Empty the Pouch (Nursing)

by Samantha Rhea, MSN, RN

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      Slides Ostomy Pouching Systems Nursing.pdf
    • PDF
      Review Sheet Changing an Ostomy Bag Nursing.pdf
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      Clinical Skills Nursing Reference List.pdf
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    00:05 Now let's talk about emptying the waist pouch, okay so there's some variations of this that we're going to walk through and there's also different reasons why we actually need to empty the pouch so let's talk about those, so first, okay when you even need to empty an ostomy bag if you take a look at this appliance this has got a great level here for you but really think about the more full this thing is, you don't want stool or feces backing up and sitting on that stoma right, so we really need to be diligent about emptying this ostomy bag. So if you look here about like one third about one half full is ideally on making sure we empty that ostomy bag if it gets about that full, and again think about it, this is probably going to be most likely setting on the patient's stomach you don't want a lot of weight either here and pulling on it, that excess weight's uncomfortable, it's going to be much heavier on the patient's stoma, it's also going to pull on the device and we don't want that.

    01:08 Now let's take a look specifically at how we empty it, so just know with patient stoma a lot of times your patients are really familiar with how to care for these so the more independence that they can do please allow them to do so, it gives them some ownership of taking care and providing self-care for themselves. Okay, so if the patient's at home or even in the hospital if they can do this themselves please allow them to do so. The patient can simply go to the toilet and empty the pouch directly into the toilet so this is really a great way to do this. Now sometimes of course the patient can't sit on the toilet like they can't ambulate for example out of the hospital bed or they can't ambulate to go to the toilet then we're going to need to assist them with this. Now to do so, if you're going to need to assist you want to take the bottom of the ostomy pouch because this is where everything's going to dump out so of course we don't want to hold the bottom down, we want to hold it up a little bit, now typically there's going to be a closure or some velcro that's going to keep this close and we want to remove this and set that aside, now don't lose the clamp! Now we want to slowly unroll the top or the opening of that, put it over maybe a basin or graduated cylinder and then we want to empty it from there. So one way to empty it, you can take your fingers and kind of slide it down the pouch to make sure you push all of the stool out. Now we just talked about ending a pouch or burping the pouch sometimes we may need to clean this if there's any excess stool or feces around that, now we just want to really take the ins take some toilet paper wipe the inside and the outside of the tail with toilet paper; this is going to help remove any excess odor. Now it's important to check both sides of that pouch for any tears or holes, now if there's anything like this you may need to replace the new pouch. Now if the pouch closes with a clamp make sure if they clamp a soil to rinse that before you apply it. Now how many times a day do you think the clients with ostomies may need to empty this? Now this is going to vary a lot on the patient's diet for example but most patients are going to need to empty this anywhere from like 4 to 10 times a day in a 24 hour period so again this is going to vary client to client.

    03:34 Hi guys, I want to show you how we want to empty an ostomy bag for a client also when we get done anytime we empty it we definitely want to make sure we clean the pouch as well so I'll show you that as well. Now again if the patient can empty the ostomy bag on their own that's great and we want to encourage them to do so, they would simply do this by going to the nearby bathroom setting over the toilet and also emptying the contents. However, many times as a nurse you may have to help a client do this so I'm going to show you how we would do that here. So before we get started make sure your patients in a comfortable position also make sure you've got your equipment and the patient is, is supported or protected, sorry, excuse me with a pad or a towel that way excess stool or anything else don't get on their linens or their bed sheet. So now let's go ahead and take a look at this, so I've got here again an absorbent towel just to make sure we don't we catch anything and it doesn't get on the patient's linen, I've also put a bedpan here so I've decided to do this because especially in the hospital once we empty the contents many times you can go to the bathroom and also rinse this out for future use, so that's what we'll use here today. So now I've got my patient's ostomy, now there's going to be a difference, this one we're looking at is a one-piece ostomy so sometimes there's two-pieces and those are really convenient. Now if a patient has a two pouch or a two-piece ostomy, if the patient has stool or feces in this we can simply just remove that pouch piece rinse it out for the patient and reapply so that makes that really nice. However, sometimes you're working with a one-piece like you see here and I'll show you how to do that now. Okay so we've got our patients one-piece, one thing to remember is hold on to the tail especially you've got to hold on to the tail if you were going to put this into a stool or toilet or if the patient was going to do this themselves.

    05:38 So now we need to remove the clamp don't lose this clamp because we're going to need this.

    05:45 So I've got the tail of the ostomy bag, I'm going to direct it into my bed pan here and I want to make sure that goes into the bed pan, so what I want to do now is take one hand or use your hand or your fingers, you want to be able to push as much of the stool as possible down into the bedpan.

    06:13 It's a good idea to kind of support the top so it's not pulling on the patient too much and now once we get towards the bottom now I can just kind of milk this down and try to get as much as the ostomy contents down as much as possible.

    06:45 Okay so once I've emptied my bag sometimes you may need to change out your glove so I'm going to do that now. Now once we've emptied our contents we can move that aside but also before I leave I want to make sure I empty or excuse me clean out the bottom of the pouch, so you can use a washcloth or toilet paper but I also like to use those bath wipes those are really helpful.

    07:21 So I'm going to take my towel make sure I cleanse off the bottom, also it's a good idea to wipe the inside of the pouch right at the tail.

    07:49 And you want to do this as much as possible and don't forget it's really important to make sure you reapply the clamp.

    08:00 Now that we've reapplied the clamp to the end of the ostomy bag, we want to make sure we remove everything from the patient's bed.

    08:16 Now of course we want to make sure we rinse this out thoroughly for future use so I'm going to take this to the bathroom and or set it aside to make sure we can rinse this out thoroughly later.

    08:30 Now don't forget before we leave the patient make sure they're comfortable so now I'm going to remove my gloves, I'm going to perform my hand hygiene then I'm going to make sure that I make the patient comfortable again before I exit the room.

    08:48 So make sure our patient's linens are back pulled up and then we're going to make sure we put up that side rail, and again check with your patient and make sure they're in a comfortable position and they're call lights within reach.

    About the Lecture

    The lecture Empty the Pouch (Nursing) by Samantha Rhea, MSN, RN is from the course Ostomy Pouching Systems (Nursing).

    Included Quiz Questions

    1. When it is one-third full
    2. Always
    3. When it is completely full
    4. When it is three-quarters full
    1. Encourage the client to empty their ostomy bag if able.
    2. Slowly unroll the tail over the basin.
    3. Hold the bottom of the pouch down before opening the Velcro closure or removing the clamp.
    4. Slide your fingers down the pouch to push out all stool.
    5. Empty the ostomy bag at least ten times a day.
    1. Wipe the inside and outside of the tail to prevent odor.
    2. Clean the pouch clamp.
    3. Check both sides for tears and holes.
    4. For a one-piece pouch, detach and clean it in the sink.
    5. Let the open pouch soak in a basin of water.
    1. Encourage the client to empty their ostomy pouch if able.
    2. Use the same gloves while emptying and cleaning the ostomy pouch.
    3. Apply a new ostomy pouch every day.
    4. Throw away the clamp after each cleaning and apply a new one.
    1. They should empty it directly into the toilet.
    2. They should empty it into a cylinder.
    3. Only home nurses should empty it.
    4. Clients only have ostomy pouches in the hospital.

    Author of lecture Empty the Pouch (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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