While our last post focused on the variety of health risks those with obesity face, this week’s post focuses on risks that don’t often come first to mind; those faced by bariatric patients while being cared for, and the medical professionals caring for them. Due to increased chances of complication and greater weight to move around, bariatric nursing and procedures poses a special challenge. This post will go over the main risks faced by caregivers and patients in a medical setting as well as best practices to keep both patients and medical staff safe.

 

Risks of Caring for Bariatric Patients

Simply due to their increased weight, handling bariatric patients can lead to injuries from strains and sprains to musculoskeletal injuries and excessive spinal loading in caregivers.[1] Often nurses are required to elevate limbs, assist patients in walking to the bathroom, or provide support in bathing, all of which can be dangerous when the caregiver is much lighter than the sick or unsteady bariatric patient. For example, the weight of a leg of a 350-pound patient would be about 62 pounds, meaning that simply to elevate this limb would exceed a safe lifting load, endangering a nurse attempting to lift it alone.[2]

Beyond physical occupational risks, caring for bariatric patients also increases the chance that medical procedures will not go to plan, endangering both the patient’s life and medical professionals’ careers. As discussed in one of our posts from last year, making sound medical decisions on behalf of a patient can be inhibited by obesity, since vitals and emergency landmarks are harder to identify,[3] a lack of bariatric medical equipment can lead to late diagnosis or misdiagnosis,[4] and complications during or after surgery increase.[5]

 

Proactive Care Practices

In order to assure both patient and medical professional safety, there are many different things to keep in mind when bariatric patients are being cared for. Here are some examples of proactive care practices that can lower risks for both parties:

  • Increase bariatric training in nurses and other medical staff
  • Increase specialty equipment for patients with greater size and weight
  • Develop specific bariatric protocols
  • Frequently address skin care so as to prevent infection and poor healing
  • Conduct bariatric mobility admission assessments to determine a patient’s level of disability to ensure they have a team that is right for them[6]
  • Be cautious of altered drug absorption due to increased dosage related to increased weight
  • Work to improve good communication between patients and staff, and between staff members

 

Though increased levels of obesity in the United States is a serious problem, it is a reality that must be faced, particularly by those who care for obese individuals. With the enactment of proactive measures and increased knowledge of bariatric risks for all, we stand a much better chance of combating the challenges posed by this condition effectively.

[1] Muir, Marylou, and Archer-Heese, Gail, “Essentials of Bariatric Patient Handling Program,” The Online Journal of Issues in Nursing, 2009, http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No1Jan09/Bariatric-Patient-Handling-Program-.html

[2] Ibid

[3] Long, Will, Brett McGary, and Edward Jauch, “EMS Challenges with Bariatric Patients – Part 1,” Carolina Fire Rescue EMS Journal, July 5, 2011, http://www.carolinafirejournal.com/Articles/Article-Detail/articleid/1586/ems-challenges-with-bariatric-patients

[4] Abrams Kaplan, Deborah, “Challenges in Imaging Obese Patients,” Diagnostic Imaging, March 26, 2014, http://www.diagnosticimaging.com/practice-management/challenges-imaging-obese-patients

[5]  “Surgical Complications Twelve Times More Likely in Obese Patients,” Hopkins Medicine, June 29, 2011, http://www.hopkinsmedicine.org/news/media/releases/surgical_complications_twelve_times_more _likely_in_obese_patients

[6] Severson and Chuang, “Ten Safety Steps”; Thomas, Shirley A. and Mary Lee-Fong, “Maintaining Dignity of Patients with Morbid Obesity in the Hospital Setting,” Bariatrictimes.com, April 15, 2011, http://bariatrictimes.com/maintaining-dignity-of-patients-with-morbid-obesity-in-the-hospital-setting/