The relationship between patient obesity and nursing workload: An integrative review

Abstract

Aims and objectives:To explore the relationship between patient obesity and nursing workload, and discuss the nursing activities most affected by patient obesity. Background:The increasing number of patients with obesity, and the severity of obesity, impacts the healthcare workforce, particularly to nurses who provide most direct care to patients. There is growing evidence to suggest that patient obesity may increase nursing workload and time taken for clinical care. Design: Integrative review.Methods: A comprehensive search of academic databases for primary research related to patient obesity and nursing workload, published since 2000, was conducted.References of relevant articles were hand-searched.Results: 27 articles were analysed. Analysis was undertaken at the levels of patient characteristics, nursing work and the healthcare system. The increasing number of patients with obesity, and the severity of patient obesity, increases nursing workload by affecting nursing time needed to deliver care. An increased number of nurses, particularly with increased clinical skill, are needed to deliver care meeting these increased needs. Organisational change is required to provide infrastructure and bariatric equipment that enables effective nursing care of patients with obesity.Organisations must consider additional time and staff needs when delivering care for patients with obesity. Conclusions:The current health system is not established to address the challenge of providing nursing care to the increasing numbers of patients with obesity. Further research on accurately and objectively quantifying the impact and severity of patient obesity on nursing clinical activities is required.Relevance to clinical practice: When determining staffing, healthcare organisations must consider the increased nursing staff, time and clinical skill required to provide care for patients with obesity. Healthcare organisations should implement policies that ensure sufficient staffing in areas where care of patients with obesity is prevalent, and provide training for and workplace availability of bariatric equipment.

The Relationship Between Eating Behaviors and Learned Helplessness among the People with Overweight and Affected by Obesity: A Cross-Sectional Study

“…Another relevant study reported that negative moods such as anger and boredom affected the emotional eating behaviors of the participants (25). One of the target groups of nurses who provide care and counseling to the public while in direct contact with the public is overweight and obese people (26). Overweight or obese people often have eating disorders (27).…”

Healthcare Workers’ Experiences of Strategies in Caring for Patients with Obesity: A Qualitative Content Analysis

“…Healthcare workers must be very skilled when caring for PWO to be able to perform tasks such as measuring blood pressure, performing venipuncture, and examining them (11). Sometimes the quality of PWO care is low due to healthcare workers' inability (29), insufficient skills or training, the lack of healthcare workers, the lack of the necessary equipment (30), the need to spend a lot of time, and the increased burden of care (11). Therefore, other healthcare workers with enough skills and capabilities help.…”

“…The increasing admission of PWO and the failure to meet their routine care needs may disturb their safety and comfort (36). Managers should increase the number of human resources, provide and prepare care equipment suitable for these patients in hospitals (11,33), and increase healthcare workers' clinical skills (11). They must encourage a teamwork approach (8) for better and higher-quality care.…”

“…Examples of difficult patient care situations include measuring blood pressure, monitoring hemodynamics, positioning, bathing (5), transferring the patient (5,6), intubating or inserting tracheostomy and a laryngeal mask airway (7,8) palpating the carotid pulse during resuscitation, as well as performing CPR (4) and venipuncture (5). Fat tissue, patients' large size (6), and the lack of treatment-care facilities appropriate to their weights (5,9,10) are the most common causes of patient care challenges, which have consequences for both nurses (such as increased workload (11), fatigue (12), and back injury (13)) and patients such as falling from the bed during difficult movements (14), fracture, head trauma, skin damage, and bedsores, which can cause patient safety incidents (15).…”

Good Things Don't Always Come in Small Packages

“…We located a second scoping review that found that safe and effective care of patients with Class 3 obesity substantially increases nursing and challenging nurses' safety if training or staffing needs are not met. 42…”