Unclamp the bottom of bag
Drain into bedpan
Use a squeeze-type bottle filled with warm water to rinse inside of appliance
Clean off clamp if soiled
Put a few drops of deodorant in appliance if not odorproof
Fasten bottom of appliance securely (fold bag over clamp 2-3 times before closing)
Check for leakage under appliance every 2 - 4 hr
Communicate with patient while attending to appliance

Remove appliance each time it needs emptying
Use any materials that could irritate bowel
Ignore patient’s needs

Gather equipment: gloves, skin prep packet, colostomy appliance measured to fit stoma properly (if new surgical stoma, it will continue to shrink with the healing process; use stoma measuring guide), skin barrier, warm water and soap, face cloth/towel, plastic bag for disposal of old equipment. Remember that bowel is very fragile; also, working near bowel increases peristalsis, and feces and flatulence may be expelled.

Remove old appliance carefully, pulling from area with least drainage to area with most drainage
Wash skin area with soap and water
Observe skin area for potential breakdown
Use packet of skin prep on the skin around the stoma; allow skin prep solution to dry on skin before applying colostomy appliance
Apply skin barrier you have measured and cut to size
Put appliance on so that the bottom of the appliance is easily accessible for emptying (e.g., if patient is out of bed most of the time, put the bottom facing the feet; if patient is in bed most of the time, have bottom face the side); picture-frame the adhesive portion of the appliance with 1-inch tape
Put a few drops of deodorant in appliance if not odorproof
Use clamp to fasten bottom of appliance
Talk to patient (or communicate in best way possible for patient) during and after procedure
Use good hand-washing technique

Tear appliance quickly from skin
Wash stoma with soap; put anything dry onto stoma
Irritate skin or stoma
Put skin prep solution onto stoma; it will cause irritation
Make opening too large (increases risk of leakage)
Have appliance attached so patient cannot be involved in own care
Use any materials that would irritate bowel
Avoid conversation/eye contact
Contaminate other incisions

Do	Do Not
Unclamp the bottom of bag Drain into bedpan Use a squeeze-type bottle filled with warm water to rinse inside of appliance Clean off clamp if soiled Put a few drops of deodorant in appliance if not odorproof Fasten bottom of appliance securely (fold bag over clamp 2-3 times before closing) Check for leakage under appliance every 2 - 4 hr Communicate with patient while attending to appliance	Remove appliance each time it needs emptying Use any materials that could irritate bowel Ignore patient’s needs

Do	Do Not
Remove old appliance carefully, pulling from area with least drainage to area with most drainage Wash skin area with soap and water Observe skin area for potential breakdown Use packet of skin prep on the skin around the stoma; allow skin prep solution to dry on skin before applying colostomy appliance Apply skin barrier you have measured and cut to size Put appliance on so that the bottom of the appliance is easily accessible for emptying (e.g., if patient is out of bed most of the time, put the bottom facing the feet; if patient is in bed most of the time, have bottom face the side); picture-frame the adhesive portion of the appliance with 1-inch tape Put a few drops of deodorant in appliance if not odorproof Use clamp to fasten bottom of appliance Talk to patient (or communicate in best way possible for patient) during and after procedure Use good hand-washing technique	Tear appliance quickly from skin Wash stoma with soap; put anything dry onto stoma Irritate skin or stoma Put skin prep solution onto stoma; it will cause irritation Make opening too large (increases risk of leakage) Have appliance attached so patient cannot be involved in own care Use any materials that would irritate bowel Avoid conversation/eye contact Contaminate other incisions