Bariatric Patient Protocols

According to the World Health Organization, obesity throughout the world has more than doubled from 2008 to 2011. Obesity is measured by the body mass index (BMI), which is the individual's kilogram weight divided by the square of his height in meters. A BMI of 30 and above is considered obese, and 40 or higher is extremely obese. When extremely obese individuals are hospitalized, they are referred to as bariatric patients.

Accommodations

• Special accommodations are necessary for bariatric patients. Larger rooms are needed to allow for the larger bariatric bed and large equipment such as lift system, wider wheelchair, wider commode and larger chair for sitting. Additional space is also necessary to permit easy movement in caring for the patient. Other needs to be taken into consideration include bariatric bedpans, wash basins, shower chairs, larger hospital gowns and larger blood pressure cuffs.

Complications

• Nursing staff should be aware of the health risks that are more likely to occur with bariatric patients. The Online Journal of Issues in Nursing indicates that bariatric patients more frequently have issues such as cardiac disease, respiratory disease, skin conditions, hypertension, diabetes, osteoarthritis, depression, stress incontinence, gallbladder disease and some types of cancer. Many bariatric patients have sleep apnea, which can lead to cardiac problems including congestive heart failure. Skin conditions often occur due to large skin folds and difficulty with hygiene.

Employee Injury

• Risks for nursing staff in the care of bariatric patients include sprains, strains and musculoskeletal injuries. Particular care must be taken when repositioning patients and helping with their daily activities such as bathing, hygiene, dressing and moving. Mechanical lifts are used to prevent such injuries. Depending on the type of equipment, additional staff may be needed. For example, it may require two people to transfer the patient with the lift while another monitors the patient during the transfer.

Mobility

• Bariatric patients have mobility problems that increase with age. Osteoarthritis can complicate the problem. Mobility devices that can accommodate the size and weight of the patient may be needed. These include walkers, wheelchairs and scooters.

  Bariatric health-care providers should receive education and training with regard to the safe handling of bariatric patients. Guidelines typically exist for specific tasks such as transfer of the patient, repositioning, accessing specific body areas, transporting and toileting.