Ostomy bag change (ostomy care) nursing procedure for nurses and nursing students. This video will demonstrate how to change a colostomy or ileostomy pouching system, specifically the one-piece pouch system. In this ostomy teaching video, you will learn the supplies you will need to change an ostomy bag (pouch, skin barrier which is also called a wafer or flange, barrier ring if needed, a clip to close the pouch, stoma measuring card, ostomy scissors, washcloths, towels, and gloves). First, you will want to perform hand hygiene and don gloves. Then, remove the pouching system (you may need adhesive remover). Properly discard the system. Then cleanse the skin around the stoma (stoma care) and the stoma with warm water. You may use mild soap but be sure it contains no alcohol, perfumes, or lotions. Assess the surrounding skin for breakdown. Then, pat the area dry and trim any hair if needed (this will help the new pouching system stick and prevent pain when the system is removed in 3-5 days). Then, measure the stoma with a measuring card. Be sure to pick a measurement that measures 1/8 inch larger than the stoma. The opening you create needs to be a good fit rather than too big (may leak stool onto the skin) or small (risk of constricting the stoma). Remember new stomas will shrink overtime and should be measured regularly to ensure
proper fit of the new ostomy system. After measuring the stoma, cut the measurement on the skin barrier/wafer. You can trace it using the measuring card or most skin barriers have it outlined for you. Then cut the opening with the ostomy scissors. Ostomy scissors are specially designed to achieve a round cut without leaving jagged edges which could cause trauma to the stoma. Next, seal the opening to the bag (if not a closed system) and apply the pouch.

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