Systematic review of educational interventions for ostomates

BACKGROUND: Stoma-related complications lead to increased hospital length of stay and readmissions. Although education of new ostomates is widely recommended, there is a lack of data regarding effective evidence-based educational interventions to prevent or decrease these complications. OBJECTIVE: The aim of this study was to systematically review the literature for educational interventions for new ostomates designed to decrease stoma-related complications. DATA SOURCES: PubMed was searched for studies on educational interventions for new ostomates. STUDY SELECTION: Studies were included if they were in English, targeted adult stoma patients, and evaluated an educational intervention at the time of stoma creation. INTERVENTION: Educational interventions were performed. MAIN OUTCOME MEASURES: The outcomes of interest were length of stay, complications, and readmissions. RESULTS: We found 1706 articles of which 7 met the inclusion criteria. Two were randomized controlled trials, and the rest were cohort studies. The overall quality of the studies was low. Each study used a unique intervention. However, all incorporated a specialized colorectal or ostomy nurse. Of the 5 studies that evaluated length of stay, 2 found a reduction in length of stay associated with the intervention, but 3 found no difference. Two studies found a reduction in complications, but 2 found no difference. Of the 3 studies that evaluated readmissions, none found a difference in the intervention group compared with the control group. LIMITATIONS: This study is limited by the search of a single database and the inclusion of only English language studies. CONCLUSION: Education is a key component of patient care; however, evidence to support an improvement in clinical outcomes is lacking. Further study is needed by the use of rigorous designs to craft a feasible educational intervention that will lead to improved patient care and outcomes.