DOI: 10.1093/bjs/znad258.547 ISSN:

1246 High Output Stoma Management Audit

J Mollier, M Jenkinson, A Serisier, P Gurung, M Jacob
  • Surgery



High output stomas lead to a myriad of complications for patients including dehydration, electrolyte imbalances, poor skin integrity & altered bowel function. However, this issue is not well recognised amongst junior doctors. This audit’s aim was to improve awareness of high output stomas including their implications and management according to the Association of Stoma Care Nurses’ (ASCN) national guidelines amongst junior doctors.


An electronic survey was distributed to 20 junior doctors working in General Surgery at Southend University Hospital, assessing their knowledge on recognition and management of high output stomas. A checklist summarising the ASCN guidelines was then created. A post-intervention survey was then distributed to assess for improvement in knowledge and application of ASCN guidelines as well as use of the checklist.


Overall, 51% answers were correct in the first survey compared to 72% answers correct in the post-intervention survey, and 83% of participants used the checklist. There was improvement in use of IV fluids (50% to 100%), monitoring fluid balance (80% to 91%), fibre restriction (37% to 70%), fluid restriction (50% to 70%), checking & replacing Mg (65% to 87%) & use of regular codeine (70% to 77%), as well as moderate improvement in appropriate doses of loperamide being given (5% to 30%).


The above audit resulted in an improvement of knowledge and application of evidence-based guidance provided by ASCN, with ultimate intent to improve patient outcomes. Further work includes distribution of the checklists throughout the hospital and to other hospitals.

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