Study Results Support Content Validation of New Standardized Algorithm for Ostomy Care

Published in October Issue of Ostomy Wound Management

Oct 28, 2010, 09:00 ET from ConvaTec

SKILLMAN, N.J., Oct. 28 /PRNewswire/ -- Quantitative and qualitative results of a study conducted with ostomy care nurses support the content validation of a new standardized algorithm for ostomy care, according to an article published this month in the journal Ostomy Wound Management.(1)

Building on existing evidence-based literature and best practice documents, including those of the Wound Ostomy and Continence Nurses (WOCN) Society, the new Ostomy Algorithm represents the first comprehensive guideline for ostomy care management to undergo content validation.  

The Ostomy Algorithm consists of 11 assessments, beginning with the type of ostomy, intended to provide a pathway to help non-specialist clinicians optimize care for their patients with an ostomy.  One of the assessments is a new evidence-based instrument, known as the SACS™ Instrument, to objectively assess and classify peristomal lesions(2), a common complication affecting people with an ostomy.(3)

"With a majority of ostomy care now occurring outside of a specialist setting, there is a clear need for evidence-based guidelines in this area," said Janice Beitz, PhD, RN, CS, CNOR, CWOCN, CRNP and lead author, "and especially as patient rehabilitation and quality of life are highly dependent on proper identification and assessment of stoma and skin complications."

Developed by an expert panel comprised of WOCN clinicians with support from ConvaTec, a world-leading developer of innovative medical technologies for community and hospital care, the Ostomy Algorithm is also modeled on the content-validated Solutions® Algorithms for Wound Care, pioneered by ConvaTec more than 10 years ago and still the only comprehensive evidence-based guidelines for wound management available today.

In the study, conducted among a nationally representative sample of 166 ostomy care experts, participants were asked to quantify the degree of validity of the Ostomy Algorithm's decisions and components, using a four-point rating scale (4 = relevant/very relevant).  The mean relevancy score for the Ostomy Algorithm overall was 3.8, resulting in an overall content validity index of .95 (out of 1.0).  Individual component scores ranged from 3.59 to 3.91.(1)

"As our study shows, the new Ostomy Algorithm was very well received by expert nurses, who gave it strong content validity scores overall and across each of its component assessments," commented Beitz.  "With further refinements based on participant feedback and upcoming research planned with staff nurses, the new Ostomy Algorithm holds tremendous potential to improve patient outcomes."

About the SACS™ Instrument

Assessment 10 in the Algorithm incorporates the SACS™ Instrument.  Developed to help establish a standard language for peristomal lesions, the SACS™ Instrument allows a healthcare professional to assess and classify a peristomal lesion in three steps.  The first step is to assess the Lesion Type (L) per one of the five lesion categories.  A visual guide of the five categories provides examples of lesion types showing progressive skin deterioration along with a standard definition for each lesion.  Once the lesion category is identified, the second step is to identify the Topographical Location (T) of the lesion in relation to the stoma.  A clock face visual using standard quadrant terminology allows the staff nurse or clinician to determine which peristomal quadrants are affected.  The third step is to document the Lesion Type (L) and Topographical Location (T) as the patient's SACS™ Classification.

Initially developed by a consensus of Italian healthcare professionals (the Studio Alterazioni Cutanee Stoma, or Study on Peristomal Skin Lesions, study group), the instrument was published in Ostomy Wound Management in 2007; following that, it was endorsed by the Italian ET association (AIOSS) and adopted in Italy.  

About ConvaTec

ConvaTec is a leading developer and marketer of innovative medical technologies that have helped improve the lives of millions of people worldwide.  With four key focus areas – Ostomy Care, Wound Therapeutics, Continence and Critical Care, and Infusion Devices – ConvaTec products support health care professionals from the hospital to the community health setting.   For more information, please visit

SACS is a trademark of ConvaTec Inc.

Solutions is a registered trademark of ConvaTec Inc.

© 2010 ConvaTec Inc.


(1) Beitz J et al.  Content validation of a standardized algorithm for ostomy care. Ostomy Wound Management.  2010;56(10):22-38

(2) Beitz J, Ho M. Content validation of an ostomy algorithm with peristomal skin assessment (SACS) instrument. Poster presented at the 2010 Joint Conference of The Wound, Ostomy, and Continence Nurses Society and World Council of Enterostomal Therapists; June 12-16, 2010; Phoenix, AZ.

(3) Colwell, J., & Beitz, J. Survey of wound, ostomy, continence nurse clinicians on stomal and peristomal complications: A content validation study. J Wound Ostomy Continence Nurse. 2007;34(1):62


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