Safely caring for plus size patients

Caring for plus size patients requires more staff and puts them at risk of injury. These challenges can be overcome by providing caregivers with the correct bariatric equipment.

 

INTERVIEW WITH TRACEY: Tips for nurses caring for plus size patients


Obesity has been called the most prevalent, chronic, relapsing, and ultimately fatal disease of the modern world. 

FACT: 13% of the world’s adult population is obese1 and the repercussions of managing this pandemic are substantial and intensifying.2

The complex and challenging needs of the plus size patient are well documented, but let’s consider for one moment how this might impact the caregiver. Can they provide effective bariatric care as well as protect themselves from injury?

  • Healthcare workers in the USA3 reported one of the highest occupational injury rates 2014, more than public construction workers! The USA is not unique in this.
  • More than half of nursing injuries were musculo-skeletal disorders such as back, shoulder and neck injury.3
  • 60% of caregivers injuries are related to physical repositioning in bed, turning & transfers4, and immobile patients need moving many times each day. When nursing plus size patients, more staff are required and greater loads are lifted.

FACT: Nurses and caregivers often put the wellbeing of their patients ahead of their own!

But that does not have to be the case.

What can be done to help?

  • Staff generally find ceiling lifts to be the least demanding method of patient handling, and it is the quickest transfer method.5 Patients also tend to prefer ceiling lifts to either floor lifts or manual handling.5
  • A purpose-designed bariatric hospital bed can aid with patient repositioning.
  • When protective equipment is available and easy to use, it is used! Reduce your exposure to physical load6 by selecting a lift sheet that is designed to replace the bed sheet and remain in situ. These are available with high safe working loads making them suitable for plus size patients. 
  • Risk doesn’t stop at the bedside. Consider bariatric bathing and toileting facilities: can they accommodate the larger patient and reduce the physical effort required by staff?

It has been almost 25-years since Garg & Owen7 reached the following conclusion and their finding is still true today:

“An appropriate ergonomic intervention programme [equipment for patient care, toileting and bathing] offers great promise in reducing physical stress and risk of low-back pain to nursing personnel.”

If you need to build or adapt your healthcare facility to cater for these demographic changes, you can download the bariatric chapter of the Arjo Guidebook for Architects and Planners.

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1World Health Organisation Fact Sheet 311 (2015): http://www.who.int/mediacentre/factsheets/fs311/en/

2Beitz JM. Providing Quality Skin and Wound Care for the Bariatric Patient: An Overview of Clinical. Ostomy Wound Manage. 2014; 60(1): 12–21

3Bureau of Labor Statistics, U.S. Department of Labor. Non-fatal occupational injuries and illnesses requiring days away from work – 2014. 2015; USDL-15-2205. http://www.bls.gov/news.release/osh2.nr0.htm (accessed February 2016).

4McCoskey KL. Ergonomics and patient handling. AAOHN Journal, 2007; 55(11): 454‐462.

5Alamgir 2009, Dutta 2012

6Knibbe HJJ, Knibbe NE. Evaluation of a novel bed sheet used to reposition and transfer patients in an intensive care unit. British J Nurs. 2015; 24: 19-23

7Garg A, Owen B. Reducing back stress to nursing personnel: an ergonomic intervention in a nursing home. Ergonomics. 1992; 35(11): 1353-1375