Sheila's case study was completed in December 2015 and reflects 2015 prices
A stoma is an opening on the front of the abdomen (tummy) which is made using surgery. It is a bud-like structure, which sits on the surface of the skin. There are three types of stoma. Patients who have inflammatory bowel disease or bowel cancer may require an ileostomy or a colostomy. These stoma provide an alternative outlet for waste products from the gut. A patient with bladder cancer, severe urinary incontinence or damage to their pelvis may require a urostomy. These stoma divert urine from the urinary tract. A stoma may be temporary (and reversed later) or permanent. Either way, having a stoma is a life changing event, and specialist nurses, like Sheila Jones and her colleagues at Royal Glamorgan Hospital, provide essential support to stoma patients and their families and carers.
Since 1992 the Stoma Care Service at Royal Glamorgan Hospital has been supporting the rehabilitation of stoma patients, and helping carers and family members to manage a significant change in lifestyle. It provides two types of nurse-led clinics, with the aim of detecting and treating anxieties and complications. Although the service is well respected, in the current economic climate it cannot rely on word of mouth to evidence its impact on patient care. With this in mind, Sheila decided to conduct an economic assessment and in doing so, identified a range of quality, productivity and prevention benefits for patient, stoma care nurses and the hospital.
The nurse-led Stoma Care Clinic ensures a well-defined pathway to support patients. It provides a patient-focused approach to diagnosis, care planning, treatment provision, follow up, and continuity of care. The holistic care and timely interventions provided by experienced, specialist nurses avoids costly care episodes and saves consultants, GPs and district nurses time, which can be used for other activity. Sheila demonstrated that an investment of £40K per annum to provide a nurse-led stoma care clinic avoids costs in the region of £150K per annum elsewhere in the system.