Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice

Abstract

This report identifies that the majority of safety incidents associated with obesity were related to infrastructure, suggesting that there is inadequate provision in place for the care of obese patients. While levels of harm were mostly low, the occurrence of incidents resulting in severe harm or death highlights the specific dangers associated with the care of the obese patient. A global approach to improving the safety of care delivery for obese patients is recommended, including obesity specific training, management structures, care pathways, and equipment provisioning.Further planning and development of operation policies is needed to ensure the safe delivery of healthcare to obese patients in the future.

What Evidence Informs the Nursing Care of People with Class III Obesity in an Acute Care Setting? A Scoping Review.

“…Inadequacies in the provision, access and resourcing of specialist equipment to care for patients, as well as time taken to source the equipment has been reported as a signi cant issue for staff (30). Lack of adequate bariatric equipment accounted for most clinical incidents reported in one study (22). Lack of equipment was also associated with patient harm (19).…”

“…Equipment was identi ed as a challenge to providing care for people classi ed as Class III obese and all ndings related to either lack of access to appropriate equipment or knowledge and skills to use equipment appropriately. The speci c issues raised were accessing appropriate equipment (16)(17)(18)(19)(20)(21); the storage of equipment (17) staff knowledge around how to use equipment (19)(20)(21); patient distress and discomfort through the use of incorrect equipment (16,(22)(23)(24); putting people at risk of harm through the use of inappropriate equipment (16,17,20,(22)(23)(24); lack of equipment to measure vital signs (19) and delay in access to rental equipment (17,19,20). Other issues identi ed were equipment failure or malfunction (22,24) and, the ability of staff to identify the weight capacity of equipment (19,21).…”

“…This included the bene t of speci c discharge planning (16,21) and evacuation planning (19), as well as the capability to weigh and measure patients on admission to hospital so that the appropriate equipment for each patient was both accessible and available (19,25). Other issues identi ed included staff training and education (16,19,20,22,23) skin care protocols (16,19,21) and the inconsistency in the use of the term 'bariatric' (17,20). Not all hospitals had established policies relating to the manual handling of people classi ed as Class III obese (20).…”

Perioperative Optimization of Patients Undergoing Bariatric Surgery

“…Sufficient manpower must be available to help transfer the anaesthetized patient from a bed to the operating table, and special inflation mattresses have been designed for this purpose. In a review of 155 patient safety incidents involving bariatric patients, 27 involved injury to staff as a direct result of difficulties with moving and handling [49]. Pressure points must be carefully padded, as any resulting pressure sores in patients who are at high risk of poor tissue healing can be troublesome [50].…”

Condição periodontal e hipertensão arterial em pacientes obesos mórbidos antes e após a cirurgia bariátrica: estudo de coorte prospectivo

“…(SALGADO JUNIOR et al, 2010;DORBROW et al, 2004;FRANCISCHI et al, 2000;FRANCSICHINI et al, 2000;GRACIANO, 1980;NG et al, 2014) (BOOTH et al, 2011FERREIRA, 2006;SUTER et al, 2006;MONDINI & MONTEIRO, 1998 • Obesidade grau I: quando o IMC encontra-se entre 30 e 34,9 Kg/m 2 .…”