You may have heard of an Appliance Usage Review, or AUR? It’s the term the NHS uses to describe the formal review of your stoma health by a qualified nurse. It’s an opportunity for you to talk to a specialist nurse about any issues you may be having with your stoma, bags and accessories. This can include physical problems with sore skin, leakages or how to adapt your product to fit your lifestyle. The stoma nurse will review the bag you're using as well as any accessories or complementary products you may have been prescribed.
During the review the nurse will look at the bag you're using to ensure it fits properly, it doesn’t matter if you have had recent surgery or have had your stoma for many years – you are entitled to a review. AURs can take place in an organised clinic at your GP surgery or in the privacy of your own home if you prefer. Although the review is a thorough one it should only take around 30 minutes. Though this can vary, your stoma nurse certainly won't put any time limit on your consultation.
During an appliance usage review your stoma nurse will:
Following the visual inspection and review of the products you are using, the nurse may be able to recommend different products or a change in your routine to deal with any issues. If the nurse believes you could benefit from using a different stoma bag for example, she will advise on what pouches to try and help organise for you to receive some.
There are several benefits to attending an AUR. Sometimes a stoma bag wearer can lose touch with their nurse and an AUR provides a new point of contact. Someone to talk to. It's important not to feel isolated
You also get a chance to look at new products. And to check the stoma bag you're currently using and whether it still suits you.
But the biggest positive is it gives you the chance to sit down with a nurse and talk through any issues you may be having. Sore skin can be a problem for stoma bag wearers. Several things can cause this.
Your stoma may have changed. It could have prolapsed or retracted. Your body too may have changed. Some stoma bag wearers can experience weight gain in the months following surgery. This could lead to problems with the bag no longer fitting correctly. This in turn can lead to sore skin. If you suffer with this an AUR can identify the problem and your nurse will be able to offer advice on how to deal with it.
Andrea Benn, Senior Medical Affairs Specialist, at ConvaTec said: "Lots of stoma bag wearers live with sore skin as they think it's normal. That it's an expected result of stoma surgery. But no stoma wearer has to put up with sore skin.
"An AUR can really help in identifying sore skin as well as other issues. A review gives the nurse a chance to look at your stoma first hand and the bag you're using. The nurse will be able to find out much more from actually seeing you in person rather than chatting on the phone.
"The review will enable the nurse to recommend new products or show you how your current product can be used more effectively to eradicate the problem of sore skin. No-one should ever think we are too busy to see them or that their problems do not warrant our time – we want to help."
Rachel found she was experiencing a variety of skin issues and didn’t know how to resolve the situation herself. Her symptoms varied between irritated skin under the baseplate as well as sore skin from the baseplate which seemed to be rubbing.
But the AUR gave the nurse an opportunity to review the products Rachel was using as well as her care routines. The nurse was able to advise Rachel to begin using an adhesive remover.
Rachel said: “Sore skin drove me to distraction. The nurse advised the red bumps under the baseplate might be down to taking the bag off too quickly, causing micro trauma. She suggested I remove the bag a little slower using adhesive remover and it has definitely helped."
"She also helped me understand the rubbing problem I was experiencing could be caused by the inflexible material used in my particular baseplate. I hadn’t realised that some stoma products have thinner or tapered edges to their adhesives which can be more flexible. They're less likely to cause rubbing and friction.”
We asked Andrea Benn how you can request an AUR. She said: “You may feel comfortable with the products you're using and be in regular contact with your stoma nurse and may feel you don’t need an AUR”.
"But if you feel you would benefit from a review you can request one at any time. You don't have to wait for your GP to host a specific clinic. You can contact the Amcare help line and ask for an AUR at home. We'll be happy to arrange this. Equally if you feel you just want to speak to someone for advice, we’re happy to answer questions over the phone – this may put your mind at rest”.