Surgical Considerations Resection or Under medical debridement of - PowerPoint PPT Presentation

Surgical Considerations � Resection or � Under medical debridement of PG monitoring & ulcer treatment � Ostomy relocation � Stoma closure with active disease � Correct a parastomal present hernia � Refashion recessed stoma

� How are we managing PPG at Mount Sinai Hospital? (self ‐ reflected practice) What does the literature say about the � etiology and management of Peristomal PG? (evaluation of practice) � Can we do it better?...and How? (best evidenced based practice)

Brief email to ETN colleagues in Western, � Mid ‐ western and Central Canada 6 acute care hospitals � Do you have a protocol for the management 1. of PPG? NO Who usually manages PPG in your facility? 2. Dermatologist & ETN wound care

� 2000 ‐ 2011 � 31 articles reviewed; 14 retained � Literature review 3 (2 medical & 1 nursing) � General management 1 � Surgical management 1 � Medical management 3 � Medical and wound management 2 � Research(LOE III) 4

Core Team ~ Mission ~ Kathryn Kozell, RN, MScN, � CETN(C) Monica Frecea, RN, ETN, � Optimize the care and quality of life MN(c) of patient’s suffering from Julie Tjan Thomas, RN, MN, � peristomal pyoderma ETN gangrenosum across the Brenda O’Connor, RN, BScN, � continuum of care through the Research Nurse Coordinator development & dissemination of Dr. Cheryl Rosen, � evidence based interdisciplinary Dermatologist recommendations . Dr. Geoffrey Nguyan, GI � Medicine, Researcher (Quality of Life)

� Patient/family centred design and validation (patient advisor) � Interdisciplinary approach based recommendations (evidence based) � Additional development team members : patient/family, pharmacy, pain management, social work, infectious disease � Diagnosis/treatment/management/on ‐ going care � Mild/moderate/severe presentations � Development or adoption of a peristomal skin assessment tool (DET) � Quality of life dermatology tools (validated) � PPG Registry (peristomal complications) � AGREE Validation � Endorsement (professional associations e.g. CAET, Canadian Dermatology Association) � Publication