Perry-Woodford Zarah L, Marinova Petya
Consultant Nurse Pouch and Stoma Care at St Mark's Hospital, Harrow.
Clinical Nurse Specialist in Pouch Care, St Mark's Hospital, Harrow.
Br J Nurs. 2022 Mar 24;31(6):S14-S21. doi: 10.12968/bjon.2022.31.6.S14.
Restorative proctocolectomy with pouch anal anastomosis is the accepted treatment for suitable patients with ulcerative colitis, yet surveillance following stoma reversal remains contentious and involves several issues. While most patients are discharged from routine follow-up between 6 weeks and 3 months, some remain on surveillance pathways indefinitely. A high volume of patients require advice for many months or years after the stoma has been reversed, with the burden of surveillance on consultant-led clinics. Nurse-led follow-up after restorative proctocolectomy has been recognised for decades but has not been validated. This study reports the first protocol-based pathway for nurse-led follow-up. Using validated questionnaires, suitable pouch patients were followed up in nurse-led clinics over a 12-month period then sent an online survey to report on the service they received. Overall, most patients were satisfied with the nurse-led follow-up; however, further engagement and investment in the workforce and infrastructure is required to offer sustainable services.
回肠袋肛管吻合术的直肠结肠切除术是适合的溃疡性结肠炎患者的公认治疗方法,但造口回纳后的监测仍存在争议,涉及几个问题。虽然大多数患者在6周和3个月之间从常规随访中出院,但有些患者仍无限期地处于监测路径中。大量患者在造口回纳后的数月或数年需要咨询,这给由顾问主导的诊所带来了监测负担。几十年来,人们已经认识到在直肠结肠切除术后由护士主导的随访,但尚未得到验证。本研究报告了首个基于方案的护士主导随访路径。使用经过验证的问卷,对合适的回肠袋患者在护士主导的诊所进行了为期12个月的随访,然后向他们发送了一份在线调查问卷,以报告他们接受的服务。总体而言,大多数患者对护士主导的随访感到满意;然而,需要进一步在人力和基础设施方面进行投入并加强参与,以提供可持续的服务。