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Bariatric Protocols

Bariatric patients are those with a high degree of obesity. They are generally considered morbidly obese and are difficult to assist if they aren't fully ambulatory. The biggest challenges are safety for the patient and aides and compassionate respect. The need for a bariatric protocol underscores the importance of assisting the bariatric patient with a strong level of dignity attached to the process. Part of the care and healing of any patient is the genuine presence of humanity that lets the patient know someone cares. Bariatric protocols ensure that this feeling of security is being delivered and that assistance can be provided without risk.

  1. Evaluation and Patient Assessment

    • When a bariatric patient enters a treatment facility or hospital, the patient's medical background needs to be verified. This will include family history, previous medical conditions and treatment, allergies and prior care providers. At this time the basic vitals will be taken such as weight, blood pressure and other statistics. Privacy should be provided for the interview and for the data-gathering processes. Every effort should be made to establish the bariatric patient comfortably, either in a suitable chair or bed during the course of the initial questioning and examination.

    Equipment, Space and Environment Considerations

    • Bariatric patients often have other health concerns that need to be accommodated. Mobility is a concern, and suitable wheelchairs, ramps and leverage systems need to be in place in a bariatric care facility. Skin conditions can develop that need to be addressed, and there may be the need for other special equipment such as bariatric toilets. All these needs need to be acknowledged and accommodated at admission and throughout treatment.

    Team Introduction and Communication

    • The process of nursing care includes conveyance of safe and secure nursing. The entire team needs to know what steps will be taken in the care program and all the pertinent information about the patient's condition and needs. The patient should meet each member of his team so he is comfortable with the level of communication and nursing he will receive. The chain of query should be made clear to the patient and readily available.

    Operational Procedure and Policy

    • It is important to have a clear written set of procedures and policy in place. This protects the patient, the caregivers and the hospital or facility. It cannot be stressed enough that safety is a priority in all instances. Staff should have extensive initial training and continued training and monitoring to ensure guideline adherence.

    Patient Handling Guidelines

    • There is an element of danger in handling bariatric patients. The movement of a limb constitutes 16 percent of a person's body weight and may be difficult to elevate and stabilize. Assistance with toilet needs, moving the patient to a new bed and meeting other needs can cause injury to the caregiver. Appropriate assistance devices and safety items like back braces should be provided for the staff. Insistence on team care is also important to reduce the element of risk associated with a sizable patient.

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