How to Change Colostomy bag

Patient X is about to be discharged today per doctor’s order. In line with this, Nurse Eva is preparing her discharge teaching plan. In her attempt to promote independence, included therein is how to change a colostomy bag. Below are the steps that should be included in the discharge plan:

  1. The bathroom is a good place to change the pouch. Empty the used pouch into the toilet first, if it needs emptying.
  2. Gather the supplies. If you have a 2-piece pouch, be sure you have the special ring seal that sticks to your skin around the stoma.

052212_1823_test13Follow these steps to prevent infection:

  • Wash your hands with soap and water. Be sure to wash between your fingers and under your fingernails. Dry with a clean towel or paper towels.
  • If you have a 2-piece pouch, press gently on the skin around your stoma with 1 hand, and remove the seal with your other hand. (If it is hard to remove the seal, you can use special pads. Ask your nurse about these.)
  • Remove the pouch.
  • Keep the clip. Put the old ostomy pouch in a bag and then place the bag in the trash.
  • Clean the skin around your stoma with warm soap and water and a clean washcloth or paper towels. Dry with a clean towel.

Check and seal your skin:

  • Check your skin. A little bleeding is normal. Your skin should be pink or red. Call your doctor if it is purple, black, or blue.
  • Wipe around the stoma with the special skin wipe. If your skin is a little wet, sprinkle some of the stoma powder on just the wet or open part.
  • Lightly pat the special wipe on top of the powder and your skin again.
  • Let the area air-dry for 1 to 2 minutes.

Measure your stoma:

  • Use your measuring card to find the circle size that matches the size of your stoma. Do not touch the card to your skin.
  • If you have a 2-piece system, trace the circle size onto the back of the ring seal and cut out this size. Make sure the cut edges are smooth.

Attach the pouch:

  • Attach the pouch to the ring seal if you have a 2-piece ostomy system.
  • Peel the paper off the ring seal.
  • Squirt stoma paste around the hole in the seal, or place the special stoma ring around the opening.
  • Place the seal evenly around the stoma. Hold it in place for a few minutes. Try holding a warm washcloth over the seal to help make it stick to your skin.
  • If you need them, put cotton balls or special gel packs in your pouch to keep it from leaking.
  • Attach the pouch clip or use Velcro to close the pouch.
  • Wash your hands with warm soap and water.


Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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