Ostomy Order Set

COMMUNITY HOSPITALS AND WELLNESS CENTERS

OSTOMY ORDER SET

1. Preoperative teaching

Urostomy Colostomy Ileostomy

2. Preoperative marking of stoma

yes no

3. Postoperative teaching

Urostomy Colostomy Ileostomy

4. May follow up in the outpatient ostomy clinic six weeks after discharge for new ostomy patients

5. POUCH CHANGE as follows:

1. Cleanse skin with water, pat dry, cut or mold appliance to fit.

2. Peristomal wound:

see wound care order set

3. Apply the following peristomal products:

no sting barrier wipe barrier ring 4x4 barrier stomahesive powder paste paste strip

4. Apply appropriate pouching products:

two piece one piece convex two piece

convex one piece

Brand name ______________ size ______________

6. Change ostomy appliance every 5 - 7 days or prn leakage.

_________________________________________________per order set

________________________________________________ MD