Enterostomatherapy

from Wikipedia, the free encyclopedia

The Enterostomatherapie (short: Stomal , Ostomy Care , colloquially often mistakenly Stomaberatung ) deals with counseling, care and rehabilitation of people who are different in the light of medical conditions an enterovirus or urostomy have received or will receive suffering from stool or urinary incontinence or are affected by a wound healing disorder or a chronic wound. In addition, the field of enterostomatherapy has recently included the focus on special nutritional problems resulting from the underlying diseases.

Enterostomatherapy is a profession that has not yet been legally protected. The qualification takes place within the framework of further training . In any case, admission requirements are state-recognized training in a nursing profession and, in the case of some further training providers, two years of professional experience.

The term ostomy advice, on the other hand, describes the environment of the sales-oriented specialist in a medical supply company or a manufacturer of ostomy supplies, which does not exclude professional qualifications.

further education

Depending on the training provider, different designations are common for the professional.

The occupational title Enterostomatherapeut (ET ) with worldwide recognition WCET (World Council of Enterostomal Therapists) can also be used alone in addition to the previous training title. In Germany, the German Employees Academy (DAA) is generally responsible for this mostly full-time training .

The qualification as a stomatotherapist and continence advisor (DBfK and DVET), which is mostly acquired as a part-time job, is listed after the training designation as with further training (mW) care expert stoma, incontinence, wound . This advanced training concept is based on the common job description of all nursing professions (health and nurse, health and child nurse, geriatric nurse) job description DBfK (German Professional Association for Nursing Professions), 1997 and on the ICN Codex 2001 ( International Council of Nurses ) . Names such as nurse for ostomy and incontinence characterize older training concepts.

Enterostomatherapy fields of activity

Ostomy care

Work with the ostomy patient begins before the operation . A preoperative discussion should leave the patient space for questions and thoughts and should be suitable to reduce fears and reservations in order to facilitate a faster recovery from the operation through positive participation in the therapy . In the next step, the optimal position of the stoma is drawn while sitting, lying and standing on the patient's stomach in order to prevent complications that could arise, for example, in the skin folds of an ostomy. The aim is to maintain the patient's quality of life as extensively as possible.

The ostomy patient is accompanied throughout the entire hospital stay. In addition to the ongoing assessment of the freshly created stoma and its proper functioning, the patient should be psychologically stabilized in this context and introduced to self-sufficiency in his or her excretory opening. Upon discharge from the hospital, the patient should be able to deal with his stoma completely or at least partially independently.

If ostomy care was taken over in the hospital by a nurse working there, the patient usually changes to the care of a resident specialist upon discharge, who the patient usually has to look for himself. If this has not yet happened in the hospital, the search for an optimal supply system for the patient begins. In addition, the enterostomatherapy specialist gives the patient all the information they need to protect the skin around the stoma, prevent complications, nutrition, return to work, leisure activities and sport, as well as privacy and sexuality . In addition, psychological problems and discussions with relatives can also come to the fore. The proper function and appearance of the stoma should be checked regularly in the beginning. Special requirements for personal support may become necessary if complications arise, in the context of special illnesses or, for example, as a result of radio and chemotherapy .

Incontinence

Urinary and fecal incontinence are ailments that are often hidden from the environment, but which can seriously affect the quality of life. In this area, enterostomatherapy is responsible for helping to determine the type of incontinence, for advising the patient about possible treatment methods and for referring to other treatment bodies such as urologists , surgeons or physiotherapists for any necessary pelvic floor exercises . In addition, the enterostomatherapy specialist will present the appropriate aids. Patient care in the context of incontinence can take place in outpatient centers as well as at home.

Wound care

Enterostomatherapy specialists can offer wound treatment and / or advice in the case of leg ulcers , pressure ulcers , diabetic wounds , suture insufficiencies , oncological wounds , coccyx fistulas , first and second degree burns and for all other types of wounds that require monitoring of healing . The care of the wounds by enterostomatherapy takes place with the consent and, if necessary, according to the doctor's instructions . Enterostoma therapists are also responsible for instructing other caregivers or caregivers and caregivers about the use of modern wound treatment methods. Among other things, they act as experts in the clinical field. Wound patients can be cared for as an inpatient, outpatient or at home.

Artificial nutrition

Further training in the field of artificial nutrition is not yet offered by all training providers. It enables enterostoma therapists to provide professional advice and supply of feeding tubes as well as advice and support against the background of digestive disorders, which may require parenteral nutrition by means of syringes , infusions or diets .

In all areas of enterostomatherapy, in addition to the immediate care of the patient, the specialist is concerned with the personal accompaniment, support and guidance of patients, relatives and other caregivers. Thematically, personal support can be related to the illness, the disease prognosis, disability or even dying.

Research and Teaching

As part of research and teaching , enterostoma therapists can be entrusted with the training of nursing staff and nursing students as well as the professional advice and guidance of nursing staff and other professional groups in the health care sector . It is also possible to work in nursing and medical studies .

Other fields of activity

Enterostomatherapy specialists also have the qualifications to be involved in the planning, implementation, monitoring and documentation of nursing measures and to participate in the creation of nursing concepts, nursing standards, treatment and nursing guidelines. The general basic knowledge includes the introduction of situation-appropriate immediate measures and nursing action in emergency situations, furthermore the planning and organization of the nursing process including transition care and discharge management as well as the interdisciplinary cooperation with the family doctor , self-help groups , old people's homes and outpatient care services.

History of Enterostomatherapy

The history of Enterostomatherapie begins in 1958. Robert B. Turnbull , a surgeon at the Cleveland Clinic in Ohio, USA, and Norma N. Gill , Stomaträgerin, then shared their knowledge and their experience and recognized the deficiency in the training of nurses in the special care of ostomy patients. Turnbull then hired Norma Gill to look after the ostomate in his clinic and created the professional title enterostomatherapist . In 1961, in Cleveland, they founded the first school for the training of nurses for enterostomatherapy, at which Anneliese Eidner, a nurse from the Erlangen University Surgical Clinic , was trained as an enterostomatherapy. In 1976 she was the first female enteromatherapist in Germany. In the 1970s, enterostomatherapy spread rapidly worldwide as an additional qualification in the context of nursing. Australia, Canada, Great Britain, New Zealand and South Africa were the first countries to look into this new area. When the World Council of Enteromal Therapists (WCET) was founded in 1978, the 30 enterostoma therapists present represented 15 countries. Norma N. Gill was elected WCET's first female president.

In 1968 the North American Association of Enterostomal Therapists was founded in the USA , later renamed the International Association for Enterostomal Therapy and since 1992 called the Wound, Ostomy and Continence Nurses Society (WOCN) . Here, too, Norma N. Gill was one of the founding members. The first German school for enterostomatherapy was founded in 1978. In 1979 the German Association of Enterostomatherapists (DVET) was brought into being.

See also

Individual evidence

  1. ↑ World Council of Enterostomal Therapists (WCET)
  2. ↑ German Employees Academy (DAA)
  3. ↑ German Professional Association for Nursing Professions (DBfK)
  4. ↑ a b http://www.dvet.de/ DVET Fachverband Stoma und Inkontinenz e. V.
  5. ↑ ICN Codex 2001
  6. ↑ Wound, Ostomy and Continence Nurses Society (WOCN)

literature

  • Henriette Feil-Peter, Elisabeth Hornburg, Christel Ravenschlag: Ostomy Care - Enterostomatherapy . Schlütersche Verlagsanstalt, Hanover, 7th edition, 2001. ISBN 3-87706-660-7
  • Thomas Bölker, Wolfgang Webelhut, Tabea Noreiks, Franz Raulf von Schmücker: Through thick and thin. The book for stoma care and urinary diversion . Schmücker, May 2003. ISBN 3-9805493-2-1
  • Magazine Stoma + Incontinence + Wound , magazine for care, training and professional policy
  • Thomas Boelker, Dietmar Hegeholz, Wolfgang Webelhuth: Out of control. Care for urinary and fecal incontinence . Noreiks, Tabea; Edition: 1 (April 2006). ISBN 3-00-017179-7
  • Helle Gotved: Successful remedies against urinary incontinence . Triad; Edition: 1st A. (March 2003). ISBN 3-8304-3014-0
  • Susanne Danzer: Chronic wounds. Assessment and treatment . Kohlhammer (April 2006). ISBN 3-17-018833-X
  • Michaela Brandstätter: Parenteral nutrition. Indications, techniques, organization . Urban & Fischer bei Elsevier (July 2002). ISBN 3-437-26750-7

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