Improving Self-Efficacy of Patients With a New Ostomy With Written Education Materials: A Quality Improvement Project

Abstract

Purpose: The purpose of this quality improvement project was to determine if supplementing the current education process for new ostomates with standardized, health literate written education materials which are initiated preoperatively improves patient self-efficacy for management of their new ostomy.

Design: A convenience sample of 25 patients undergoing new ostomy placement were selected to receive the written education materials. The project occurred in two outpatient clinics and an 874-bed hospital.

Methods: Preoperative education by wound, ostomy, continence (WOC) nurses in the outpatient clinic was supplemented by the new health literate written education materials, and this education continued during the postoperative period before hospital discharge. Stoma self-efficacy was measured at three timepoints: pre- and posteducation in the outpatient clinic and before discharge from the hospital following surgery.

Findings: Mean total self-efficacy scores significantly increased from 27.32 (SD = 12.15, confidence intereval [CI] = 22.30, 32.34) pre-education in the clinic to 39.56 (SD = 9.26, CI = 35.74, 43.38) posteducation in the clinic (P = .000), and further increased to 47.20 (SD = 7.38, CI = 44.14, 50.25) at discharge from the hospital postsurgery (P = .0004).

Conclusions: Initiating education preoperatively and supplementing it with standardized, health literate written education materials improved patients' stoma self-efficacy. By improving self-efficacy, patients may be more effective in self-management of their ostomy and better prepared to care for themselves upon discharge from the hospital to prevent complications and improve outcomes.

Keywords: ostomy; patient education; preoperative; quality improvement; self-efficacy; stoma.