Understanding the Bariatric Client and Providing a Safe Hospital Environment

Abstract

Mobility is a basic human need that, when not met, leads to a cascade of physical problems. Meeting the challenge of safe mobility for bariatric patients is a concern for many healthcare institutions. More than 20% of the adult population now has a body mass index equal to or greater than 30 and are classified as obese. Obesity is associated with many well-known health risks, including heart disease, metabolic disorders, and cancer. Nurses should be aware of these health risks, the interplay between mobility and health risks, and the national guidelines for treating the obese patient population. This article presents an overview of national guidelines for identifying, evaluating, and treating bariatric patients and identifies issues that create challenges to providing a safe environment for mobility among hospitalized obese patients.

Obesity in Nursing Homes: An Escalating Problem

“…Owing to the susceptibility of obese persons to pressure ulcers, 24 nursing homes may need more special mattresses or pressure‐reducing overlays on mattresses to minimize pressure sores and maintain skin integrity and Hubbard tanks to provide treatment 25 . Indeed, bed and wall railings, hydraulic lifts, commodes, and shower chairs have weight limitations of 250 pounds to 300 pounds 26 . Heavy‐duty assistive devices used for mobility, such as canes, walkers, and wheelchairs, and gurneys used for transporting patients may need to be special ordered if they not routinely available.…”

Body Mass Index, Weight, and Pressure Ulcer Prevalence

“…1,2 The development of a pressure ulcer in any patient is a serious complication that is fraught with pain, [3][4][5] a decrease in quality of life, [6][7][8][9] and significant expenditure of both time and money in the medical community. Immobile patients are at greater risk for developing pressure ulcers.…”

Medical Assessment and Preparation of Patients Undergoing Bariatric Surgery

“…Chairs in the waiting area and in clinic rooms should provide armless bariatric chair (Mechanick, Kushner et al 2009). Wheelchairs availability in hospital should accommodate both the weight and size of patients (Barr and Cunneen 2001). Other essential patient care equipments such as suitable examination table in the clinic room, appropriate weighing scales and stadiometer should be available (Mechanick, Kushner et al 2009).…”

“…Other essential patient care equipments such as suitable examination table in the clinic room, appropriate weighing scales and stadiometer should be available (Mechanick, Kushner et al 2009). Facilities such as toilets should not be overlooked and fixtures to help individuals with mobility problems may need to be adapted for bariatric patients (Barr and Cunneen 2001).…”