Name of the Procedure:

Common name: Ostomy Pouch Change (2-piece system) Technical term: Ostomy pouch, drainable, high output, for use on a barrier with flange, with filter (HCPCS Code A4413)

Summary

This procedure involves attaching a two-piece ostomy pouch system to a stoma, which is an opening created surgically on the abdomen to divert waste from the bowel or urinary system. The two-piece system includes a drainable pouch with a filter that attaches to a barrier with a flange, allowing for better waste management.

Purpose

The procedure addresses the need to manage high-output waste for patients with an ostomy. The goals are to ensure a secure fit, prevent leakage, and provide a comfortable and functional way to collect bodily waste.

Indications

• Patients with high-output stomas (e.g., ileostomy, colostomy, or urostomy)
• Those experiencing frequent leakage or skin irritation with other pouching systems
• Need for effective odor management and drainage

Preparation

• Ensure the stoma area is clean and dry before application
• No special fasting or medication adjustments generally required
• Possible stoma assessment by a healthcare professional

Procedure Description

1. Clean and dry the skin around the stoma.
2. Measure the stoma and cut the barrier opening to fit.
3. Remove the backing from the barrier and apply it around the stoma.
4. Attach the drainable pouch to the flange on the barrier, ensuring a secure fit.
5. Ensure the filter in the pouch is positioned correctly for optimal performance.
6. Close the bottom of the drainable pouch.

Duration

Typically, it takes about 15-30 minutes to complete the procedure.

Setting

This procedure can be performed in various settings, including:

• Hospital
• Outpatient clinic
• At home by the patient or a caregiver

Personnel

Usually performed or supervised by:

• Ostomy care nurses
• Patients themselves, once trained
• Caregivers

Risks and Complications

• Skin irritation or damage around the stoma
• Leakage and odor issues
• Infection at the stoma site

Benefits

• Secure waste management
• Enhanced comfort and reduced skin irritation
• Improved quality of life and independence

Recovery

• Immediate use of the new pouching system post-procedure
• Regular monitoring and care of the stoma
• Follow-up appointments if complications arise

Alternatives

• One-piece ostomy pouching systems
• Alternative types and brands of two-piece systems
• Continuous monitoring to find the best fit and functionality

Patient Experience

• Minimal discomfort during the procedure
• Learning curve for new users; training provided by healthcare professionals
• Pain management typically not necessary; comfort measures include proper fit and skin care tips