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Guideline Summary
Guideline Title
Part 2. Incontinent urostomy: community care, follow-up and complications. In: Incontinent urostomy.
Bibliographic Source(s)
Incontinent urostomy: community care, follow-up and complications. In: Geng V, Cobussen-Boekhorst H, Fillingham S, Holroyd S, Kiesbye B, Vahr S. Incontinent urostomy. Arnhem (The Netherlands): European Association of Urology Nurses (EAUN); 2009 Mar. p. 19-65.
Guideline Status

This is the current release of the guideline.

Scope

Disease/Condition(s)

Diseases and conditions requiring incontinent urostomy

Guideline Category
Counseling
Evaluation
Management
Prevention
Treatment
Clinical Specialty
Nursing
Surgery
Urology
Intended Users
Advanced Practice Nurses
Guideline Objective(s)
  • To provide guidelines clearly stating the level of evidence of each procedure and recommendation with the aim of improving current practices and delivering a standard and reliable protocol for incontinent urinary diversion care
  • To support practitioners who are already assessed as competent in incontinent urinary diversion care
  • To help urology nurses assess the evidence-based management of urostomy care and to incorporate the guidelines' recommendations into their clinical practice
Target Population

Adult population with incontinent urostomy

Note: This guideline focuses on incontinent urinary diversion, leaving the topic of continent urinary diversion for a future publication in this series. The guidelines contain only material on adults and not children.

Interventions and Practices Considered

Pre-operative assessment

  1. Activities of daily living (ADL)
  2. Social context and support
  3. Psychological aspects, compliance and cognition
  4. Cultural and religious issues

Patient Preparation

  1. Siting (site marking)
  2. Assuring patient has adequate supply of ostomy products
  3. Patient education

Procedure Before and after Surgery and at Discharge

  1. Pre-operative information on stoma management supplemented by booklets and demonstrations of relevant stoma appliances
  2. Post-operative teaching
  3. Discharge and follow-up

Post-operative Care

  1. Post-operative observation of stoma
  2. Stoma management by patient and family/carers

Discharge Care

  1. Patient control visits/calls
  2. Providing patient with patient diary
  3. Providing patient with information about possible complications

Proactive and Preventive Care

  1. Providing patient with advice on traveling with a stoma
  2. Providing patient with Medic alert bracelet, 'Can't Wait' card, disability card
  3. Patient education on urinary tract infections (UTIs), fluid intake and effect of food on urine
  4. Skin care
  5. Urine testing from an ileal conduit: glucose levels in diabetic patients and UTI testing; pregnancy testing

Products

  1. Urostomy appliances
  2. Skin barriers (second skin)
  3. Adhesive removers
  4. Karaya moisture absorber

Managements of Complications and Problems of Having an Urostomy

  1. Management of physical problems, including skin irritation and disorders, retraction, leakage, pH of urine, UTIs, and purple bag syndrome
  2. Management of psychological problems related to having a stoma
  3. Treatment of erectile dysfunction in men
  4. Treatment of sexual dysfunction in women
Major Outcomes Considered
  • Risk-benefit of treatment
  • Complications from treatment
  • Incidence of adverse effects
  • Psychological and social functioning
  • Sexual function

Methodology

Methods Used to Collect/Select the Evidence
Hand-searches of Published Literature (Secondary Sources)
Searches of Electronic Databases
Description of Methods Used to Collect/Select the Evidence

Literature Search

The data underpinning this document were gathered through a systematic literature search. The focus of this search was to ensure identification of the available high-level data (meta-analyses, randomized controlled trials, Cochrane reviews and other high-quality guidelines documents). A critical assessment of the findings was made, not involving a formal appraisal of the data. Articles were selected from Medline, Cinahl, Scopus, Sciencedirect, PubMed and the Cochrane database, as well as from relevant textbooks and other guidance documents.

Search Keywords

The Working Group first tried to find randomised, controlled trials, reviews or meta-analyses. If these references did not provide enough information, the Working Group continued their search by looking for studies with lower levels of evidence. The evidence found on each topic is shown in the recommendations of each chapter or subchapter. The choice of literature is guided by the expertise and knowledge of the Guidelines Working Group. The question for which the references were searched was: Is there any evidence for incontinent urinary diversion for nursing interventions in different care situations such as preoperative, operative and post operative, acute as well as long term?

The references for these Guidelines were searched using the keywords listed below. Several databases (Medline, PubMed, Embase, Cinahl and Cochrane) were searched as well as private libraries, databases and books of the authors, using the keywords in different combinations. The references were searched by different experts in the field of urostomy. The same reference was often used repeatedly to build up the guidelines.

Keywords (alphabetical order)

  • Activity of daily living
  • Bricker
  • Colon conduit
  • Coping
  • Cranberry
  • Cystectomy (Mesh)
  • Education
  • Fluid balance
  • Ileal conduit
  • Incontinent urostomy
  • Nursing assessment (Mesh)
  • Nutrition
  • Pain management
  • Patient care planning (Mesh)
  • Patient education
  • Post-operative care
  • Pre-operative care
  • Psychological impact
  • Stoma
  • Stoma care
  • Stoma care nursing
  • Stoma care pouching system
  • Skin care (Mesh)
  • Skin irritation
  • Social issues
  • Stent
  • Stoma
  • Teaching
  • Urethral cutaneous stomy (Cutaneous stoma)
  • Urinary diversion (Mesh)
  • Urinary tract infection
  • Urological nursing
  • Urostomy
  • Wet urostomy
Number of Source Documents

Not stated

Methods Used to Assess the Quality and Strength of the Evidence
Weighting According to a Rating Scheme (Scheme Given)
Rating Scheme for the Strength of the Evidence

Levels of Evidence

1a Evidence obtained from meta-analysis of randomized trials

1b Evidence obtained from at least one randomized trial

2a Evidence obtained from one well-designed controlled study without randomization

2b Evidence obtained from at least one other type of well-designed quasi-experimental study

3 Evidence obtained from well-designed non-experimental studies, such as comparative studies, correlation studies and case reports

4 Evidence obtained from expert committee reports or opinions or clinical experience of respected authorities

Methods Used to Analyze the Evidence
Review of Published Meta-Analyses
Systematic Review
Description of the Methods Used to Analyze the Evidence

The Working Group included an extensive number of topics, which are not always only applicable to urostomies, but decided to include them because they make the guideline more complete.

The recommendations provided in these documents are based on a rating system modified from that produced by the Oxford Centre for Evidence-based Medicine (see the "Rating Scheme for the Strength of the Evidence" field.

Some of the literature was not easy to grade. If, however, the European Association of Urology Nurses (EAUN) Working Group thought the information would be useful in practice, it was ranked as level of evidence 4 and grade of recommendation C.

Methods Used to Formulate the Recommendations
Expert Consensus
Description of Methods Used to Formulate the Recommendations
  • The expert panel consisted of a multi-disciplinary team of nurse specialists (e.g., stoma care nurse, wound-continence-stoma care nurse).
  • Whenever possible, the Guidelines Working Group graded treatment recommendations using a three-grade recommendation system (A to C) and inserted levels of evidence to help readers assess the validity of the statements made. The aim of this practice was to ensure a clear transparency between the underlying evidence and a recommendation given.
Rating Scheme for the Strength of the Recommendations

Grades of Recommendation

  1. Based on clinical studies of good quality and consistency addressing the specific recommendations and including at least one randomized trial
  2. Based on well-conducted clinical studies, but without randomized clinical trials
  3. Made despite the absence of directly applicable clinical studies of good quality
Cost Analysis

A formal cost analysis was not performed and published cost analyses were not reviewed.

Method of Guideline Validation
External Peer Review
Internal Peer Review
Description of Method of Guideline Validation

A draft for review was sent to the European national urological nurses societies, specialised nurses in various European countries, a few urologists, the European Association of Urology (EAU) Guidelines Office and the EAU executive responsible for European Association of Urology Nurses (EAUN) activities. The document was revised based on the comments received. A final version was presented and approved by the EAUN Board.

Recommendations

Major Recommendations

Definitions for the levels of evidence (LE) (1a-4) and grades of recommendation (GR) (A-C) are provided at the end of the "Major Recommendations" field.

Principles of Management: Nursing Interventions

Pre-operative Assessment

Activities of Daily Living (ADL)

Pre-operative assessment of the functional status of the patient, including data about work, sport activities and home-making. (LE=4, GR=C)

Social Context and Support

  • Pre-operative assessment of social circumstances to identify any requirement for physical alterations to home. (LE=3, GR=C)
  • Pre-operative assessment of eligibility for financial support. (LE=3, GR=C)
  • Inclusion of family member at pre-operative assessment to establish support mechanism. (LE=3, GR=C)
  • Provision of written information at pre-operative stage to clarify and support discussions. (LE=3, GR=C)

Psychological Aspects, Compliance and Cognition

  • Pay special attention to patients with a history of mental illness. (LE=4, GR=C)
  • Pre-operative assessment of psychological capability essential. (LE=4, GR=C)
  • Audio or visual information should be provided. (LE=4, GR=C)

Cultural and Religious Issues1

  • Be aware of the patient's country of origin and religion. (LE=4, GR=C)
  • Note their individual 'feast, festival and fasting calendar'. (LE=4, GR=C)
  • Maintain the patient's dignity at all times. (LE=4, GR=C)
  • Understand cultural dietary/product usage considerations, e.g., gelatine (animal product). (LE=4, GR=C)
  • Provide translators when necessary. (LE-4, GR=C)
  • Promote cultural awareness among team members. (LE=4, GR=C)

1Recommendations from Black P. Practical stoma care. Nurs Stand 2000;14(4):47-53.

Patient Preparation

Siting (Site Marking)

Table: Siting (Site Marking) Procedure2
  1. Inform the patient about the aim and procedure and be aware that site marking should be a joint decision of the patient and (stoma care) nurse. This is because consent promotes acceptance.
  1. Collect all relevant information about the disorder and the planned surgery. This is because different stomas have different preferences for site marking.
  1. Collect patient-specific information about lifestyle, profession, body, skin, religion, orthopaedic aids, hobbies and sports. This is because wheelchair-bound patients, or patients who wear orthopaedic aids, should not be hindered by the stoma. Always carry out the site marking with patients in their wheelchair or using their aid.
  1. Let the patient lie down on the bed and let him/her hitch up the abdomen. This is because stomas will be placed within the rectus abdominus.
  1. Make an imaginary line between the umbilicus, the pelvic crest and the os pubis. Mark the place as an orientation point marking where the stoma can possibly come out. Within this triangle, the stoma will preferably be placed, leaving enough room for the flange.
  1. Let the patient bend and sit so that possible folds and dips can be registered. This will help to prevent leakage by folds and pits and enable the device to be adequately fitted.
  1. Discuss clothing in relation to the site marking. This can prevent patient disappointment and limitation of ADLs and daily habits and prevent complications.
  1. Check that the site is visible in different positions and is accessible for the patient, so that the patient can take care of his/her stoma.
  1. Eventually, place a test pouch over the marked point and evaluate this with the patient. In this way, you can see how the device behaves during motion and how the device relates to scars, the umbilicus, and body structures. The device should be observed when filled with water. Allergic reactions to the device should be observed.
  1. Discuss with the patient the chosen site, so that the patient can agree with it and understands the choice.
  1. Mark the site definitely. Take care that the surgeon will still be able to see the marked place after disinfection has taken place.
  1. Do not use tattoo ink. Tattoo is a permanent marking.
  1. Inform the surgeon if the site is different to what would be expected. In this way, you can stop the surgeon from using the usual site and make sure the surgeon use the correct site for the patient.

2Adapted with permission from the evidence-based Stoma Care Guideline: Pre-operative site-marking, Dutch Stoma Care Nurses Society, 2006.

  • Pre-operative site marking should be a standard procedure when a patient is due to undergo surgery that includes stoma formation, but also when a patient is due to undergo surgery and there is a possibility that a stoma could be performed. (LE=4, GR=C)
  • Pre-operative stoma site marking must be done under the responsibility of a nurse specialist (NS), whose level of education is acceptable and who works as an NS. (LE=4, GR=C)
  • The procedure described in the table above ("Siting [Site Marking] Procedure") provides the basic document for all protocols to be written in institutions. (LE=4, GR=C)
  • Pre-operative assessment of the patient's manual dexterity and use of mechanical aids. (LE=4, GR=C)

Products

Patients must have an adequate supply of products on discharge. (LE=4, GR=C)

Patient Education

Patient Organisations and Brochures

The nurse should be aware of national patient organisations and the availability of brochures. (LE=4, GR=C)

Optimal Timing for Learning and Practicing Skills

  • Motivation and previous educational experiences are important. (LE=3, GR=C)
  • A nurse needs to be sensitive to educational difficulties and be prepared to use a variety of strategies. (LE=3, GR=C)
  • An NS must remember that he/she may not be able to meet all of a patient's needs and should refer on to other specialist staff where these services are available. (LE=3, GR=C)
  • Patients should always have access to an NS. (LE=4, GR=C)

Procedure before and after Surgery and at Discharge

Pre-operative Information

  • Patients should be offered a contact number for a person living with a stoma. (LE=4, GR=C)
  • Pre-operative information on stoma management should be offered, supplemented by booklets and demonstrations of relevant stoma appliances. (LE=4, GR=C)

Post-operative Teaching

Give a checklist of instructions how to change a stoma appliance to the patient. (LE=4, GR=C)

Discharge and Follow-up

A checklist could be useful to ensure that aspects of patients education are not overlooked. (LE=4, GR=C)

Post-operative Care

Post-operative Observation of Stoma

  • Post-operative visual check of stoma to be recorded at the same time and frequency as cardiovascular observations. (LE=2b, GR=B)
  • Check the temperature of the stoma through the appliance. (LE=4, GR=C)

Stoma Management by Patient and Family/Carers

Role of Family and Carers3

  • Inform patients they can bring a relative to the pre-operative meeting, thereby giving the relative opportunities to ask questions and to discuss issues regarding treatment. (LE=2b, GR=B)
  • Understanding of family dynamics is essential. Obtain a quick assessment of family dynamics when meeting with the client and family. Watch how the client and his or her family interact. (LE=2b, GR=B)
  • Provide ostomy teaching prior to surgery. If this is not possible, begin teaching as soon as the client is alert, awake, and says their pain is under control. (LE=2b, GR=B)
  • Encourage patients to participate in ostomy care as much as possible. (LE=2b, GR=B)
  • Introduce new ostomy products slowly and easily. Present the patient with choices and allow him or her to decide whether any changes should be made. (LE=2b, GR=B)

3Adapted from Wong VK, White MA. Family dynamics and health locus of control in adults with ostomies. J Wound Ostomy Continence Nurs 2002;29(1):37-44.

Procedure for Discharge Care

Table: Suggestion for Pouch-Changing Procedure
  • Remove the pouch
  • Inspect stoma and skin
  • Wash around the stoma
  • Dry around the stoma
  • Eventually apply skin care products
  • Competently apply a new pouch and check that is correctly sealed
  • Prepare the night bag to the pouch
  • Empty the pouch during the day

 

Table: Topics to Be Discussed at Discharge with the Patient and Carers
  • Explain the process of follow-up by the surgeon and stoma care nurse
  • Provide a contact telephone number for acute problems or questions
  • Explain what to do when problems occur, such as odour, urinary tract infection (UTI), leakage, etc
  • Explain that mucus is normal and what to do when there is more mucus than normal
  • Explain that the stoma is oedematous and swollen in the initial post-operative period and that its size will gradually reduce over 6-8 weeks
  • Explain that the stoma can bleed easily on contact
  • Explain the colour of normal urine, red or cloudy urine, offensive odour and the action to take
  • Explain about bathing, clothing, travelling, work, hobby, sexuality, etc
  • Stoma management is best learned by steps of enhancing learning. (LE=3, GR=C)
  • A teaching plan will increase learning by the patient. (LE=3, GR=C)
  • At discharge the nurse should discuss topics mentioned in the table above and support this with written information. (LE=3, GR=C)

Discharge Care

Patient Control Visits/Calls

  • Patient's visits to or calls by the NS start prior to surgery and for at least 3 months after hospital discharge, but preferably until 2 years after discharge. (LE=3, GR=C)
  • Patients should know that specialised stoma care from a NS is available to them long term. (LE=3, GR=C)
  • Patients should have a contact telephone number, together with details of their local community stoma care clinic or hospital. (LE=3, GR=C)
  • Patients with specific problems should be referred to other specialist staff if these services are available. (LE=3, GR=C)
  • Long-term (annual) follow up in a urological department is needed because of the high rate of urostomy-related complications. (LE=2b, GR=B)

Patient Diary

The NS should provide the patient with a brief written history of surgery, reason for surgery, type of stoma and appliances used. (LE=4, GR=C)

Information about Possible Complication

Discharge information must be given about the common complications. (LE=4, GR=C)

Proactive and Preventive Care

Traveling with a Stoma

Table: Patient Advice for Traveling with a Stoma
  • Always take extra appliances, as a change of climate may need more frequent changes of appliance.
  • Patients can obtain information on where to buy additional supplies at a travel destination from the urostomy manufacturer.
  • Appliances should be kept out of the heat to prevent the adhesive melting.
  • To save space, appliances can be taken out of their boxes and packed into clean plastic bags.
  • Always carry appliances in the hand luggage, when traveling by air, in case checked-in luggage arrives later or disappears.
  • Scissors cannot be taken through security in airports, so all appliances should be cut to fit on beforehand.
  • Extra luggage (5 kg) when traveling by plane is possible. A medical letter must be provided.

The NS should give advice on travelling with a stoma. (LE=4, GR=C)

Medic Alert Bracelet, 'Can't Wait' Card, Disability Card

The NS should provide patient with a travel certificate and 'Can't Wait' card on discharge for future use. (LE=4, GR=C)

Treatment for Urinary Tract Infections (UTIs), Fluid Intake and Effect of Food on Urine

Patient education before discharge about UTI symptoms and adequate fluid intake. (LE=4, GR=C)

Skin Care

  • Regular observation of peristomal skin to identify potential complications. (LE=4, GR=C)
  • Use skin care tools for correct identification. (LE=4, GR=C)

Urine Testing from an Ileal Conduit

To collect urine for analyses catheterise the ileal loop. (LE=4, GR=C)

Parastomal Hernia (PSH)

Prevention of PSH

Support garments should be recommended post surgery. (LE=4, GR=C)

Latex Hypersensitivity

  • All devices used by urostomy patients should preferably be latex free to reduce their risk of developing latex allergy because of their lifelong use of appliances. (LE=4, GR=C)
  • Patients must also know that if they have an allergic reaction, it could be an allergic reaction to latex. (LE=4, GR=C)

Products

Refer to the original guideline for a discussion of types of urostomy appliances (bags) and other urostomy products (barrier strips/rings, pastes, belts, and binders).

Skin Care Products

Skin Barriers (Second Skin)

Use a silicone based product in all patients who require a skin barrier. (LE=4, GR=C)

Karaya Moisture Absorber

Use Karaya moisture absorber or a similar powder in patients with appliance adhesion problems or follow local policy. (LE=4, GR=C)

Complications and Problems of Having a Urostoma (Urostomy)

Physical Problems

Skin Irritation

  • A stoma nurse should collect data related to the skin, such as underlying skin diseases or immunological disorders, as part of the pre-operative assessment of the peristomal skin. (LE=4, GR=C)
  • To prevent skin irritation from failure of the pouching system, due to a poorly sited stoma, the stoma site should be marked out prior to surgery by a stoma (or Wound, Ostomy and Continence) nurse. (LE=4, GR=C)
  • To prevent skin irritation, the Guidelines Group recommends cleaning of the peristomal skin using warm water and gently drying with gauze. Men should be shown how to shave peristomal hair without damaging the skin and moving outwards away from the stoma. (LE=4, GR=C)
  • To prevent skin irritation the patient should be taught to cut the barrier, so that the opening just fits the size of the stoma. This will minimise the risk of urine coming into contact with the peristomal skin. It is important to tell the patient that the stoma will decrease in size for at least 8 weeks after surgery and that the size of the opening of the barrier must also change. (LE=4, GR=C)
  • When treating skin irritation, it is important to assess the aetiology. A skin barrier that resists urine erosion can be used. (LE=4, GR=C)

Leakage

Patients with a leakage problem should be advised to consult a stoma care nurse for solving the problem. (LE=4, GR=C)

Urinary Tract Infections (UTIs)

No treatment for asymptomatic bacteriuria, unless there is a history of recurrent pyelonephritis (asymptomatic bacteriuria: presence of bacteria in urine without symptoms). (LE=2b, GR=B)

Complications Caused by Significant Variation in pH of Urine

The following are recommended for acid urine (LE=2b)

  • An 'acid-ish' diet – a diet high in animal protein, which includes butter, cheese, fats, and lentils
  • Decreased intake of citrus fruits (orange juice!)
  • Ammonium chloride as the preferable urinary acidifier

UTI, Mucus and Stones Formation: Use of Cranberry

Cranberry can be advised in daily practice when patients have complaints of (symptomatic) UTI and/or excess mucus, and/or skin problems, and/or leakage problems. (LE=4, GR=C)

Refer to the original guideline document for further discussion of physical problems associated with urostomy, including retraction, mucus production, granuloma, stomal bleeding and ulceration, and purple bag syndrome.

Psychological and Social Problems

Refer to the original guideline document for a discussion of postoperative social considerations as well as cultural and psychological aspects of care.

Sexual Function

Sexual Dysfunction in Males

Treatment of Erectile Dysfunction

Male patients with post-operative erectile dysfunction should be assessed for suitability for treatment if requested. (LE=4, GR=C)

Sexual Dysfunction in Females

  • Radical pelvic surgery need not mean the end of an active sex life for either men or women. Restoration of sexual activity may, however, require further treatment, a certain degree of adaptability and specialist intervention. (LE=4, LE=C)
  • Patients should be advised pre-operatively of potential alterations to their pre-surgical sexual function. (LE=4, GR=C)
  • Post-operative counselling should include discussion of treatment options and their suitability for individual patients. (LE=4, GR=C)

Definitions:

Levels of Evidence (LE)

1a Evidence obtained from meta-analysis of randomized trials

1b Evidence obtained from at least one randomized trial

2a Evidence obtained from one well-designed controlled study without randomization

2b Evidence obtained from at least one other type of well-designed quasi-experimental study

3 Evidence obtained from well-designed non-experimental studies, such as comparative studies, correlation studies and case reports

4 Evidence obtained from expert committee reports or opinions or clinical experience of respected authorities

Grades of Recommendation (GR)

  1. Based on clinical studies of good quality and consistency addressing the specific recommendations and including at least one randomized trial
  2. Based on well-conducted clinical studies, but without randomized clinical trials
  3. Made despite the absence of directly applicable clinical studies of good quality
Clinical Algorithm(s)

None provided

Evidence Supporting the Recommendations

Type of Evidence Supporting the Recommendations

The type of supporting evidence is identified and graded for each recommendation (see the "Major Recommendations" field).

Benefits/Harms of Implementing the Guideline Recommendations

Potential Benefits

Appropriate preoperative and postoperative management of urostomy

Potential Harms

Not stated

Contraindications

Contraindications

Phosphodiesterase type 5 (PDE5) inhibitor treatment is not suitable for men using nitrates or with a diagnosis of hypertension or recent myocardial infarction.

Qualifying Statements

Qualifying Statements

These guidelines are not meant to be proscriptive, nor will adherence to these guidelines guarantee a successful outcome in all cases. Ultimately, decisions regarding care must be made on a case-by-case basis by health care professionals after consultation with their patients using their clinical judgement, knowledge and expertise.

Limitations of Document

The European Association of Urology Nurses (EAUN) acknowledge and accept the limitations of this document. It has to be emphasised that the current guidelines provide information about the treatment of an individual patient according to a standardised approach. The information should be considered as providing recommendations without legal implications. The intended readership is the pan-European practising urology nurse and nurses working in a related field. This guidelines document is of limited use to, for example, urologists, other healthcare providers or third-party payers. Cost-effectiveness considerations and non-clinical questions are best addressed locally and therefore fall outside the remit of these guidelines. Other stakeholders, including patient representatives, have not been involved in producing this document.

Implementation of the Guideline

Description of Implementation Strategy

An implementation strategy was not provided.

Implementation Tools
Chart Documentation/Checklists/Forms
Mobile Device Resources
Resources
For information about availability, see the Availability of Companion Documents and Patient Resources fields below.

Institute of Medicine (IOM) National Healthcare Quality Report Categories

IOM Care Need
Living with Illness
IOM Domain
Effectiveness
Patient-centeredness

Identifying Information and Availability

Bibliographic Source(s)
Incontinent urostomy: community care, follow-up and complications. In: Geng V, Cobussen-Boekhorst H, Fillingham S, Holroyd S, Kiesbye B, Vahr S. Incontinent urostomy. Arnhem (The Netherlands): European Association of Urology Nurses (EAUN); 2009 Mar. p. 19-65.
Adaptation

Not applicable: The guideline was not adapted from another source.

Date Released
2009 Mar
Guideline Developer(s)
European Association of Urology Nurses - Medical Specialty Society
Source(s) of Funding

European Association of Urology
Hollister Incorporated

Guideline Committee

European Association of Urology Nurses Guidelines Working Group for Urostomy

Composition of Group That Authored the Guideline

Primary Authors: V. Geng; H. Cobussen-Boekhorst; S. Fillingham; S. Holroyd; B. Kiesbye; S. Vahr

Financial Disclosures/Conflicts of Interest

The European Association of Urology Nurses (EAUN) Guidelines Working Group members have provided disclosure statements of all relationships that might be a potential source of conflict of interest. The information has been stored in the European Association of Urology (EAU) database. This Guidelines document was developed with the financial support of the EAU and Hollister Incorporated. The EAUN is a non-profit organisation and funding is limited to administrative assistance and travel and meeting expenses. No honoraria or other reimbursements have been provided.

Guideline Status

This is the current release of the guideline.

Guideline Availability

Electronic copies: Available in Portable Document Format (PDF) from the European Association of Urology Nurses (EAUN) Web site External Web Site Policy. Also available as an E-book External Web Site Policy and as a handheld version External Web Site Policy from the EAUN Web site.

Print copies: Available from the European Association of Urology, PO Box 30016, NL-6803, AA ARNHEM, The Netherlands. E-mail: eaun@uroweb.org.

Availability of Companion Documents

A Quality of Life Evaluation Form can be obtained through contacting the European Association of Urology Nurses (EAUN) External Web Site Policy.

Patient Resources

None available

NGC Status

This NGC summary was completed by ECRI Institute on August 17, 2010. The information was verified by the guideline developer on September 21, 2010.

Copyright Statement

This summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.

Disclaimer

NGC Disclaimer

The National Guideline Clearinghouse™ (NGC) does not develop, produce, approve, or endorse the guidelines represented on this site.

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