Continuity of Outpatient Care for Patients with an Intestinal Fistula in China

Abstract

Objective: To report on the current state of outpatient nursing care for patients with an intestinal fistula in a stoma clinic in China.

Methods: This retrospective study included 41 patients with an intestinal fistula who visited the stoma clinic in a tertiary hospital in Shanghai, China, between January 2019 and December 2023. Electronic medical records were selected for analysis of patients' clinical data, fistula diagnosis and treatment process, and outcome regression.

Results: Few patients with an intestinal fistula are referred to the stoma clinic for nursing care (1.29%). At patients' first visit to the stoma clinic, the majority of those with an intestinal fistula (87.80%) had perifistular moisture-associated skin damage (MASD). The mean discolor, erosion, and tissue score was 6.73 ± 4.35, the mean healing time for MASD was 8.77 ± 8.51 days, and the mean number of follow-ups was 3.41 ± 1.92. The majority of patients (87.80%) complained of accompanying pain of different degrees. The mean self-healing time for nonoperative treatment was 301.96 ± 193.95 days. Enterostomal therapists applied the dressings to care for the skin around the fistula and formulated and guided a personalized management method to effectively contain output.

Conclusions: The quality of outpatient nursing care for patients with an intestinal fistula needs to be optimized. Standardized assessment and individualized precise intervention can reduce the incidence of complications such as MASD and improve the quality of care and prognosis of patients.

Keywords: complications; countermeasures; intestinal fistula; moisture-associated skin damage; nursing care; out-of-hospital mentoring; retrospective analysis.