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Canadian Association for Enterostomal Therapy







Association Canadienne des Stomothérapeutes


December 2014


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For more information call 1-800-263-7400 visit Hollisterr.com .com 1. Malone M, Bjarnsholt T T,, McBain AJ, et al. The prevalence pr of biofilms in chronic wounds – a systematic review and meta-analysis a-analysis of published data. J Wound W Care. 2017; Jan 2;26(1):20-25. 2. Percival SL, Suleman L. Slough and biofilm: removal of barriers to wound healing by desloughing. J Wound Care. 2015; Nov;24(11):498-510. 10. 3. Nakagami G, Schultz G, Gibson DJ, et al. Biofilm detection by wound blotting can predict slough development in pressure ulcers: a prospective observational study. Wound Rep and Reg. 2017; 25:131-138. 38. 4. Applewhite AJ, Attar P, P, Liden B, Stevenson Q. Gentian violet and methylene blue polyvinyl alcohol foam antibacterial dressing as a viable form of autolytic debridement in the wound bed. Surg Technol Technol Int. 2015 May; 26:65-70. 5. Hill R. Optimizing the wound bed by removing r devitalized tissue and using methylene blue and gentian violet antibacterial foam dressings: a case series. Poster presented at Wounds Can nada; May 12-14, 2017; Kamloops, BC. 6. Prest D. Managing challenging chronic wounds in the community setting using an antibacterial PV VA A foam dressing dr containing methylene blue and gentian violet. Poster prresented at CA AWC; WC; October 29 – November 1, 2015; Tor Toronto, ON. 7. Woo KY Y,, Heil J. A prospective evaluation of methylene blue and gentian violet dressing for management of chronic wounds with local infection. on. Int Wound W J. 2017; doi: 10.1111/iwj.12753

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The LINK, the official publication of the Canadian Association for Enterostomal Therapy (CAET) is published three times a year. It is indexed in the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database.


The LINK accepts contributions in the form of professional news, research projects and findings, clinical papers, case studies, reports, review articles, questions for clinical corner, and letters to the editor. Advertising and news from industry are also welcome. The deadline for submissions to the next edition of The LINK is December 10th, 2017. La revue Le LIEN est une publication officielle de l’Association canadienne des stomothérapeutes publiée trois fois par année et indexée dans la banque de données «Cumulative Index to Nursing and Allied Health Literature». Le LIEN accepte toute contribution sous les formes suivantes: nouvelles professionnelles, projets de recherches, études cliniques, études de cas, rapports, revues d’articles, questions destinées à la section clinique et lettres à l’éditeur. Les publicités et nouvelles de l’industrie sont aussi les bienvenues. La date limite pour la soumission d’un écrit à paraître dans le prochain numéro de Le LIEN est le 10 décembre 2017. For further information or to submit content/ Pour de plus amples renseignements ou pour soumettre un écrit, veuillez contacter: Tel: 1-888-739-5072 Email: [email protected] The LINK is published by Clockwork Communications Inc. on behalf of CAET. Clockwork Communications Inc. PO Box 33145, Halifax, NS, B3L 4T6 Tel: 902.442.3882 Fax: 888.330.2116 www.ClockworkCanada.com Managing Editor: Deborah McNamara Art Director: Sherri Keenan Translator: Jocelyne Demers-Owoka Please forward any changes in membership status or address to: Noëlla Trudel Tel: 1-888-739-5072 Fax: 613-834-6351 E-mail: [email protected] Website: www.caet.ca/membership.htm ISSN 1701-2473 Publications Mail Agreement No. 42202514 Return Undeliverable Canadian Addresses to 66 Leopolds Drive, Ottawa, ON, K1V 7E3 [email protected]




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CAET PRESIDENT’S MESSAGE Submitted by: Rosemary Hill, RN, BSN, CWOCN, CETN(C), CAET President. [email protected]


s 2017 comes to a close let’s take a moment to pause… pause to celebrate, pause to take inventory, and pause to see what we can learn from this past year. For CAET it has certainly been quite a year! Some of the projects and activities included the redesign of our CAET website. The site contains considerable amounts of very useful information presented in a user-friendly format. That includes archived monthly webinars on topics related to Wound, Ostomy and Continence. If you missed any of the webinars I would encourage you to check out the website, under education, for some key current clinical topics presented by speakers who are well known Enterostomal Therapy leaders. A new, and very welcome, addition is the Members Only Discussion Forum which can be accessed from the member section of the website. This online conversation continues to provide an opportunity for members to share and discuss relevant practice issues/challenges and creative ideas. CAET’s “Find an ET” has also been upgraded and is running efficiently with its revised database. Members have the ability to list their work email

to receive enquiries via “Find an ET”. Other website projects included the recently redesigned ISTAP website (an official interest group of CAET). Check it out at www.skintears.org. CAET Academy experienced a surge of new applications and expanded to offer a third cohort starting in May 2017 (in addition to the cohorts that begin in January and September). The increase in applicants came primarily from the west coast where several ET positions are now open and numerous nurses are looking to join this specialized field. Another highlight in May was the CAET’s 36th Annual Conference in London, ON. This was a very well attended conference due, in no small part, to our collaboration with the Ontario South West Regional Wound Care Group led by its Chair Crystal McCallum. Kudos to Mary Hill and her Conference Planning team who provided us with numerous great learning opportunities that resulted in the creation of many new partnerships. Mid October 2017 was an exciting time of strategic planning for CAET and the

CAET’s most significant impact for 2017 was the CAET Members vote in favour of re-naming of our association and specialty. 4

December 2017


Academy. The CAET Board, Executive Director, Academy Director and Core Program Leaders participated in an extensive three-day long strategic planning session to create the plan that will direct the CAET for the next three years. This plan will be presented at the Annual Members Meeting during the 2018 National Conference in May. CAET’s most significant impact for 2017 was the CAET Members vote in favour of re-naming of our association and specialty. This collective, and detailed, process was led by Executive Director Cathy Harley. After more than 36 years using the term Enterostomal Therapy Nurse we will now move forward under the role title of Nurse Specialized in Wound, Ostomy, and Continence (NSWOC) with a new association name of Nurses Specialized in Wound, Ostomy, and Continence Canada. We will launch our new names the first week of May 2018. I have shared some of my reflections on the changes and growth to our association in 2017. I would now encourage you to reflect on your own personal journey in 2017. What were your highlights and what challenges will prompt change in the year ahead? As you think of the coming year don’t forget to consider the opportunity to attend the 2018 CAET National Conference, May 3-6 in Victoria, BC, with its theme of Turn Knowledge into Action. We will see you there! cd

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MESSAGE DE LA PRÉSIDENTE DE L’ACS Soumis par : Rosemary Hill, inf., B.Sc.Inf., stomothérapeute certifiée, ICS(C), présidente de l’ACS [email protected]


lors que l’année 2017 tire à sa fin, prenons un moment pour nous arrêter… nous arrêter pour célébrer, faire l’inventaire et réfléchir aux leçons que nous pouvons tirer de cette dernière année. Pour l’ACS, ce fut certainement une année assez mouvementée!

En 2017, l’événement ayant eu le plus grand impact pour l’ACS a été le vote des membres en faveur du changement de nom en anglais de notre association et de notre spécialité. 6

December 2017


Outre nos projets et activités, le site Web de l’ACS a été remanié. Ce dernier contient une quantité considérable de renseignements très utiles présentés sous forme conviviale, notamment une section d’archives de nos webinaires mensuels portant sur les plaies, les stomies et la continence. Si vous avez manqué n’importe lequel de ces webinaires, je vous encourage à jeter un coup d’œil à notre site Web, sous l’onglet Éducation, pour consulter des sujets-clés cliniques actuels présentés par des conférenciers réputés à titre de leaders en stomothérapie. Un nouvel ajout bien apprécié est le groupe de discussion réservé aux membres auquel on peut accéder à partir de la section réservée aux membres du site Web. Cette conversation en ligne continue de donner la chance aux membres de partager et de discuter d’enjeux/de défis pertinents à la pratique et d’idées créatives. La section « Trouvez une stomothérapeute » a également été mise à jour et fonctionne plus efficacement grâce à sa base de données révisée. Les membres peuvent indiquer leur courriel au travail pour recevoir des demandes par le biais de la fonctionnalité « Trouvez une stomothérapeute ». Parmi

les autres projets liés au site Web, notons que le site Web de l’ISTAP (International Skin Tear Advisory Panel) (un groupe d’intérêt officiel de l’ACS) a récemment été remanié. Jetez-y un coup d’œil à : www.skintears.org. L’Académie de l’ACS a connu une hausse des nouvelles demandes et a élargi ses services pour offrir une troisième cohorte qui a commencé en mai 2017 (en plus des cohortes qui commencent en janvier et en septembre). Les nouveaux postulants proviennent principalement de la côte ouest où plusieurs postes de stomothérapeutes sont maintenant disponibles, ce qui pousse un grand nombre d’infirmières à vouloir se joindre à ce domaine spécialisé. Un autre point saillant au mois de mai a été la 36e Conférence annuelle de l’ACS à London, ON. Cette conférence a connu une grande affluence en grande partie en raison de notre collaboration avec le groupe Ontario South West Regional Wound Care Program dirigé par sa présidente, Crystal McCallum. Toutes mes félicitations à Mary Hill et son équipe de planification de la conférence qui nous ont permis de profiter de plusieurs excellentes opportunités d’apprentissage menant à la création de nombreux nouveaux partenariats. La mi-octobre 2017 a été un moment trépidant marqué par la planification MESSAGE DE LA PRÉSIDENTE DE L’ACS continue à la page 11

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EXECUTIVE DIRECTOR’S REPORT Submitted by: Catherine Harley, RN, eMBA, CAET Executive Director. [email protected]


ecember is a time of reflection. Looking back on 2017 the year has definitely been one of transition for CAET. The association has evolved, guided by our 2014-2017 strategic plan, and we hope that you were able to see and feel the progress that we have made. Enhancing Member Value: Our priority has been, and continues to be, about creating value for our members and growing our membership. In addition to expanding our reach within all facets of the wound, ostomy and continence health sectors we have launched several initiatives aimed at developing our next generation. These include having new ETNEP Graduates involved in projects, such as the CAET/ET name change project, and introducing new CAET Academy financial awards. We will continue to provide opportunities for new Enterostomal Therapy Nurses to participate in initiatives with experienced Enterostomal Therapy Nurses. Strengthening Communications: In 2017 the CAET launched a new website, a new member database, an upgraded “Find an ET Nurse” search engine and an on-line Member Discussion Forum. We participated in social media through the CAET Facebook page and @ETNurses twitter account. We published three issues of The Link, the official publication of the CAET, and continued to be actively involved in the Canadian Feature section of the JWOCN. We also provided monthly e-blasts of information to CAET Members. These, and many other initiatives, not only changed how

members experienced CAET but also the public and industry at large. Renaming and Rebranding CAET: On May 25, 2017 members in all provinces, except Quebec, voted in favour of a name change for Enterostomal Therapists to Nurses Specialized in Wound, Ostomy, and Continence (NSWOC) and the Canadian Association for Enterostomal Therapy will change to Nurses Specialized in Wound, Ostomy, and Continence Canada (NSWOCC). A contest was launched for CAET Members to submit a new idea for an association logo and branding colours to be used with the new name. The deadline for submissions was October 20, 2017. Please see the news section of caet.ca for further information on this contest. Bolstering Educational Offerings: In addition to the usual January and September ETNEP intakes, we added a third intake, in May 2017, in order to better meet the increased healthcare market demands for ET Nurses. The first K2P Wound Care Program, in partnership with Bow Valley College, was also launched this year. CAET also provided a webinar series to support continuing education. You can access past webinars through caet.ca (click on education and then webinars). The 2017 CAET National Conference in London, ON, was jam-packed with terrific educational opportunities including plenaries and workshops, from Enterostomal Therapy experts, as well as engaging breakout sessions focused on the topics you need most to improve your career.

Our priority has been, and continues to be, about creating value for our members and growing our membership. 8

December 2017


Improving Governance: We have reviewed the bylaws and policies in preparation for the CAET name change. This will help to streamline processes and support transparency. A new Core Program was created to manage the Canadian Feature Section of the JWOCN. Existing Core programs were energized to increase member engagement as we continue to build CAET’s future. With improvements in fundraising and expense management, for many key areas of the association, CAET is building a roadmap for financial and organizational stability that will keep it prospering for many years to come. Heartfelt thanks to CAET’s Board of Directors and Core Program Leaders, volunteers, the CAET Academy Faculty, contractors, Industry Partners, and to all of our members for the hard work and commitment to making CAET’s mission possible. Our accomplishments are the result of a collective effort. As you look to 2018 please make the most of your CAET membership. Attend the 37th National CAET Conference, at the member discounted price, or attend a Regional Meeting. Volunteer for a CAET Core Program. Start a conversation in the new CAET Discussion Forum. Recruit a peer to join CAET. Make 2018 your year to connect, learn, and grow. Thank you for your continued support! Happy Holidays! Here’s to an exciting 2018! cd


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RAPPORT DE LA DIRECTRICE GÉNÉRALE Soumis par : Catherine Harley, IA, M.B.A. pour cadres, directrice générale de l’ACS. [email protected]


e mois de décembre est propice à la réflexion. Rétrospectivement, l’année 2017 a sans contredit été une année de transition pour l’ACS. L’association a évolué, orientée par son plan stratégique de 2014 - 2017, et nous espérons que vous avez pu constater et ressentir les progrès que nous avons faits.

Rehausser la valeur pour les membres : Notre priorité a été et continue d’être la valeur qu’offre notre association aux membres en plus d’accroître le nombre de nos membres. Outre notre portée accrue dans tous les aspects des secteurs de la santé liés aux plaies, aux stomies et aux problèmes de continence, nous avons lancé plusieurs initiatives visant à développer notre prochaine génération. Parmi ces dernières, notons : la participation de nouveaux diplômés du PFIS dans des projets, comme le projet de changement de nom de l’ACS/des stomothérapeutes, et l’introduction de nouveaux prix de soutien financier à l’Académie de l’ACS. Nous continuerons d’offrir aux nouvelles stomothérapeutes des occasions de participer à des initiatives en compagnie de stomothérapeutes chevronnées. Renforcer les communications : En 2017, l’ACS a lancé un nouveau site Web doté d’une nouvelle base de données de ses membres, d’un moteur de recherche amélioré « Trouvez une stomothérapeute » et d’un groupe de discussion en ligne, réservé aux membres. Nous avons participé aux médias sociaux par le biais de la page 10

December 2017


Notre priorité a été et continue d’être la valeur qu’offre notre association aux membres en plus d’accroître le nombre de nos membres.

Facebook de l’ACS et du compte Twitter @ETNurses. Nous avons publié trois numéros de la revue Le Lien, la publication officielle de l’ACS et nous avons continué de participer activement à la section Chronique canadienne du JWOCN. Nous avons également offert aux membres de l’ACS des cyberenvois de masse mensuels d’information. Ces initiatives et de nombreuses autres ont non seulement modifié la façon dont les membres vivent leur expérience au sein de l’ACS, mais aussi la façon dont le public et l’industrie dans son ensemble la vivent. Renommer et modifier la marque de l’ACS : Le 25 mai 2017, les membres de toutes les provinces, à l’exception du Québec, ont voté en faveur d’un changement de nom en anglais des stomothérapeutes pour adopter celui de Nurse Specialized in Wound, Ostomy, and Continence (NSWOC) et le nom anglophone de l’association, soit Canadian Association for Enterostomal Therapy deviendra Nurses Specialized in Wound, Ostomy, and Continence Canada (NSWOCC). Un concours a été lancé à l'intention des membres de l’ACS afin de soumettre de nouvelles idées pour le logo de l’association et les

couleurs de la marque à être utilisées avec le nouveau nom. La date limite pour les soumissions était le 20 octobre 2017. Veuillez consulter la section Nouvelles du site www.caet.ca pour de plus amples renseignements concernant ce concours. Soutenir les programmes éducatifs : En plus des admissions habituelles au PFIS de janvier et septembre, nous avons ajouté, en mai 2017, une troisième session afin de mieux répondre à la demande accrue du marché en soins de santé pour les infirmières stomothérapeutes. Le premier programme K2P en soins des plaies, en partenariat avec le Collège Bow Valley, a également été lancé cette année. De plus, l’ACS a offert une série de webinaires afin d’appuyer la formation continue. Vous pouvez consulter les webinaires précédents en visitant le site Web www.caet.ca (cliquez sur l’onglet Éducation, puis sur celui Webinaires). La Conférence nationale 2017 de l’ACS à London, ON, a connu un achalandage monstre offrant de remarquables séances éducatives, notamment des séances plénières et des ateliers pour les stomothérapeutes chevronnées ainsi que des séances inspirantes en ateliers, axées sur les


RAPPORT DE LA DIRECTRICE GÉNÉRALE (suite) sujets dont vous avez le plus besoin pour propulser votre carrière. Améliorer la gouvernance : Nous avons révisé les règlements généraux et les politiques en vue du changement de nom en anglais de l’ACS afin de faciliter les processus et d’en appuyer sa transparence. Un nouveau programme de base a été créé pour gérer la section Chronique canadienne du JWOCN. Les programmes de base existants ont été dynamisés afin d’accroître la participation des membres à mesure que nous continuons de développer l’avenir de l’ACS. Grâce aux améliorations ayant été apportées à la gestion du financement et des dépenses pour plusieurs domaines clés de l’association, l’ACS élabore une feuille de route pour la stabilité financière et organisationnelle qui l’aidera à prospérer durant plusieurs années à venir. Sincères remerciements au conseil d’administration, aux leaders des

programmes de base, aux bénévoles de l’ACS, aux membres de la faculté de l’Académie de l’ACS, aux entrepreneurs et aux partenaires de l’industrie ainsi qu’à tous nos membres pour leur travail acharné et leur engagement à concrétiser la mission de l’ACS. Nos réalisations sont le résultat d’un effort collectif. Alors que vous songez à 2018, n’hésitez pas à profiter pleinement de votre adhésion à l’ACS. Participez à la 37e Conférence nationale de l’ACS, au prix réduit pour les membres, ou participez à une réunion régionale. Faites du bénévolat pour un programme de base de l’ACS. Entamez une conversation dans le nouveau groupe de discussion de l’ACS. Recrutez un pair pour adhérer à l’ACS. En 2018, impliquez-vous, apprenez et épanouissez-vous! Merci pour votre soutien continu! Joyeuses fêtes! Que 2018 soit des plus trépidantes! cd

MESSAGE DE LA PRÉSIDENTE DE L’ACS (suite) (cont. from page #6) stratégique de l’ACS et de l’Académie de l’ACS. Le conseil d’administration, la directrice générale, la directrice de l’Académie et les leaders du programme de base de l’ACS ont participé à une séance de trois jours de planification stratégique dans le but de créer le plan qui orientera l’ACS pour les trois prochaines années. Ce plan sera présenté lors de l’Assemblée annuelle des membres qui se tiendra durant la Conférence nationale en mai 2018. En 2017, l’événement ayant eu le plus grand impact pour l’ACS a été le vote des membres en faveur du changement de nom en anglais de notre association et de notre spécialité. Ce processus collectif et détaillé a été mené à bien par la directrice générale, Cathy Harley. Après plus de trente-six ans à utiliser le terme « Enterostomal Therapy Nurse », le titre anglophone de notre rôle passera

à « Nurse Specialized in Wound, Ostomy, and Continence (NSWOC) » et le nouveau nom en anglais de notre association sera dorénavant « Nurses Specialized in Wound, Ostomy, and Continence Canada ». Nous lancerons nos nouveaux noms durant la première semaine de mai 2018. Je vous ai fait part de mes réflexions quant aux changements et à la croissance de notre association en 2017. Je vous encourage maintenant à réfléchir à votre propre cheminement en 2017. Quels en ont été les points saillants et quels défis vous amèneront à apporter des changements dans l’année à venir? En y réfléchissant, n’oubliez pas d’envisager de participer à la Conférence nationale 2018 de l’ACS, du 3 au 6 mai à Victoria, C.-B., sous le thème Du savoir à l’action. En espérant vous y voir! cd le LIEN

decembre 2017


CAET Executive President: Rosemary Hill President-Elect: Chris Murphy Secretary: Laureen Sommerey Treasurer: Corey Heerschap Executive Director: Catherine Harley

Regional Directors BC/Yukon: Lani Williston Prairies/NWT/Nunavut: Patrice Jull Ontario: Donna Fossum Québec: Nevart Hotakorzian Atlantic: Kathy Mutch

CAET Staff Membership Coordinator: Noëlla Trudel Webmaster: ImaginationPlus Bookkeeper: André Lavigne

Core Programs Informatics and Research: Karen Napier Marketing: Debbie Howe National Conf. Planning: Mary Hill Public Relations: Kim LeBlanc Professional Development & Practice: Laura Robbs

CAET/JWOCN Editorial Board

CAET Academy Director: Virginia McNaughton Office Coordinator: Suzanne Sarda IT Support: Linda Forster Academic Advisors: Gail Creelman, Deb Cutting, Cathy Downs, Mary Engel, Mélanie Fauteux, Marilyn Langlois, Toba Miller, Nancy Parslow, Dorothy Phillips, Barb Plumstead, Laura Robbs, Louise Samuel, Teri Schroeder, Louise Turgeon. Preceptor Coordinator: Nicole Denis


December 2017


Features Editor: Lina Martins BC/Yukon: Kim LeBlanc Prairies/NWT: Mary Hill Ontario: Lina Martins Québec/Atlantic: Louise Forest Lalande

CAET Ad Hoc Committees Bylaws Chair: Vivien Wass Nominations Chair: Jillian Brooke


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CAET ACADEMY DIRECTOR’S REPORT Submitted by: Virginia McNaughton, BA, MPA, RN, CETN(C), Director of the CAET Academy [email protected]


id you know that in the Roman calendar December was the tenth month? We so take it for granted that December is the twelfth month that most of us probably don’t register that decem means ten in Latin… not twelve!

It is easy to take things for granted and to stop noticing those things that are so familiar to us. But by not noticing or “seeing” we miss so many opportunities for new learning and personal growth. The CAET Academy’s wish, for all of you, is that you move into 2018 with your eyes wide open, embracing all the possibilities and meeting every challenge with courage and stamina! I outlined, in the Fall issue of The LINK, our new ideas for learning and growth. Now I am pleased to tell you that our virtual journal club, e Connection, has launched thanks to Kathryn Kozell. And our 2017/18 webinar series is in full swing. Taking nothing for granted we continue to look for new ways to bring value to you, our members, including opportunities to raise the ETNEP to graduate level and to expand the Recognition of Prior Learning program to include Continence in addition to the existing wound component. Through this additional recognition for Continence, we look forward to welcoming Nurse Continence Advisors to the Tri Specialty of ET Nursing. Our first cohort of grads in the K2P Foundations of Skin and Wound 14

December 2017


An ever-increasing number of nurses are recognizing the value of our tri-specialty.

Management gave this course rave reviews. Their feedback was incorporated into the Fall 2017 Launch of Cohort 2. This Cohort is starting with 15 nurses and Cathy Downs has taken over leadership of this course. A heartfelt thanks to Cathy! We are continuing to review and revise our Preceptorship Program – why not consider becoming a preceptor? We have hired 2 Preceptor Coordinators, Liette St-Cyr in Quebec and Karleen NortonBreitkreuz in Alberta, to ensure that clinical placements go smoothly. Thanks to both of them! An ever-increasing number of nurses are recognizing the value of our tri-specialty. Many have worked with ETNs and witnessed, first-hand, the leadership and expertise provided by our specialty. With the growth in recognition comes a growth in the demand for ETNs. In September CAET Academy launched its 23rd on-line ETNEP Cohort and we have, to-date, graduated over 400 ET Nurses! As our numbers increase so does our need for faculty and so we welcome Terri Schroeder, Jeannette Barsky, Eleanore Howard, Cathy Downs, and Laura Robbs to our ETNEP faculty!

Looking to the future, the CAET Board and the CAET Academy are taking nothing for granted. The new possibilities in learning technology such as using gamification tools, adapting our technology for use on mobile devices, and the possibility of our programs reaching beyond our borders to Asia and other countries, require us to ensure that not only do we deliver best practices in ET Nurse education but that our on-line program delivery also meets best practices. We have hired Benchmark Consulting (www.benchmark performance.ca) to do a complete review of the ETNEP and to help us to strategize for the future. By the time you read this we will have begun to put the results of this review into our new threeyear strategic plan! We are excited by all the possibilities that 2018 offers and we wish you a happy and healthy 2018. We look forward to you joining as many of our extracurricular offerings as you have time for. Consider your New Year’s resolution to be accepting a volunteer position with the CAET – your time and talent will never be taken for granted! cd



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RAPPORT DE L’ACADÉMIE DE L’ACS Soumis par : Virginia McNaughton, IA, B.A., MPA, ICS(C), directrice de l’Académie de l’ACS [email protected]


aviez-vous que dans le calendrier romain, le mois de décembre était le dixième mois? Nous tenons tellement pour acquis que décembre est le douzième mois que la plupart d’entre nous ne nous rendons pas compte que Decem signifie dix en latin… et non douze!

Il est facile de tenir certaines choses pour acquis et de ne plus remarquer les choses qui nous sont si familières. Toutefois, en ne remarquant pas ou en ne « voyant » plus ces choses, nous ratons de nombreuses occasions d’apprendre et de nous épanouir. Le souhait de l’Académie de l’ACS pour vous tous est que vous entamiez l’année 2018 en ouvrant tout grands vos yeux, en profitant de toutes les possibilités et en faisant face à chaque défi avec courage et détermination! Dans le numéro Automne de la revue Le LIEN, j’ai fait un bref compte rendu de nos nouvelles idées pour favoriser l’apprentissage et l’épanouissement. Je suis maintenant fière de vous annoncer que notre club virtuel de la revue appelé, e Connection, a été lancé grâce à Kathryn Kozell. De plus, notre série de webinaires pour 2017 - 2018 bat son plein. Ne tenant rien pour acquis, nous continuons d’envisager de nouvelles façons d’accroître la valeur de notre association pour vous, nos membres, en incluant des occasions pour accroître le nombre de diplômés du PFIS et pour élargir le Programme de reconnaissance des acquis afin d’inclure la continence, en plus de la composante existante sur les plaies. Grâce à cette reconnaissance additionnelle de la continence, nous avons très hâte

d’accueillir les infirmières conseillères en continence au sein de la triple spécialité de la stomothérapie. Notre première cohorte de diplômés du cours K2P sur les fondements de la gestion de la peau et des plaies en a fait l’éloge. Sa rétroaction a été incorporée au lancement du programme de l'automne 2017 pour la cohorte 2. Cette cohorte entame le programme avec 15 infirmières et Cathy Downs est responsable du leadership de ce cours. Sincères remerciements à Cathy! Nous continuons à réviser et à revoir notre programme de préceptorat – pourquoi ne pas envisager de devenir un précepteur? Nous avons embauché deux coordonnatrices responsables du préceptorat, Liette St-Cyr au Québec et Karleen Norton-Breitkreuz en Alberta, afin de veiller à ce que les stages cliniques se déroulent sans accrocs. Un gros merci à elles! Un nombre toujours croissant d’infirmières reconnaissent l’importance de notre triple spécialité. Plusieurs d’entre elles ont travaillé avec des stomothérapeutes et ont été des témoins privilégiées du leadership et de l’expertise de notre spécialité. Cette reconnaissance accrue engendre une hausse de la demande pour des stomothérapeutes. En septembre, l’Académie de l’ACS a lancé sa 23e cohorte en ligne du PFIS et, à ce jour, plus de 400 infirmières stomothérapeutes ont obtenu leur diplôme de notre programme! L’augmentation de nos chiffres est proportionnelle à nos besoins en

Un nombre toujours croissant d’infirmières reconnaissent l’importance de notre triple spécialité. 16

December 2017


personnel enseignant pour le PFIS et nous sommes heureux d’accueillir Terri Schroeder, Jeannette Barsky, Eleanore Howard, Cathy Downs et Laura Robbs! Regardant vers l’avenir, le conseil d’administration de l’ACS et l’Académie de l’ACS ne tiennent rien pour acquis. Les nouvelles possibilités d’apprentissage qu’offre la technologie, comme l’utilisation d’outils de ludification, l’adaptation de notre technologie pour l’utiliser sur des appareils mobiles et la possibilité que nos programmes soient accessibles au-delà de nos frontières, jusqu’en Asie et d’autres pays, nous forcent à nous assurer que non seulement nous enseignons aux infirmièresstomothérapeutes les pratiques exemplaires, mais que notre programme en ligne comporte également ces pratiques exemplaires. Nous avons fait appel à l’entreprise Benchmark Consulting (www.benchmark performance.ca) pour effectuer une révision complète du PFIS et pour nous aider à établir des stratégies pour l’avenir. Au moment où vous lirez cet article, nous aurons commencé à intégrer les résultats de cette révision dans notre nouveau plan stratégique triennal! Nous sommes enthousiasmés à l’idée de toutes les possibilités que nous offre l’année 2018 et nous vous souhaitons une bonne et heureuse année 2018. Nous espérons que vous participerez à autant d’activités parascolaires que votre horaire vous le permettra. Pour cette nouvelle année, votre résolution pourrait être celle d’accepter un poste de bénévole au sein de l’ACS – votre temps et votre talent ne seront jamais tenus pour acquis! cd

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The views or opinions expressed in the editorial or articles are those of the authors and do not necessarily represent the policies or views of the Canadian Association for

This publication is copyright in its entirety. Material may

Enterestomal Therapy (CAET). Although

not be reprinted without the

reasonable efforts are made to ensure

written permission of

accuracy CAET, and its agents, take no

CAET. Contact through

responsibility whatsoever for errors,


omissions or any consequences of reliance on material or the accuracy of information.

Publication does not constitute CAET endorsement of, or assumption of liability for, any claims made in advertisements.


decembre 2017





n aspect of education provided by Enterostomal Therapy Nurses should be informing potentially eligible clients about the Canada Revenue Agency’s (CRA) Disability Tax Credit (DTC) available to some people living with an ostomy. The DTC is a non-refundable tax credit used to reduce the amount of tax payable on an individual’s income. The DTC is an aspect of financial support that has not been well understood and often overlooked, additionally, there have been recent changes to the application process. Background: The DTC has a long and ever-changing history that led to where it is today. Prior to 1986 the CRA had a standard deduction reserved for individuals who used wheelchairs or were blind. Over the years the definition of who is eligible has evolved and in 2005 the definition expanded to include all persons who struggle with “severe and prolonged impairments in mental or physical functions”. This has opened the door for people who faced challenges with common day-to-day tasks to be eligible to receive disability benefits through the DTC. The Canadian Government’s correct assumption is that people with disabilities will have unavoidable, additional expenses that put them and their families at a financial disadvantage. Another recent change to this process is a change to the application form (Form T2201) – prior to 2017 the signature portion of the form had always required a physician’s signature but this has recently been changed to have a Nurse


December 2017


Practitioner’s signature also considered acceptable. In 2017 the CRA also shortened the application form, from 12 pages to 6 pages, thus streamlining the process for completing this form. Many Canadians who live with an ostomy are unaware of their eligibility for this credit and those who embark on completing the application process often encounter difficulties as the application process is challenging. Addressing the Challenges: In response to this the Canadian Association for Enterostomal Therapy (CAET) and Ostomy Canada Society formed a joint committee, in 2016, to find ways to improve things for Canadians living with an ostomy by explaining the process involved in application for the DTC. The DTC joint committee included the Presidents of both CAET (Rosemary Hill) and Ostomy Canada Society (Ann Ivol), as well as members from both groups (see Table 1 for a full listing).

The committee began its work in the Fall of 2016. The first unanimous decision was that the creation of a brochure would be the best way to help communicate the necessary information for DTC application. The purpose of the brochure was to provide information in a clear and simple format. The goal was to outline who is eligible, how to apply, and where to access the form to Canada Revenue Agency (approval from the CRA is required before those living with an ostomy become entitled to the DTC benefit). Within 6 meetings a draft had been created and it was then fine-tuned. The productivity of this committee speaks to the benefits of collaboration among all those with a vested interest in a solution. Through the hard work of all on the committee both English and French brochures are now available and are titled Disability Tax Credit for People Living with an Ostomy and Crédit d’impôt pour personne handicapée (CIPH) pour les personnes stomisées (see images 1 and 2).


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FEDERAL DISABILITY TAX CREDIT (cont.) refundable CRA tax credit. The committee is encouraging all Enterostomal Therapy Nurses, particularly those with an outpatient clinic, to access copies of the brochure. It can be downloaded at www.caet.ca or free hardcopies can be ordered via www.ostomycanada.ca or by calling 1.888.969.9698. CAET and Ostomy Canada Society are sharing the cost of preparing and printing the brochures. Ongoing Efforts: The DTC joint committee has also decided to advocate for future inclusion of ETNs to be included as one of the professions that can sign Form T2201. At the time of this writing the Presidents of both CAET and Ostomy Canada Society have written letters, requesting this change, to both the Honourable Carla Qualtrough, Minister of Sport and Persons with Disabilities, and the Honourable Diane Lebouthillier, Minister of National Revenue. A 90 day follow up has been placed on these communications.

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fã~ÖÉ=OW cêÉåÅÜ=ÄêçÅÜìêÉ=ÅçîÉê This straight-forward brochure breaks down the key information about tax credit eligibility and application in an easy to understand format. It also includes national contact information as well as a space for the ostomy chapters to provide local contact information. Details about it have been shared with all Ostomy Canada Society Chapters and with CAET members across the country. Both CAET and Ostomy Canada Society hope this brochure will help increase understanding about eligibility and the application process in a clear way that helps more people living with an ostomy to avail of this non-

Future plans of the DTC joint committee include continuing to lobby the government of Canada for the inclusion of an ETN signature option on the application form. Additional efforts of the committee members are also focused on arranging to have DTC information in the journals and websites of various professional associations including Physicians’, Pharmacists’, and Nurse Practitioners’. An image, highlighting the key points, is being developed for use on these websites and to provide a link to the brochure. Ostomy Canada Society will also be further promoting the committee’s activities in a feature article in their next Ostomy Canada magazine.

For more information about the brochure and any future updates on changes to the DTC process please visit www.CAET.ca. cd le LIEN

decembre 2017


SAVE V THEE DA ATE TE! 37th National N CAET A Conference e

Turn Kno Tu K owle ledge d e iintto A Action i n Ed Educa ti in tion i Speci S iialized li d Wou ound, Ostomyy & Continencce Care

Victtoria BC Vi t i C









THE CONTINENCE EXCHANGE: TO FOSTER AND SUPPORT ETN CONTINENCE PRACTICE Submitted by: Laura Robbs RN, MN, NCA, CETN(C). “The Continence Exchange” aims to foster and support ETN continence practice. This regular feature will offer a forum to share and exchange continence-related knowledge, experiences, questions and issues among ETNs. Please email [email protected] with interesting or challenging case studies or questions from your own continence practice. Laura Robbs comment on readers’ case studies, and answer as many questions as possible, in subsequent issues of The Link. Chart 1

Causes of Indwelling Urinary Catheter Bypassing of Urine2

Obstructed urine flow from kinking/twisting of the catheter or tubing. Blockage of the catheter lumen from encrustation or stones.

Urethral damage from traumatic insertion or removal of the catheter, balloon inflation in the urethra, frequent insertions, or long-term use. Bladder spasms and pain.

Chart 2

Prevention and Treatment of Indwelling Urinary Catheter Bypassing of Urine1,2 Routine use of a catheter securement device and a small catheter and balloon (˂ 18 French) will minimize risk of bladder spasms, leakage and bladder neck/urethral erosion. Avoid temptation to use a larger catheter and balloon with urinary catheter bypassing of urine.1 Fill the balloon according to the manufacturer’s instructions to avoid under- or over-filling. Improper inflation can cause the catheter tip to bend and cause improper drainage, bladder spasms, and bladder irritation.2

Place the drainage bag in a dependent position, about 12 inches (30 cm) below the level of the hips to ensure drainage. Keep the tubing above the level of the drainage bag and free of kinks.2 Use a pure silicone catheter as the thinner wall and wider lumen may help to maintain catheter patency for longer periods.1

If simple measures do not help, the catheter could be blocked and should be changed.1

Consider treatment with an antimuscarinic medication to reduce persistent leakage with overactive bladder once other factors above have been addressed. If an antimuscarinic is prescribed the patient care plan must address the possibility of side effects such as constipation and confusion. Reassess in 7 days.1

Constipation is a predictor of urinary incontinence and detrusor overactivity. Establish a bowel program to prevent constipation.1 22

December 2017


CAET Member Question: Help! Urine is bypassing my patient’s indwelling urinary catheter. What should I do? eakage around an indwelling urinary catheter is caused by the bladder forcing urine around the catheter.1 Leakage around the catheter should prompt the Enterostomal Therapy Nurse to ask the following questions:


“Is this catheter necessary? Can the catheter be removed and an alternative continence measure instituted?”1 If the catheter cannot be removed then the causes, prevention and treatment measures outlined in Charts 1 and 2 should be considered. Causes and prevention/treatment have been compiled from two sources. Indwelling urinary catheters are necessary for some patients. Avoidance of long term catheterization is recommended.1 If, however, the use of indwelling urinary catheters is unavoidable both staff and patients need education to ensure that complications, such as urine bypassing the catheter, are minimized.1 cd REFERENCES:

1. Moore, K.N. & Franklin, L. (2016). Indwelling and Intermittent Catheterization in Continence Management. Wolters Kluwer: Philadelphia. 2. Wound, Ostomy and Continence Nurses Society (2016). Care and management of patients with urinary catheters: A clinical resource guide. Accessed September 11, 2017 http://c.ymcdn.com/sites/www.wocn. org/resource/resmgr/publications/ Care_&_Mgmt_Pts_w_Urinary_Ca.pdf

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REPORT FROM ATLANTIC REGION By: Kathy Mutch RN, BN, CETN(C), Atlantic Regional Director. [email protected]

Enterostomal Therapy nursing is challenging so it can be very important to do something each and every day, at work, to ensure we return with enthusiasm, compassion and inspiration.


nterostomal Therapy nursing is challenging so it can be very important to do something each and every day, at work, to ensure we return with enthusiasm, compassion and inspiration. As we head in to a new year I asked my colleagues in Atlantic Canada to share a piece of news, that excites or inspires them, about their practice or profession. I wanted to share them with all of you. “I met a client in the grocery store and he walked up to me and told me he wouldn't have gotten through the last year without my support. Reinforced to me how important our profession is.” - Charlene Adams, NL “Having a new ostomy patient thank me for taking the time to listen to her and treating her with kindness and respect. She said I made her feel very comfortable during this difficult time.” - Elizabeth Baker, NS “One of the surgeons and I have opened a chronic wound clinic and have had some wounds greater than 12 months old heal.” - Keri Coulson, NS “…I am always excited when a difficult wound finally heals or a leaking ostomy is finally conquered, giving quality of life back to the client. ….over the past year I've been instrumental in developing a wound photography policy, a Turn/Activity Schedule, a Wound Care Plan & Documentation Flow Sheet, and a Chart Audit Form – all of which are now used at South Shore Health


December 2017


hospitals. The Chart Audit Form has been incorporated by the NSHA Pressure Injury Prevention Committee as part of the PIP Program.” - Susan Ernst, NS “I had the pleasure to sit on the disability tax credit committee where we developed a brochure to educate healthcare professionals and people living with an ostomy on the tax credit. This group was great to work with. I also enjoy working in private practice – can set my own hours – it is great!!” - Kathy Esligar, NB “I was appointed to the newly created position of "Provincial Program Lead, Wound Care". The mandate is to develop a standard approach for all aspects of wound care throughout the province. I will be working part time in this position while continuing to be an Academic Advisor for CAET ETNEP. So much for retirement!” - Eleanore Howard, NS “My best moment in the past year was when I received the Enterostomal Therapy Registered Nurse of the Year Award by Ostomy Canada Society. What made it even more special was that I was nominated by a former patient.” - Marg James, NB “This past year we had a successful Education Day for nurses in the Atlantic region with 200 people in attendance including vendors. Presenting to the attendees was both an intimidating and an exhilarating


REPORT FROM ATLANTIC REGION (cont.) experience.” - Michele Langille, PE “I would say the completion and implementation of policy on footcare for PCH inpatients and the +++ positive feedback from patients on same.” - Marcia Leard, PE “Sorry, this year has been quiet, focusing much needed time with family. Just happy to be finished the ETNEP course!!!” - Sheila Moffatt, NS “I had 2 patients I helped quite a bit pass away, both suddenly. Their families came in to see me to thank me, put my name in a word of thanks. They said how much I meant

to the patients and they wanted me to know the difference I was making.” - Susan Peckford, NL “I have had a story published in a book the Community Health Nurses of Canada had done at their meeting this year. Caring and Connecting: Touching the Lives of Canadians through Community Health Nursing is a compilation of stories submitted by community health nurses across Canada. It is a wonderful testament to the impact community health nurses have on individuals, families and communities. …The same story was submitted to the Ostomy Canada magazine. … Also realizing the importance of having a position filled at our local

hospital with a person who is passionate about her role! This is a win-win for our hospital and our ostomy community.” - Joan Peddle, NB “At the IWK we were able to collaborate with Ostomy Halifax and Camp Brigadoon to send eight new campers to camp in 2017 including our kids with cecostomy and our young folks with ostomies.” - Bridget Pinaud, NS These diverse and inspiring answers tell so much about the relationships we share with patients and families, about teamwork, about big projects that take many months, and about moments in time that we will never forget. Thanks to each of you for sharing! cd

REGIONAL REPORT FROM PRAIRIES / NWT / NU By: Patrice Jull, RN, BScN, ETN, Regional Director for Prairies/NWT/NU. [email protected]

s we head into winter and the holiday season it is a good time to reflect on your accomplishments over the past year and your contributions to the care of people living with a wound, ostomy, and/or continence issue.


in our region – email me to join. You will also want to check out the new CAET Discussion Forum for Members (in the members only section click on Discussion Forum). This will provide you with the ability to engage in discussions on various wound, ostomy and continence issues.

In Alberta a group of ETs and other disciplines are in the process of updating the 2009 Wound Care Guidelines. Each section will be published on the Alberta Health Services website and the guidelines cover community and acute care for all ages. Watch for the Pressure Injury Prevention and Pressure Injury document that will also be posted soon. If you haven’t already done so now is the time to join our private Facebook group to create, share, discuss and connect ETs

Tap into CAET continuing education and explore the old-world charm of Victoria, BC, at the amazing 2018 CAET National Conference on May 36, 2018. Register now to be part of this exciting event. The CAET webinar series is also a great benefit to members and a wonderful continuing education opportunity for our tri-specialty. Visit www.caet.ca and click on education and then webinars.

Now is the time to renew your CAET Membership. There are many benefits of being a CAET Member, including voting privileges. For information on benefits visit the website and click on join us! Make sure that your voice is heard by being part of your professional association. Have a wonderful holiday season and may it be filled with your favourite things and the people you love. cd le LIEN

decembre 2017



REGIONAL REPORT FROM ONTARIO By: Donna Fossum RN, BScN, CETN(C), Ontario Regional Director. [email protected]


’d like to wish everyone a festive holiday season. Stay warm…. and hopefully we don’t need our shovels until next month!

I hope you are enjoying CAET’s new website. I know it has been a long time coming but I believe it was worth the wait. The information for members and the public is now easier to locate and the information pertaining to board activities is well organized and professionally stored. There is an opportunity for members to initiate and contribute to discussion forums. CAET Academy has listed, and archived, the continuing education webinars for viewing at your convenience. I encourage you to visit the website and flip through the pages. There is valuable information for both nurses and clients. Rosemary Hill has written this issue’s feature article about the Disability Tax Credit. I hope you are able to print and share the brochure it mentions with your clients who are living with an ostomy. The brochure is available through our website. This is a great financial support for people in addition to the Assistive Devices Program. In May of 2017 the Ontario government approved changes to the Nursing Act that will permit RNs to diagnose and prescribe medications. The College of Nurses of Ontario (CNO) has been working on making 26

December 2017


Our name change was voted on by CAET Members at the 2017 AMM and our specialty will now become “Nurses Specialized in Wound, Ostomy, and Continence” or NSWOC. regulations that will guide our practice in this area. CAET has created a task force to work with CNO to assist ET nurses in this process. CAET has been working to establish a formal collaboration with the Canadian Society of Colo-Rectal Surgeons to create national best practice recommendations for stoma markings. This project will be launched early next year. Stay tuned for more updates. Incidentally, Dr. Malloo, Colo-rectal surgeon at the Ottawa Civic Hospital, and a former Executive Member of the Canadian Society of Colo-Rectal Surgeons, was very impressed with our “Find an ET Nurse” program and has presented this to his board. We hope to find that the program becomes more utilized as it becomes better known. If you have not signed up for the program please consider doing so through your membership. This is a great benefit to people when they are looking for help with wound, ostomy, and/or continence care. CAET is very involved with the Canadian Nurses Association through

its role in the Canadian network of nursing specialties and its involvement in CNA Certification. We are working to ensure that the tri-specialty of wound, ostomy, and continence nursing continues to be recognized as a nursing specialty and that CETN(C) certification numbers continue to grow. Our name change was voted on by CAET Members at the 2017 AMM and our specialty will now become “Nurses Specialized in Wound, Ostomy, and Continence” or NSWOC. This formal name change will take place at our annual conference May 3rd to May 6th, 2018 in Victoria BC. More information is available at www.caet.ca. Lastly, I would like to remind everyone that my term as the Regional Director for Ontario will come to a close in May. Please consider taking on this position for a 2-year term. It is a great way to enhance your professional development and learn more about the CAET Board and Core Programs. cd


REGIONAL REPORT FROM BC & YUKON By: Lani Wiliston, RN, BScN, CETN(C), BC & Yukon Regional Director. [email protected]

Many nurses from the Caribou and Chilcotin areas of BC were evacuated and some lost their homes.


s 2017 draws to a close I am reflecting on the events that shaped this year. The forest fires that covered a large area of BC are one of the first things that enter my mind. Many nurses from the Caribou and Chilcotin areas of BC were evacuated and some lost their homes. They were forced to leave their homes and jobs for many weeks and stay in evacuation centers or with family or friends. The amount of resilience, positive attitude, and caring they demonstrated was amazing to see. They volunteered their time to help others during times of their own personal discord. Their selfless conduct deserves to be applauded. This year I was lucky enough to work with two ETNEP preceptorship students and watch their skills grow and develop. It gives me immense pleasure to be able to facilitate learning experiences for them and to observe their passion. Although each student is unique, in many ways, they share a common trait – the desire to support and assist their patients through difficult times. I find that I learn so much from each student as they share their experiences, ideas, and what they are doing. I see how they manage to balance their family life, school life, and work life – something that is never easy or without

challenges – and I am always astounded by their dedication to do their very best and give 100%! I think of the many people with ostomies that I know… and I realize that the end of the year is a time to stock up on their ostomy supplies the year ends and their Pharmacare deductible starts over again. This is a busy time for ostomy nurses as the patients want to be sure they are in the correct appliances before year-end and to solve any ongoing issues they have been having. I see the funding issues faced by many of our patients and realize how much assistance they need to ensure they are aware of all funding available to them. It is so important the ET nurses have the knowledge to direct these patients and help them in getting the assistance they deserve. As I look forward to 2018 I get excited for the CAET National Conference in Victoria on May 3rd to 6th. I hope as many BC ETs as possible will attend and mingle, learn, and network with everyone from across Canada. We also have association and specialty name changes to look forward to in 2018. Our numbers continue to grow as does our passion to provide quality ostomy, wound, and continence care! Happy Holidays to everyone. cd le LIEN

decembre 2017



RAPPORT RÉGIONAL DU QUÉBEC Soumis par : Nevart Hotakorzian, Ba. Sc. Inf., stomothérapeute, directrice régionale du Québec [email protected]


tre infirmière stomothérapeute est unique. Les personnes affectées réalisent combien notre rôle est important dans leur vie lorsque le besoin se présente. Nous sommes peu nombreuses au Québec, mais en croissance continuelle. La passion de nos membres et leur dévouement font progresser notre spécialisation. Les stomothérapeutes qui contribuent à son progrès me surprennent régulièrement. Il est encourageant de voir l’effort et la persévérance de nos étudiants de l’Académie de l'ACS. Nous savons que ce programme est exigeant et demande un dévouement exceptionnel pour bien réussir. Il est encore plus difficile lorsque vous avez votre travail habituel et votre famille qui sont en concurrence dans l’occupation de votre temps. Je veux donc prendre le temps de féliciter nos étudiantes du Québec qui ont obtenu leur diplôme de la cohorte 20 : Catherine Brissette, Marie-Andrée Masson, Mélanie Therrien et Laurence Quintin. Bravo pour votre bel effort! Je suis heureuse aussi d’accueillir nos douze nouveaux étudiants du Québec de la cohorte 23. Je souhaite que vous trouviez dans cette merveilleuse profession une place pour vous épanouir et contribuer à l’amélioration de la qualité de vie d’un grand nombre de personnes. Vous verrez l’appréciation de ceux qu’on arrive à 28

December 2017


Je suis heureuse aussi d’accueillir nos douze nouveaux étudiants du Québec de la cohorte 23.

aider; le sentiment qu’elle procure va au-delà des mots. Je souhaite du fond de mon cœur que vous puissiez vivre cette expérience régulièrement dans votre carrière. Persévérez et ce grand sentiment de satisfaction sera votre récompense. Toujours dans la même veine de pensée, Véronique Brassard, stomothérapeute et vice-présidente de l’Association des infirmières et infirmiers stomothérapeutes du Québec (AIISQ), a reçu le prix Florence de l’Ordre des infirmières et infirmiers du Québec (OIIQ) pour 2017. Elle a été choisie comme exemple pour la relève, car déjà à 25 ans, elle démontre de l’engagement à développer la profession, à élaborer des outils cliniques et à faire de la formation. Elle a actuellement entrepris une maîtrise avec l’intention de faire de la recherche pour l’avancement de la pratique en soins de plaies. Pour regarder la vidéo sur le site Web de l'OIIQ à propos de Véronique, allez à http://www. oiiq.org/lordre/prix-etdistinctions/prix-florence/recipiendaire s-2017/prix-releve. Mes félicitations à Chantale Dufresne

de la cohorte 18 qui a remporté le Prix d'excellence académique de l'Académie de l'ACS pour l’excellence de ses notes. J'ai pu parler avec Chantale lors de notre dernier congrès à London, en Ontario. Elle est une fille passionnée qui veut donner le meilleur d’elle-même pour ses patients. Le congrès provincial 2017 de l’Association québécoise des personnes stomisées (AQPS) a eu lieu au Crown Plaza à Montréal du 28 au 30 septembre et quelques stomothérapeutes de notre province ont participé pour animer des groupes. Enfin, l'AIISQ tient à remercier Claire Émond, notre collègue stomothérapeute, qui a accepté le rôle de présidente de l'AIISQ lors de la réunion régionale du printemps dernier. Bienvenue dans votre nouveau rôle Claire. Nous vous souhaitons une expérience positive et enrichissante. Sur ce, je vous souhaite, ainsi qu’à vos proches, un joyeux temps des fêtes et beaucoup de plaisir à vous retrouver en famille pour célébrer. cd


REGIONAL REPORT FROM QUEBEC By: Nevart Hotakorzian, BScN, Enterostomal Therapy Nurse, Quebec Regional Director. [email protected]


eing an Enterostomal Therapy Nurse (ETN) is unique and that uniqueness is primarily appreciated by those who have needed and benefitted from our services. They are the ones who have realized how vital our role is in their lives. We are few in number, in Quebec, but growing constantly. Through the passion of our members, and their dedication, our specialization continues to advance. I never cease to be amazed by the ETNs who contribute to the progress of this profession. It is encouraging to see the hard work and perseverance of our students in the CAET Academy. We know that this program is demanding and requires exceptional dedication to succeed. It is even more difficult when you have your usual work and your family life competing for your time. I want to take this opportunity to congratulate our Quebec students who succeeded from Cohort 20: Catherine Brissette, MarieAndrée Masson, Mélanie Therrien, and Laurence Quintin. Congratulations on your accomplishment!

I am also pleased to welcome our twelve new Quebec students, in Cohort 23, to this wonderful profession.

I am also pleased to welcome our twelve new Quebec students, in Cohort 23, to this wonderful profession. I hope that you find a place to blossom and to contribute to improving the quality of life for a large number of people. You will see the appreciation of those whom you help and you will learn that the feeling it provides goes beyond words. I wish, with my whole heart, that you will experience this regularly in your career. Persevere and you will be rewarded with satisfaction. On the topic of appreciation one of Quebec’s ET Nurses was recently recognized. Véronique Brassard, ETN and vice-president of the Québec ETN

association (AIISQ), received the Florence Award of the Order of Nurses of Quebec (OIIQ) for 2017. She has been chosen as an example for the next generation. At the age of 25 she demonstrated a commitment to develop the profession, develop clinical tools, and conduct training. Currently she is in the process of doing her Master's Degree with the intention of doing research for the advancement of wound care practice. To watch the video on the website of the OIIQ about Véronique go to http://www.oiiq.org/lordre/prix-etdistinctions/prix-florence/recipiendaires2017/prix-releve. My compliments to Chantale Dufresne, from Cohort 18, for her excellent grades and receiving the CAET Student Academic Award. I was able to speak with Chantale, at our last conference in London, ON, and found her to be a passionate girl who wants to give her best to her patients. The Quebec Association of People Living with Ostomies (AQPS) held their 2017 Provincial Conference at the Crown Plaza in Montreal from September 28th to 30th and a few ETNs from our province participated and facilitated presentations. Finally, the AIISQ would like to thank Claire Émond, our ETN colleague, who accepted the role of President of the AIISQ during last Spring’s Regional Meeting. Welcome to your new role Claire. We wish you a positive and rewarding experience and looking forward to work with you. Happy holidays and may you enjoy the time spent with family and friends. cd le LIEN

decembre 2017



INFORMATICS & RESEARCH By: Karen Napier RN, BScN, CETN(C), MClSc-WH. [email protected] he projects that fall under the Informatics & Research portfolio are determined by the CAET board and align with the strategic plan for the association. There is currently a very active body of work under this portfolio.


All of our projects involve volunteer CAET members working together in teams. Thank you to all of the individuals who have volunteered through the CAET over the last year. Thank you all for your patience and flexibility in giving of your time to move our initiatives forward. Your support and contributions have been greatly appreciated!

The Enterocutaneous Fistula Recommendations revision continues. While it is taking us significant time to revise this document there has been much growth and learning along the way. At the time of this writing we were halfway through finalizing the review of the updated document so we are almost there. This team has done some great work on updating the recommendations! My collaborative work with the Advancement of Wound Care Association (AAWC) on Wound Infection Guidelines is currently undergoing peer-review. Our group is hoping this document will have been

shared with the public by the time you read this report. I am also working with a local Alberta group of ETs on a data collection tool that will help us to define that work that we do. This tool will also help us to define the volume of work that manage day to day. Happy Holidays everyone! cd

PROFESSIONAL DEVELOPMENT AND PRACTICE By: Laura Robbs RN, MN, CETN(C), NCA [email protected] There are three areas that, in my role of Professional Development and Practice Core Program Leader, I will be focusing on in 2018: 1. Revision of the CAET Standards of Practice; 2. revision of the ET Nurse Position Statement; and 3. continuing to support and foster continence ETN practice. The CAET Standards for ET Practice were last revised in April 2016 and all CAET members have access to the second edition of the standards. The third revision of the standards is about to get underway and is scheduled for completion by May 2018. I am looking for experienced ETNs to help with the revision. 30

December 2017


CAET has an ET Nurse Position Statement outlining what an ETN is and how they are differentiated in the healthcare sector through the tri-specialty of wound, ostomy, and continence care. Thank you to the following ETNs who helped draft the initial revision: Michelle Fleur De Lys, Teri-Anne Schroeder, Arden Townshend, and Anna Tumchewics. We will now be working on Phase Two of this revision by putting the initial draft into the correct format for position statements. The final will be ready for presentation at the AMM in 2018. I am continuing to develop activities to support and foster ETN continence practice. My first project was the creation of a regular column, in The Link, called “The Continence Exchange” which

provides a forum to share and discuss continence related knowledge, experiences, questions, and issues. To date we have published on three topics: A case study examining chronic urinary retention; a project that demonstrated a decrease in pressure injuries by reducing layers of linen and incontinence products for ICU patients; and preventing/treating leakage around an indwelling urinary catheter. I am open to any questions or suggested topics from members so please do not hesitate to send me your thoughts. cd


PUBLIC RELATIONS By: Kimberly LeBlanc MN, RN, CETN(C), PhD (student) [email protected]

2017 National Wound Summit: Wound Care Alliance Canada (WCA)


ound Care Alliance (WCA) Canada is a partnership, established in 2012, between the Canadian Association for Enterostomal Therapy (CAET) the International Skin Tear Panel (ISTAP), Regroupement Québécois en Soins de Plaies, RQSP, the Ontario Woundcare Interest Group (OntWIG), the British Columbia provincial Wound and Skin Care Program, the Alberta Wound and Skin Care Group, and the MEDEC National Wound Care Committee. WCA has also partnered with the Canadian College of Health Leaders for management support. On September 15, 2017, representatives from each of the partner groups, from across Canada, met in Toronto to discuss a national initiative to improve wound care outcomes across Canada. This was the third national meeting since the partnership’s formation. Meeting participants also included representation from Government / First Nations (Health & Social Services Government of Yukon/Whitehorse, Health Quality Ontario, Six Nations Council Health Services, Eagle Wings Nursing Ontario); provincial wound and skin committees (BC, ON, QC, AB,

On September 15, 2017, representatives from each of the partner groups, from across Canada, met in Toronto to discuss a national initiative to improve wound care outcomes across Canada.

NS, PE, NB, and NL); national wound and skin care organizations (CAET, Wounds Canada, and the Lawson Health Research Institute Canadian Lymphedema Framework); International Skin Tear Advisory Panel; allied organizations (Canadian Nurses Association, Canadian Home Care Association, Canadian College of Health Leaders, Diabetes Canada, Ontario Society of Occupational Therapists, Canadian Neuro Trauma Unit, Canadian Patient Safety Institute, Ontario Long Term Care Association, Canadian Physiotherapists Association, and Dieticians of Canada); Universities (University of Western, Queen’s University); and business partners. The objectives of the meeting included: 1. To provide an update to our stakeholders on best practice in wound and skin care by province, nationally and internationally; 2. To continue the process of developing a national strategy and engaging all participants in our collective vision; 3. To gain further input from stakeholders around the design of a framework for a Canadian Wound Care Centre of Innovation with a focus on wound documentation and reporting and standardizing wound assessments; and 4. To explore potential partnerships in a Canadian Wound Innovation Centre of Excellence in order to support sustainability. Janet Davidson, the Chair of the Canadian Institute for Health Information (CIHI) and the Chair of this le LIEN

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PUBLIC RELATIONS (cont.) The WCA partners also reaffirmed their commitment to continued collaboration among the groups, from across Canada, to raise awareness for wound care and to improve patient care for all Canadians. WCA meeting, gave the welcoming remarks. The remainder of the day included plenary presentations in the morning and three breakout sessions, in the afternoon, to discuss the future wound care infrastructure, research mandate, and approaches to standardization. Plenary presentations focused on an overview of wound care initiatives from across Canada presented by: • BC Provincial Wound and Skin Care Program – Shannon Handfield RN, BScN, CWOCN • Alberta Wound & Skin Care Committee – Karen Napier RN, BScN, MSClinWH, CETN(C) • OntWIG – President: Valerie Weinberg RN(EC), MN, NP-PHC, ENC(C) • RQSP Quebec – Chair: Chantal LaBrecque RN, BSN, MSN • Nova Scotia Health Authority: Provincial Lead Wound Care Eleanore Howard RN, MSN, CETN(C) • New Brunswick – Regional Skin and Wound Committee for Horizon Health Network and chair for local Skin and Wound committee in Area 7 - Tracey Fournier RN, BScN • Prince Edward Island – Provincial Skin and Wound Care Committee Kathy Mutch RN, BScN, CETN(C) • Newfoundland & Labrador – Regional Wound and Skin Care Clinical Nurse Specialist - Pam Moyer RN, BScN, MN • CAET – President-Elect – Dr. Christine Murphy RN, BScN, MN, PhD, CETN(C) • ISTAP – President – Dr. Kimberley 32

December 2017


LeBlanc RN, BScN, MN, PhD, CETN(C) • Canadian Lymphedema Framework – Dr. David Keast MD, BSc, MSc, Dip Ed, CCFP, FCFP(LM) • National Initiative for Wound Education – Dr. Pamela Houghton PhD, Professor School of Physical Therapy Later in the day three breakout sessions challenged participants to discuss several topics that are key to future planning: 1. Developing a national wound care research agenda to support a national wound care standard; 2. Envisioning a future wound care infrastructure to improve both clinical and cost outcomes; and 3. Creation and promotion of national standardized wound care with a focus on assessment and documentation. Ms. Davidson concluded the day by stating that she would lobby CIHI for a follow-up study on the extent of compromised wounds in Canada as the last CIHI report, documenting the extent of these wounds, was published in 2011-12. Lee Fairclough, VicePresident of Health Quality Ontario (HQO), and Terri Irwin, Director of the Quality Standards Program for HQO, provided an overview of the Ontario initiative, led by HQO, to develop wound care standards across Ontario. Many participants in attendance are also members of the HQO Expert Committee, which is Co-Chaired by Laura Teague and Gary Sibbald, including CAET members of the HQO committee Christine Murphy, Cathy Harley, and Kimberly LeBlanc.

Key Points Established at the Meeting: 1. Participants desire research to establish a greater understanding as to the burden of wounds in Canada (including but not limited to prevalence and incidence studies); 2. Research is needed to determine the economic and psychological burden of wounds in Canada; 3. National databases are required for benchmarking the prevalence of wound care issues; 4. Canadian healthcare professionals need to agree upon standardized operational definitions and research methodology to allow for metaanalysis and compilation of study results; 5. Emphasis should be placed on implementation science and knowledge translation; 6. Wound care initiatives MUST be bilingual, multi-cultural, sustainable, and able to be implemented across health care sectors; and 7. Research and initiatives must include First Nations and support First Nation lead projects. The WCA partners also reaffirmed their commitment to continued collaboration among the groups, from across Canada, to raise awareness for wound care and to improve patient care for all Canadians. The alliance partners will meet every 6 weeks to continue to move plans forward. The WCA meeting was made possible, in part, by the generous support of CAET, OntWIG, Acelity, Smith and Nephew, 3M, Coloplast, and Hollister. Thank you to these sponsors for their important support. Many thanks should also be given to the leadership role played by CAET and, in particular, by Cathy Harley. The day would also not have been possible without the support of Laura Teague (Past-President OntWIG) from the WCA Steering Committee. cd



Victoria’s conference theme is Turn Knowledge into Action and the NCPC is creating an exciting educational program


AET’s National Conference Planning Committee (NCPC) is busy creating an exciting conference that will take place in Victoria, BC, May 3 to 6, 2018. Register before March 31, 2018 for early bird rates! We are thrilled that over 60% of participants from last year’s conference in London plan to attend the Victoria conference and we look forward to seeing you there! Victoria offers a unique blend of old world charm and new world experiences on beautiful Vancouver Island. Surrounded by the beautiful Pacific Ocean visitors must take the time to walk the beaches and observe the diverse marine life. Visit the world-class Royal BC Museum, tour 125-year-old heritage buildings, and explore the Victoria Parliament Buildings which are particularly spectacular at night. Craigdarroch Castle, built by Robert Dunsmuir, coal baron, during the reign of Queen Victoria, is a National Historic Site that has been meticulously restored and gives visitors a glimpse of the lifestyle of the privileged during the 1890s. Be sure to indulge in high tea at the Fairmont Empress Hotel with its strong British influence and its iconic presence on Victoria's sparkling inner harbour. All of these experiences are located within minutes of the Victoria Conference Center and the Victoria Marriott Inner Harbour Hotel. Plan to extend your time on the island and enjoy the world renowned Butchart Gardens or experience an outdoor adventure in anything from hiking, cycling and kayaking, to diving, fishing, picnicking, or even ziplining above the treetops. Vancouver Island and Victoria’s rich and fascinating history is rooted in First Nations culture stretching back thousands of years and on British and Asian traditions since the mid-1800s. These influences echo proudly through Victoria’s

amazing architecture, heritage sites, museums, gardens, galleries, markets and cultural celebrations. Victoria’s conference theme is Turn Knowledge into Action and the NCPC is creating an exciting educational program. The 2017 Conference, in London, ON, received overwhelmingly positive evaluations and we are incorporating the feedback received into Victoria’s educational program. The conference will showcase ETNs working with First Nations populations and we are developing hands-on workshops based on feedback from delegates at the 2017 conference. Learn about new products and modalities that you can incorporate into your practice. Enjoy networking events where you can engage with colleagues, industry representative, and meet new ETNs and other healthcare professionals. As the Conference Planning Committee Chair, and Core Program Lead for NCPC, I am pleased to be working with Catherine Harley, CAET Executive Director, who is responsible for conference Operations and Finance, and with the following wonderful committee members: Marilyn Elder, BC Eileen Emmott, AB Leslie Heath, ON Monica Frecea, ON Marcia Leard, Atlantic Region Lina Martins, ON Kim Mayenburg, BC Kim Meeker, ON BJ Paproski, BC Louise Samuel, QC Julie Tjan Thomas, ON Noëlla Trudel, QC (CAET Membership Coordinator) For more conference details or to register visit www.CAET.ca. Thank you and see you in Victoria! cd le LIEN

decembre 2017




Did you know... 90% of wounds wounds with elevaated protease activity will not heal without pro oper interventions.

How are you y man naging them? To learn how ho PROMOGRAN PRISMA™ can help, please contact your Acelitty representative at 800-668-5403 or visit it systagenix.ca

Reference: Serena T, Cullen B, Baylifff S et al. Protease activity levels associated with healing status of chronic wounds [abstract] Serena T, Cullen B, Bayliff S et al.. Woounds UKK 2011. NOTE: Specific indicationns, contraindications, warnings, precautions and safety information may exist for Systagenix and KCI (Acelity companies) prodducts. Please consult a healthcare provider and product instructions for use priorr to application. Copyright 2017 KCI Licennsing, Inc. All rights reserved. All trademarks designated herein are proprietary to Systagenix Wound Management IP Co B.V., its affiliates and/or licensors. PRA001634-R0-CA, EN (10/17)

Upcoming Events WCET April 14 - 18, 2018 Kuala Lumpur, Malaysia www.wcetn.org

EWMA May 9 - 11, 2018 Krakow, Poland www.ewma.org

SAWC April 25 - 29, 2018 Charlotte, NC www.sawc.net

WOCN Society 50th Anniversary Conference June 3 - 6, 2018 Philadelphia, PA www.wocn.org

CAET National Conference Turn Knowledge into Action May 3 - 6, 2018 Victoria, BC www.caet.ca

International Continence Society August 28 - 31, 2018 Philadelphia, PA www.ics.org

NPUAP March 1 - 2, 2019 St. Louis, MO www.npuap.org/events/ World Union of Wound Healing Society (WUWHS) Global healing Changing Lives March 8-12, 2020 Abu Dabi, UAE http://www.wuwhs2020.com

ET Nurses Week is April 16 - 20, 2018

THE CAET – JWOCN CONNECTION The CAET Feature Section of JWOCN is Seeking

Authors to Share their Expertise in…

wound, ostomy and continence clinical practice, program development/education and quality improvement. Submissions are 250-500 words including pictures, tables and figures. OR Are you writing an original manuscript for publication? Consider JWOCN first!

Contact your CAET Regional Editorial Board Representative for more information. (First time authors are encouraged. Coaching from the Editorial Board is FREE)

Canadian Feature Editor: Lina Martins ([email protected]) BC/Yukon: Kim LeBlanc ([email protected]) Prairies/NWT: Mary Hill ([email protected]) Ontario: Lina Martins ([email protected]) Québec & Atlantic: Louise Forest Lalande ([email protected])

Share your professional ETN expertise NOW


decembre 2017


Keynote Speakers K

Ven enue: Kuala Lumpur Convention Centre (KLCC C M C), Malaysia ysia Sto oma, Wo ound & Continence Care

Ms Michelle Lee W Wai ai Kuen

Ms Carmen George

Ms Elizabeth English

Ms Vicki Patton

Melbourne, Australia

Adelaide Australia Adelaide,

Sydney, Australia

Hong Kong



Clinical Nurse Consultant, Pelvic

Nurse Consultant, Wound and Stoma Care,

Stomal Therapy Nurse

Stomal Therapy Nurse

Floor Unit, St George Public Hospital

Department ment of Surgery, Queen Mary Hospital

Prof Dr Hiromi S anada

Prof Drr Harikrishna K. R. Nair SIS, KMN

Dato Dr Meheshinder Singh

Tokyo, T okyo, Japan

Kuala Lumpur, Malaysia

Kuala Lumpur, Malaysia

Kuala Lumpur, Malaysia


Head Wound Care Unit, Dept. of Internal Head,

Consultant Con sultant General and Colorectal Surgeon

Co onsultant Urologist and President

Professor, Department of Gerontological

Medicine, KLH

Pre esident, Malaysian Society of Colorectal

Continence Foundation of Malaysia

Nursing/W Wound ound Care Management,

Founding President Malaysian Society of Wound o

Surgeons (MSCRS)

The University of T Tokyo okyo

Care Professionals MSWCP

Assoc. Prof Dr Rohani Arshad

Ms Gulnaz Tariq Tariq

Kuala Lumpur, Malaysia

Abu Dhabi, United Arab Emirates

Associate Professor, MAHSA A University and

Senior Charge Nurse/Unit Manager

Director, Nursing Professional Group

Medical/ Surgical - Nursing Sheikh Khalifa

Dr Peter Ng Eng Pin

Who should attend?

Medical City

Enterostomal Therapist/E.T


Clinical Nurse Specialist in Stoma/W Wound/ ound/ Continence

Community nurses

Staffff Nurses/ Medical Assistants/ Assistants Medical Offficer ficer

N sing Educators/researcher Nurs

Doctors - Colorectal/Surgical/ Orthopedic/Plastic/Skin/Geriatric

Any interested parties - patient support An port group

Pre-Congress Workshop WORKSHOP 1: WOUND Diabetic Foot Management: Assessment & Care including Pre eventive Measures WORKSHOP 2: OSTOMY Peristomal Skin Complications and its management WORKSHOP 3: CONTINENCE Urinary & Faecal Incontinence: History, Evaluation & Manage ement WORKSHOP 4: COMMUNICATION Challenges in Communication in an Ethnocentric Community

www.wcet20 018.com Org ganised by

Supported by

Simultaneous Interpretation n Service S (SIS) would be provided in Chinese and J Japanese languages Super Early Bird Reg gistration Ends 30 November 2017

Early Bird Registration Ends 28 February 2018

[email protected]


OSTOMY CANADA SOCIETY INC. REPORT Submitted By: Ann Ivol, President, Ostomy Canada Society / Société canadienne des personnes stomisées www.ostomycanada.ca


ur efforts to reach out to the wider community for qualified volunteers to be Directors on the Board of Ostomy Canada Society have been fruitful thanks to the support of CAET and our other partners. At the Annual General Meeting (AGM), held in Mississauga, ON, on August 19, five new directors were acclaimed: Karen Bruton, Victoria, BC; Sharon Deaves, Georgetown, ON; Andrea Leard, Vancouver, BC; Andréanne Gousse, StGeorges, QC; and John Molnar, St Catharines, ON. Four directors are returning for the second year of their term: Ann Durkee, Hebron, NS; Deb Carpentier, Regina, SK; Debra Rooney, Vancouver, BC; and Jude Ruest, Saguenay, QC. As of the writing of this report we still need one more Director and Board Secretary.

Ostomy Canada Society was represented at two recent conferences: United Ostomy Associations of America (UOAA), in August, in Irvine, California, and l’Association québécoise des personnes stomisées (AQPS), in September in Montreal, QC. The Ostomy Canada Society Board has made the decision to not host a national conference in 2018 because it has become increasingly difficult to find a chapter and volunteers able to organise such an event. With the success of regional conferences, in Quebec and the Atlantic Region, we feel that this is

perhaps a better option for us at the present time. There is also a possibility that Ostomy Canada could be part of a joint CAET Conference in the future.

This issue’s Feature Article, by CAET President Rosemary Hill, highlights a new pamphlet entitled Disability Tax Credit for People Living with an Ostomy. A few months ago Cathy Harley, Executive Director of CAET, and myself had an opportunity to be part of a teleconference with Mina Mawani, the President and CEO of Crohn’s and Colitis Canada, as well as with other Crohn’s and Colitis Canada staff. It is hoped that, with this first step, we will begin to build a collaborative relationship between our three organizations. We all want to support those who live with chronic illness and/or an ostomy. For the past three summers Ostomy Canada Youth Camp has shared the Easter Seals’ facilities at Camp Horizon, Bragg Creek, AB, with Crohn’s and Colitis Canada’s Camp Got2Go. This provides an opportunity for Ostomy Canada Society and Crohn’s and Colitis Canada to learn from, and support each other, through their respective camp programs. ET Nurses are also essential in the care of campers and in teaching them how to manage

their ostomy or continent diversion. We appreciate the ETNs who have volunteered their time to support campers over the years at this annual summer event and encourage all CAET members to consider it. This issue’s Feature Article, by CAET President Rosemary Hill, highlights a new brochure entitled Disability Tax Credit for People Living with an Ostomy. Members of the Ostomy Canada Disability Tax Credit (DTC) Committee, which included members of CAET, have taken six months to produce this brochure. We are hoping that persons living with an ostomy will find the information helpful when applying for the Canadian disability tax credit. Hard copies of the DTC brochure are available, in both English and French, from the Ostomy Canada office in Mississauga, ON (1888-969-9698). Both electronic versions can also be downloaded at ostomycanada.ca. I look forward to the opportunity for further collaboration between CAET and Ostomy Canada in 2018 and beyond. cd


December 2017




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20 miles this week k 2 successful merg gers 0 irritation arround ound his stoma

The focus on evidence-based practice and the positive patient p outcomes that re esult is inspiring. We learn so much from o WOC nurses who talk about patient ient case studies and share feedback. You are the heart of what we do. Thank you for being ther ere and expre essing your commitment as an advocate for healthy peristomal skin. We understand how much skin health impacts quality off life — for both you and your patients. Which is why the right fit to prevent e leakage and best forrmulations to support skin health are the foundation of our portfolio of products. o By focusing our o effforts forts in those two areas e you and your patients have more time to focus on the things thatt re eally matterr.. At Hollister Ostomy Care, e we look forward to continuing this share ed journey with you to ensure e the best possible outcomes for all those we serve e. www.hollister.com