Background: Leakage is the number one concern for people with an ostomy. The 2019 Ostomy Life Study, a global study of more than 5000 ostomates, showed that 92% of people living with a stoma worry about leakage. Getting the right stoma appliance for each patient is key to increasing patient quality of life. Aim: The study was designed to assess the use of the Peristomal Body Profile Assessment Tool in helping choose the most appropriate stoma products for a given patient, decreasing incidents of leakage and peristomal skin complications. Methods: A multi-centre (33 sites, 147 patients) low-interventional clinical investigation was conducted in which the use of the Peristomal Body Profile Assessment Tool was evaluated as a tool to reduce incidents of leakage, increase peristomal skin health and increase patient quality of life. A focus group of randomised participating clinicians (n=16) was held to explore the audit results. Results: The assessment tool most often took between 2 and 5 minutes to complete. It supported clinicians in selecting the right appliance for each patient, avoiding leakages and preventing associated peristomal skin complications. The assessment tool helped improve the accuracy and quality of documentation in the patients' medical/nursing notes, increasing the quality and continuity of care. Participants reported that using the assessment tool helped reduce care costs by reducing the need for product changes, supporting product usage and return patient visits. Conclusion: Use of the Peristomal Body Profile Assessment Tool helped clinicians choose the most appropriate stoma appliance the first time, resulting in patients having healthier peristomal skin, fewer leakages, more confidence in their stoma appliance and a higher quality of life.

Background: Leakage of stomal effluent outside the baseplate that soils clothes or bedsheets is a common problem for many people with a stoma and significantly impacts their quality of life. Aim: To understand behavioural changes for people experiencing faecal leakage outside the baseplate regarding the usage of pouching systems, supporting products and interactions with health professionals. Methods: Retrospective, self-reported questionnaire. Findings: Respondents on average experienced 1.1 incidents of faecal leakage outside the baseplate per fortnight. In periods with issues of leakage, 21% of respondents had been in contact with health professionals, 40% increased their use of pouching systems, 25% increased their use of existing supporting products, and 21% included additional supporting products to their change routine. The increased use of healthcare resources was estimated to cost £32.47 in the 3 weeks following a leakage incident. Conclusion: Incidents of leakage outside the baseplate lead to increased use of healthcare resources.

Specialist nurses can use quantitative data and validated assessment tools to make evidence-based decisions, improve patient outcomes and demonstrate value

The impact of having a stoma on an individual's quality of life (QoL) can be significantly worsened by leakage and consequent peristomal skin complications. Therefore, ostomates require individualised, person-centred and evidence-based care. Stoma care nurses can facilitate this using stoma-specific validated assessment tools, including the Body Profile Assessment Tool, Stoma Quality of Life Tool, Ostomy Skin Tool and Ostomy Leakage Impact Tool. These provide precise, repeatable quantitative data, which avoids reliance on vague language and allows for baseline comparisons to measure progression. This case study describes a female ileostomate who faced a number of stoma-related complications, including body image and confidence. Initial trial-and-error attempts to find an effective combination of products were fragmentary and failed to provide an effective long-term solution. During the COVID-19 pandemic, the patient underwent a remote telephone consultation, aided by digital photography. The stoma care nurse used validated assessment tools to determine the patient's needs. Based on this, she was recommended a new pouching routine suited to her inward body profile, and her progress was measured using the assessment tools. These showed sustained and considerable improvements in peristomal skin health, mental wellbeing and overall QoL. The patient's prescription costs were also dramatically reduced.