Systematic ReviewResearchPatient EducationWorkflow

App-based and combined eHealth support improved selected stoma outcomes in a network meta-analysis

International journal of nursing practice (PubMed)Jul 22, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review and network meta-analysis of 48 studies involving 4,463 adults with intestinal stomas found that app-based and combined eHealth programs improved selected complication, self-care, quality-of-life, and self-efficacy outcomes.

What NurseJet pulled from the source

App-based interventions were estimated to reduce stoma complications and improve self-care, while web support plus phone calls ranked highest for quality of life and self-efficacy. App plus telemonitoring ranked highest for stoma adaptation. Estimates for anxiety, depression, satisfaction, and some combined approaches were imprecise, and network rankings do not show that one digital program will work best across settings.

Why this matters for nurses

Ostomy nurses teach pouching, skin protection, hydration, nutrition, complication recognition, and self-management across a transition that continues well beyond discharge. Digital tools may extend that support, but they need clinical ownership, accessibility, and a reliable route to in-person assessment.

Bedside takeaway

Digital stoma support appears useful for selected outcomes, but it needs accessible teaching, clinical follow-up, and a clear route to hands-on assessment.

How This Applies in Practice

Use this when: Selecting or reinforcing a clinically supported digital follow-up plan for an adult learning to manage an intestinal stoma.

On your shift

Assess the patient's ability to use the platform, upload or describe concerns, understand instructions, and obtain caregiver or interpreter support when needed.
Reinforce pouching, peristomal skin, hydration, output, nutrition, supply, and complication guidance through the approved education pathway.
Verify that the patient knows how to reach the ostomy team and when leakage, skin injury, high or absent output, dehydration, pain, fever, or stoma changes require direct assessment.

Keep in mind: An app or phone program cannot replace hands-on examination when complications are suspected, and the review does not identify one best platform. Follow the ostomy-care protocol, facility policy, and patient-specific provider orders.

Explain this for my unit

Key takeaways

The review included 48 studies and 4,463 adults with intestinal stomas.
App-based support was associated with fewer complications and better self-care.
Web support plus phone calls ranked highest for quality of life and self-efficacy.
Several estimates were imprecise, and indirect network rankings do not establish one universally superior eHealth model.

Practice implications

Match digital follow-up to the patient's health literacy, language, dexterity, vision, connectivity, and caregiver support. Reinforce how to submit concerns, when to contact the ostomy team, and which symptoms require urgent in-person evaluation rather than relying on an app alone.

Limitations & cautions

The review combined varied digital formats, comparators, outcome measures, and study designs. Some ranked estimates had confidence intervals crossing no effect or were extremely wide, and network rankings depend on indirect comparisons and consistency assumptions, so they should not be treated as a prescriptive hierarchy.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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International journal of nursing practice (PubMed)

International journal of nursing practice (PubMed). Effectiveness of eHealth Interventions on Health Outcomes in Adult Patients With Intestinal Stoma: A Systematic Review and Network Meta-Analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42485499/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Nursing open (PubMed)Jul 1, 2026Research ArticlePractice applicable

A randomized trial of 170 adults scheduled for intestinal stoma surgery found that adding practice with a wearable stoma-care training belt to standard preoperative education improved self-care skills, adjustment, anxiety, and education satisfaction through 30 days after discharge.

Med-SurgAI summaryReview source

Research ArticleResearchPatient EducationWorkflowPractice applicableAI summary · original source linked below

Patients at two university hospitals were randomized to standard care alone or standard care plus preoperative belt-based practice. The intervention group had higher stoma-care skill and adjustment scores at every postoperative assessment, lower anxiety from discharge through day 30, and higher satisfaction at the preoperative and discharge assessments. The study evaluated short-term patient-reported and skill outcomes rather than complications or readmissions.

Key takeaways

The trial randomized 170 patients preparing for intestinal stoma surgery at two university hospitals.
The training belt allowed preoperative practice without applying an adhesive system directly to the abdomen.
Skill and adjustment scores favored belt-based practice at discharge and through 30 days after discharge.
The abstract does not establish effects on stoma complications, healthcare use, or outcomes beyond the first postoperative month.

Why this matters on shift

Wound and ostomy nurses help patients build confidence with equipment before they must manage a new stoma at home. The trial supports hands-on rehearsal as an addition to the established teaching pathway while keeping the evidence focused on early skills, adjustment, anxiety, and satisfaction.

Bedside takeaway

Hands-on preoperative stoma practice improved early skills and adjustment, but clinical and longer-term outcomes were not measured.

Nursing implications

When an approved simulation device is available, integrate supervised practice into the existing preoperative stoma-education plan. Observe the patient's technique, revisit difficult steps before discharge, and arrange follow-up for ongoing skill or adjustment concerns.

Limitations & cautions

The trial was conducted in general-surgery departments at two university hospitals and followed patients for 30 days after discharge. The abstract does not report blinding, clinical complications, readmissions, long-term self-management, or whether the findings generalize to other devices, stoma types, or care settings.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Nursing open (PubMed). Effect of a Stoma Care Training Belt on Stoma Care Skills, Adjustment, Anxiety and Satisfaction in Intestinal Stoma Patients: Randomized Controlled Study.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Critical care nursing clinics of North America (PubMed)Jun 22, 2026Systematic ReviewPractice applicable

A clinical review describes ICU nurses as central to coordinated prevention of multidrug-resistant organism transmission through stewardship, pathogen surveillance, appropriate isolation precautions, and evidence-based hygiene practices.

ICU Med-SurgAI summaryReview source

Systematic ReviewInfection ControlWorkflowPatient EducationPractice applicableAI summary · original source linked below

The review links ICU vulnerability to immunosuppression, invasive devices, broad-spectrum antimicrobial exposure, and the care environment. It emphasizes a multimodal, team-based approach rather than a single intervention, including laboratory and antibiotic stewardship, passive and active surveillance, timely use and de-escalation of precautions, and hygiene measures. The abstract does not report a systematic search or pooled patient outcomes.

Key takeaways

Critically ill patients face overlapping exposure risks related to devices, antimicrobials, immune dysfunction, and the ICU environment.
The review frames MDRO prevention as coordinated work across bedside nursing, infection prevention, laboratory, and antimicrobial-stewardship teams.
Nursing responsibilities include surveillance, hygiene, and correct implementation and de-escalation of ordered precautions.
This is a clinical review, so it does not quantify the independent effect of any single prevention measure.

Why this matters on shift

ICU nurses are continuously positioned to recognize new transmission risks, maintain device and hygiene practices, and identify when precaution or antimicrobial plans need clarification. The review supports reliable team coordination while leaving organism-specific actions to current infection-prevention guidance.

Bedside takeaway

MDRO prevention in the ICU depends on coordinated surveillance, precautions, stewardship, hygiene, and reliable bedside execution.

Nursing implications

Verify the organism-specific precaution plan at handoff, perform the approved hygiene and device-care bundle, and communicate changes in cultures, antimicrobial therapy, or isolation status. Escalate uncertainty promptly to infection prevention and the treating team.

Limitations & cautions

The PubMed abstract describes a narrative clinical review without a reported systematic search, evidence grading, sample, or pooled effect estimates. It does not establish the comparative effectiveness of specific surveillance, isolation, stewardship, or hygiene interventions, and local resistance patterns may change implementation.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Critical care nursing clinics of North America (PubMed). Infection Prevention and Control in the Intensive Care Unit: Preventing the Spread of Multi-Drug-Resistant Organisms.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Pulmonology (PubMed)Jul 22, 2026Systematic ReviewPractice applicable

An umbrella review of 13 systematic reviews involving 15,363 people with COPD found that digital self-management interventions improved several pooled health-related outcomes, while evidence certainty ranged from very low to moderate and heterogeneity was substantial.

Med-SurgAI summaryReview source

Systematic ReviewResearchPatient EducationWorkflowPractice applicableAI summary · original source linked below

Across 11 meta-analyses and two narrative syntheses, digital interventions were associated with improvements in physical activity, quality of life, lung function, adherence, anxiety, and depression. Results were inconclusive for dyspnea, physical capacity, sedentary time, emergency visits, and mortality. Differences among programs, populations, outcomes, and review methods limit confidence in applying one pooled estimate to a specific tool.

Key takeaways

The umbrella review included 13 systematic reviews representing 15,363 participants with COPD.
Pooled findings favored digital self-management for physical activity, quality of life, lung function, adherence, anxiety, and depression.
Effects on dyspnea, physical capacity, sedentary time, emergency visits, and mortality were inconclusive.
Substantial heterogeneity and very low-to-moderate evidence certainty limit claims about a best platform or long-term clinical benefit.

Why this matters on shift

Medical-surgical nurses reinforce COPD self-management before discharge and help identify whether patients can use a digital plan safely after leaving the hospital. The review suggests digital support can extend education and follow-up, but it does not replace individualized assessment or establish fewer emergency visits or deaths.

Bedside takeaway

Digital COPD support may improve several self-management outcomes, but platform choice and escalation still require individualized clinical oversight.

Nursing implications

Confirm that the digital program is part of the clinical care plan and that the patient can access and understand it. Reinforce how to record symptoms, use the program's escalation pathway, and seek direct assessment when symptoms worsen rather than relying on the platform alone.

Limitations & cautions

This umbrella review synthesized existing reviews rather than individual trials. Interventions, comparators, populations, outcome definitions, and follow-up periods varied; heterogeneity was substantial for most outcomes; and GRADE certainty ranged from very low to moderate. The evidence was inconclusive for emergency visits and mortality.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pulmonology (PubMed). Effectiveness of self-management digital interventions in improving health-related outcomes in patients with chronic obstructive pulmonary disease: An umbrella review.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

Preoperative stoma-belt practice improved self-care skills and adjustment after surgery

ICU review centers nurses in coordinated prevention of multidrug-resistant organism spread

Digital COPD self-management improved several outcomes, but evidence certainty remained limited