people with ostomy, wound and continence needs.
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What is WCET?

• Since 1975, WCET is
• a unique global non-profit organization
• Ongoing education activities
• Scholarships NNG Foundation
• Twinning Project
• Biennial congress (even years)
• Journal
• BullETin
• Website www.wcetn.org
• And more!

• Who we are
• Members
• IDs
• Executive Board
• Central Office
• Executive Director

A w rld of expert professional
nursing care for peole with ostomy, wound, and
continence needs.
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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.
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WCET Mission

• To lead the global advancement of specialised
  professional nursing care for people with ostomy,
  wound or continence needs.

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
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WCET Vision

• To ensure specialised nursing care is available
  worldwide for all people with a need for wound,
  ostomy or continence care.
• To provide nurses worldwide with access to
  ostomy, wound or continence specialty education.
• Recognition as the global organisation for
  ostomy, wound or continence care providers
• Identification as the global leader in the
  specialty of ostomy, wound or continence care. 

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
32
WCET Core Values

• Respect - for the dignity and individual
  diversity of all persons
• Integrity - adherence to a recognised code of
  ethics
• Communication fostering collaboration between
  members, non-members, and organisations
• Holistic care - incorporating care for body, mind
  and spirit
• Scientific approach - advancement of research and
  evidence-based specialised education and care
•  
•  

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
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Education Committee

• Setting guidelines for ETNEPs and WCET-REPs
  worldwide
• Providing assistance to develop ETNEPs and REPs
• Reviewing the programmes submitted for WCET
  recognition
• Providing information on educational resources
  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.
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Norma N. Gill Foundation Committee

• Administration of 5 types of scholarship
• WCET annual membership fee scholarship (20
  5900HUF)
• Congress Travel scholarship
• ETNEP/REP scholarship
• General scholarship for onsite training in an
  emerging country
• Educational materials scholarship

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
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Norma N. Gill Foundation Committee

• Twinning
• Project

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
36
Publications and Communications Committee

• Responsible for all the WCET publications other
  than the WCET Journal and the BullETin
• Website www.wcetn.org
• WCET brochures, country reports, etc.

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
37
Constitution Committee

• Ensures that the existing WCET Constitution
• facilitates the ease of operation of the
  organisations affairs
• complies with Charities Commission requirements
• Reviews the existing Constitution and submits
  recommendations for amendments
• New constitution approved in 2008 in Slovenia

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
38
WCET Editorial Advisory Board

• Responsible for
• Publication of the Journal
• Acquiring articles for the Journal
• Reviewing and editing submitted articles
• Mentoring and assisting authors
• Editing journal supplements
• Promoting the WCET Journal

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
39
WCET Editorial Advisory Board

• Articles in languages other than English
• (plus English translation)

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
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18th Biennial Congress of the WCET

•                      
• June 12th 16th 2010
• In partnership with the
• Wound, Ostomy and Continence Nurses Society
  (WOCN)
• of the USA

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.
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Phoenix, Arizona, USA
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WCET Membership Benefit

• When you join the WCET one of the benefits is a
  discount on the WCET Biennial Congress
  registration fee !
• Join now! The registration discount will more
  than cover your joining fee!
• 2010 WCET Congress - Phoenix, Arizona

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Join the World of WCET!
Expand Your Horizons!

• www.wcetn.org

A w rld of expert professional
nursing care for people with ostomy, wound, and
continence needs.