Quality of life – Quality of Care Judith Weller Venetz Head stoma care nurse University Hospital of Lausanne and Domiciliary care nursing service, County of Vaud Switzerland

Quality of life – Quality of Care ET nurses DO make a difference to QOL A day in the life of an ET nurse Role Competencies The World Council of Enterostomal Therapists (WCET)

Quality of life – Quality of Care ET nurses DO make a difference to QOL

« A stoma is for life » Barbara Wade Comparison of 12 districts in the UK with an ET nursing service 12 districts without an ET nursing service. Questions to patients at 10 weeks and 1 year post-operatively about Self-care Appliance problems Satisfaction with appliance Extent and severity of physical symptoms Social constraints QOL Wade B. A Stoma is for Life. Scutari Press 1989

« A stoma is for life » Barbara Wade Ten weeks after surgery, better outcomes if ET nurse involvment (better informed, better self care, more family involvement, fewer « accidents ») BUT BUT having access to a ET was not significantly related to QOL, social constraints or psychological adjustment WHY? Is the ET less important than other factors? (age, length of illnesss before operation, physical state, permanence of stoma, underlying pathology, sex, marital status,). It is difficult to identify criteria solely attributable to nursing care.

« A stoma is for life » Barbara Wade One year post-operatively In the ET districts, the ET nurse was seen as the major source of potential help for stoma care. The family doctor was consulted less often than in the non-ET districts. 40% of the patients in the ET districts had sought help with their stoma during the previous 6 months - against 21% of patients in the non-ET districts.

Montreux study 7910 patients Questionnaire completed by patients just after the operation 3 months after the operation 1 year after the operation Analysis by external statisticians CORCE (Convatec Ostomy Resource Centre Europe) Supplement to Eurostoma. Winter 1995/1996; vol 13

Montreux study Factors not relevant to QOL : age sex nationality social status type of stoma underlying pathology

Montreux study The ostomate’s QOL is linked to the stoma care he/she receives QOL depends on three main factors : (in order of importance) 1. The quality of the relationship with the ET 2. The overall care received from the whole health care team 3. The confidence in the pouching system and independence in its use

The greater the involvement both directly and indirectly of an ET in the management of wounds, the greater the savings and the shorter the healing times. Harris C, Shannon R An innovative Enterostomal Therapy nurse model of community wound care delivery. A retrospective cost-effectiveness analysis. J Wound Ostomy and Continence Nursing ; 35(2) : Wound Care

Study of 344 wounds cared for by ET nurses and 464 wounds cared for by staff nurses over an 18 month period in South Florida. 36.3% of the wounds cared for by staff nurses healed 78.5% of the wounds cared for by ET nurses healed BUT Average number of visits by staff nurses : less than 17 Average number of visits by ET nurses : 31.6 Arnold N, Weir D. Retrospective analysis of healing in wounds cared for by ET nurses versus staff nurses in a home setting. J Wound Ostomy and Continence Nursing ;21 (4): Wound Care

Quality of life – Quality of Care A day in the life of an ET nurse Role Competencies

A day in the life of an ET nurse Get up early for urostomy and ileostomy patients Clinical skills ET nursing is 51% practical and 49% the helping relationship

A day in the life of an ET nurse Colleague off sick. Organisational skills Unexpected events…..stay zen!! Computer skills

A day in the life of an ET nurse Doctors’ rounds Teamwork skills Multidisciplinary team Individual roles but mutual collaboration and respect

A day in the life of an ET nurse Coffee break WC break

A day in the life of an ET nurse Pre-operative visit with a patient and his family Counselling/communication skills neuro-linguistic programming systemic theory sexuality religious and cultural differences Stoma siting

A day in the life of an ET nurse Meeting with a delegate from a pharmaceutical company ethical issues ( Code of business practice. Eucomed guidelines on interactions with healthcare professionals) stock management nurse prescribing? – legal issues

A day in the life of an ET nurse lunch meeting with your manager Marketing skills keeping statistics writing reports assertiveness skills

A day in the life of an ET nurse give a course to… nurses, doctors, pharmacists, medical students, student nurses, ambulance drivers, physiotherapists, ostomy visitors, general public… etc. etc. etc. Offer to organise and give courses Educational skills Presentation skills Audio-visual techniques Adult learning theory

A day in the life of an ET nurse Research project questionnaire for patients clinical trial Research skills literature search via the internet critical reading of research articles

A day in the life of an ET nurse Continuing education for the ET

A day in the life of an ET nurse Go home Look after yourself! Beware of « burn-out »!! Stress management strategies

A day in the life of an ET nurse Association work Hungarian ET nurses’ Association IOA WCET

E T = Superwoman!!!

Quality of life – Quality of Care

A world of expert professional nursing care for people with ostomy, wound and continence needs.

What is WCET? What is WCET? Since 1975, WCET is a unique global non-profit organization Ongoing education activities Ongoing education activities Scholarships NNG Foundation Scholarships NNG Foundation Twinning Project Twinning Project Biennial congress (even years) Biennial congress (even years) Journal Journal BullETin BullETin Website Website And more! And more! A w rld of expert professional nursing care for peole with ostomy, wound, and continence needs. Who we are: Members IDs Executive Board Central Office Executive Director

International Delegates(ID) Represent their country Vote on behalf of their country members at the General Meeting held during Congress Link between the Executive Board and their country members The ID for Hungary is Julianna Czupi A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

WCET Mission To lead the global advancement of specialised professional nursing care for people with ostomy, wound or continence needs. To lead the global advancement of specialised professional nursing care for people with ostomy, wound or continence needs. A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

WCET Vision To ensure specialised nursing care is available worldwide for all people with a need for wound, ostomy or continence care. To provide nurses worldwide with access to ostomy, wound or continence specialty education. Recognition as the global organisation for ostomy, wound or continence care providers Identification as the global leader in the specialty of ostomy, wound or continence care. Identification as the global leader in the specialty of ostomy, wound or continence care. A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

WCET Core Values Respect - for the dignity and individual diversity of all persons Integrity - adherence to a recognised code of ethics Communication – fostering collaboration between members, non- members, and organisations Holistic care - incorporating care for body, mind and spirit Scientific approach - advancement of research and evidence-based specialised education and care A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

Education Committee Setting guidelines for ETNEPs* and WCET-REPs* worldwide Setting guidelines for ETNEPs* and WCET-REPs* worldwide Providing assistance to develop ETNEPs and REPs Providing assistance to develop ETNEPs and REPs Reviewing the programmes submitted for WCET recognition Reviewing the programmes submitted for WCET recognition Providing information on educational resources relevant to ET nursing Providing information on educational resources relevant to ET nursing *ETNEP: Enterostomal Therapy Nursing Education Programme *REP: Recognised Education Programme A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

Norma N. Gill Foundation Committee Administration of 5 types of scholarship: WCET annual membership fee scholarship (£20 = 5’900HUF) Congress Travel scholarship ETNEP/REP scholarship General scholarship for onsite training in an emerging country Educational materials scholarship A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

Norma N. Gill Foundation Committee TwinningProject A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

Publications and Communications Committee Responsible for all the WCET publications other than the WCET Journal and the BullETin: Responsible for all the WCET publications other than the WCET Journal and the BullETin: Website Website WCET brochures, country reports, etc. WCET brochures, country reports, etc. A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

Constitution Committee Constitution Committee Ensures that the existing WCET Constitution Ensures that the existing WCET Constitution facilitates the ease of operation of the organisation’s affairs facilitates the ease of operation of the organisation’s affairs complies with Charities Commission requirements complies with Charities Commission requirements Reviews the existing Constitution and submits recommendations for amendments Reviews the existing Constitution and submits recommendations for amendments New constitution approved in 2008 in Slovenia New constitution approved in 2008 in Slovenia A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

WCET Editorial Advisory Board Responsible for: Publication of the Journal Publication of the Journal Acquiring articles for the Journal Acquiring articles for the Journal Reviewing and editing submitted articles Reviewing and editing submitted articles Mentoring and assisting authors Mentoring and assisting authors Editing journal supplements Editing journal supplements Promoting the WCET Journal Promoting the WCET Journal A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

WCET Editorial Advisory Board Articles in languages other than English (plus English translation) A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

June 12th – 16th 2010 In partnership with the Wound, Ostomy and Continence Nurses’ Society (WOCN) of the USA 18th Biennial Congress of the WCET A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.

Phoenix, Arizona, USA

WCET Membership Benefit When you join the WCET one of the benefits is a discount on the WCET Biennial Congress registration fee ! When you join the WCET one of the benefits is a discount on the WCET Biennial Congress registration fee ! Join now! The registration discount will more than cover your joining fee! Join now! The registration discount will more than cover your joining fee! 2010 WCET Congress - Phoenix, Arizona 2010 WCET Congress - Phoenix, Arizona

Join the World of WCET! A w rld of expert professional nursing care for people with ostomy, wound, and continence needs.