Colostomy                          
Illeostomy                          
Urostomy/Ileal Conduit                          
Continent Urostomy                          
Estimate the number of patients you have treated in the past month for...
What is your profession?
Surgeon
Other Physician
Wound Ostomy Continence Nurse
Registered Nurse (RN)
Advanced Practice Nurse
Home Health Care Nurse
UOAA Support Group Leader
Hospital Administrator
Other
 
Yes No
What percentage of your patients received pre-op education in the past month?
None
1% - 25%
26% - 50%
51% - 75%
76% - 100%
 
What methods are available to you for implementing educational sessions with your patients? Check all that apply:
Internet - Computer
DVD/CD Video
What materials are typically included in your pre-op education sessions with your patients? Check all that apply:
Procedure information
Stoma care images/photos
Demonstration of skills
Printed self-care instructions
Support group contact info
Video/Digital Media (CD, DVD)
Links to online resources
Commercial handouts/brochures
Sample supplies/equipment
Stoma location marking
Empty their pouch                          
Measure pouch to fit
their stoma		                          
Apply a newly cut pouch                          
Clean the skin around
their stoma		                          
Identify when to call
their surgeon		                          
Prior to discharge, estimate the percentage of your patients that can independently...
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