Emptying Colostomy Bag

Considerations: 

• Ostomy bag should be emptied when 1/3 to 1/2 full or when a leak occurs. 
• Be sure to take steps to ensure student privacy when performing the procedure. 
• Encourage the student to assist in the procedure as much as they are able to help student learn self-care skills. 

 

Supplies: 

• Clean gloves 
• Basin for stool collection (if not near a toilet) 
• Washcloths, diaper wipes, tissues or paper towels 
• Pouch deodorant 
• Student’s Individualized Health Care Plan (IHCP) and health care provider’s order 
• Parent/Guardian authorization form 

Procedure:

1. Review student’s IHCP and health care provider’s order 
2. Ensure proper documentation of parent/guardian authorization to perform this procedure 
3. Position student taking steps to ensure privacy 
4. Explain the procedure to the student at their level of understanding 
5. Encourage the student to assist in the procedure as much as they are able to help student learn self-care skills 
6. Wash hands 
7. If student will be assisting, have student wash hands 
8. Put on gloves 
9. Inspect the area around the stoma for:
   a. Redness 
   b. Irritation appearing around the stoma
   c. Signs of leaking around the pouch or skin barrier
   d. Bleeding 
10. Inspect the stoma for signs of:
    a. Bulging
    b. Getting longer
    c. Darkening in color or turning bluish 
11. If emptying into the toilet, place a piece of toilet paper in the toilet to prevent splashing 
12. Raise the pouch so the opening faces up 
13. Open the pouch
    a. Either unclamp or unroll the integrated drainage outlet 
14. Lower the pouch toward toilet or collection container 
15. Slide your hands down the pouch to push out the stool
    a. If there is a smaller or larger amount of stool output than expected follow up with parents/guardian, especially if student complains of cramping or abdominal pain or looks dehydrated .
16. Wipe inside the tail of the bag above the level of the pouch closure to prevent stool from leaking out when the pouch is closed.
    a. This will prevent soiling and odor
    b. Toilet paper or commercial infant wipes can be used for this purpose 
17. If used, add pouch deodorant 
18. Re-clamp or reseal the pouch 
19. Remove gloves
20. Wash hands 
21. If the student assisted with the procedure, have the student wash their hands 
22. Document assessment, intervention and procedure in student’s health care record 
23. Follow up with parents/guardian and health care provider, as needed 

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References:

American College of Surgeons. (2015). Step-by-step skills checklist and evaluation. Retrieved June 22, 2023, from https://www.facs.org/media/5nrphcg3/skills_checklist.pdf  

Children’s Hospitals and Clinics of Minnesota.  (2021).  Fecal pouch emptying.  Retrieved June 22, 2023, from https://www.childrensmn.org/educationmaterials/childrensmn/article/15550/fecal-pouch-emptying/ 

Children’s Hospital St. Louis. (2015). Ostomy home care teaching manual. Retrieved June 22, 2023, from  https://www.stlouischildrens.org/sites/legacy/files/Ostomy%20Home%20Care%20Teaching%20Manual.pdf  

Hollister. (2018). Caring for your child with an ostomy. Retrieved June 22, 2023, from https://www.hollister.com/-/media/files/pdfs-for-download/ostomy-care/caring-for-your-child-with-ostomy_923057-0318.ashx  

Lynn, P. (2019). Emptying and changing an ostomy appliance. In Skill checklists for Taylor’s clinical nursing skills. A nursing process approach. (5th ed.). (pp. 297-298). 

Porter, S.M., Page, D., Engholm. H., & Somppi, C. (2019). Students supported by medical technology. In J. Selekman, Shannon, R.A., Yonkaitis, C.F. (Eds.). School nursing, a comprehensive text (3rd ed., pp. 721-740). Philadelphia PA.: F.A. Davis Co. 

Stetzer, M.N. (2021). Essential ostomy knowledge for nurses: Promoting adaptation in children with new ostomy and their caregivers. Pediatric Nursing, 47(2), 71-78. 

University of Wisconsin Hospitals. (2020). Health facts for you. Caring for your child’s ostomy. Retrieved June 23, 2023, from https://patient.uwhealth.org/healthfacts/7652  

Wound, Ostomy, and Continence Nurses Society. (n.d.). Pediatric ostomy care. Best practice for clinicians. Retrieved June 22, 2023, from https://cdn.ymaws.com/member.wocn.org/resource/resmgr/document_library/PEDIATRIC_OSTOMY_CARE-_BEST_.pdf  

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Acknowledgment of Reviewers:

Angie Bulmahn, MSN, RN, NCSN
School Nurse Specialist
Missouri Department of Health and Senior Services

Marjorie Cole, MSN, RN, FASHA
State School Nurse Consultant
Missouri Department of Health and Senior Services

Renee Falkner, BSN, RN
School Nurse Supervision Specialist | Therapylog

Katherine Park, DNP, RN, NCSN
Nationally Certified School Nurse, Pierremont Elementary
Adjunct Professor, Maryville University School of Nursing
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Page last updated March 28, 2024
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The information and materials presented in this Website are intended for informational purposes only and are not designed to diagnose or treat a health problem or disease, or assist in diagnosis or treatment of the same. The information is not intended to substitute for, supplement or replace clinical judgment. If there are any concerns or questions about or relating to a nursing or medical procedure, contact the individual’s healthcare provider. The information provided on this Website is not intended to be a substitute for medical orders and persons without the proper education, training, supervision and/or licensure should not perform the procedures.

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