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Bariatric ConferenceWPICS

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					Planning for Appropriate Care
   for the Bariatric Patient
  Robert G. Guest MSPT,Cert. MDT




                .
           Bariatric

The term bariatric derived from the
     Greek root baro (weight),
   suffix - iatr (treatment) and
    suffix – ic (pertaining to).




                 .
  Obesity in the U.S.A.
    •64% adults being obese
•Numbers are rising from 19.4% in
     1997 to 26.6% in 2007
  •Obesity-attributable medical
  expenditures estimate in 2003
      reached $75 billion



                 .
Eating Habits




      .
Life Style




    .
          Diagnosis
•The Body Mass Index is widely
accepted as the marker for excess
          body weight.
•Waist circumference (associated
 with central obesity) is another
             marker



                .
Body Mass Index (BMI)



BMI = Weight (Kg)/Height (M2)




              .
.
Body Mass Index Classifications
•   Underweight         < 20
•   Healthy Weight      20 - 24.9
•   Overweight          25 – 29.9
•   Obese ( Class 1 )   30 – 34.9
•   Obese ( Class 2 )   35 – 40
•   Morbid Obesity      40+


                        .
.
    Health Conditions Related to
          Morbid Obesity
•   Type 2 diabetes
•   Heart disease
•   High blood pressure
•   Obstructive sleep apnea
•   Acid reflux/Gerd
•   Osteoarthritis
•   Depression

                        .
                  Problems
•   Infrequency of bariatric admissions
•   Myths & fears
•   Staffing
•   Environment (space consideration)
•   Equipment
•    Maintaining dignified care for the bariatric
    patient

                         .
Bariatric Admission

 Emergency vs Elective




           .
     Guidelines for the Bariatric
             Admission
•   Patient assessment
•   Environmental assessment
•   Staffing
•   Equipment assessment
•   Patient transport
•   *Discharge Planning


                      .
                   Patient

•   Present medical condition
•   Past medical history
•   Past surgical history
•   Social history
•   BMI score or patient’s trunk/pelvic width



                        .
Body Shape




     .
.
.
              Environment
• Know the measurements of doorways
• Arrange the room prior to the patient’s
  arrival
• Allow room for equipment, staff and
  furniture (if possible)
* Designated bariatric suite or private room


                       .
.
Emergency Department




          .
.
                       Staff

•   Appropriate staffing (teamwork)
•   Education (patient and equipment)
•   Communication (lift documentation tool)
•   Maintain handling tasks in a safe and dignified
    manner




                            .
.
               Equipment
• Each unit should be aware of the standard
  weight limit for their equipment i.e. beds,
  chairs, wheelchairs, gurneys, mechanical
  lifts and treatment tables
• Use the proper equipment based on the
  patient’s weight, height and shape
• Choose the least physically demanding
  device to promote safety

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.
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.
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                 Equipment
•   Bed
•   Mechanical lifts (floor vs.ceiling)
•   Non-friction sheets & Air assistive device
•   Turn & position sheets/straps
•   Commode & bedpan
•   Chair, wheelchair & shower chair
•   Blood pressure cuff & abdominal binders
•   ID wristbands, gowns, slippers & linen

                         .
.
Bariatric Bed Accessories?




            .
 Owning vs.Renting Equipment

• Based on number of bariatric admissions
• Rental costs
• Space needed to store the equipment




                      .
          Patient Transport
• Map out routes
• Know the doorway and elevator widths
• Know the number of staff needed for the
  transport
• Communication amongst departments i.e.
  scheduling for a diagnostic procedure
• Have the appropriate equipment available
  for transport & transfers

                      .
.
.
                 Discharge
• Starts day one on admission
• Compose & maintain a list of resources ie.
  healthcare facilities, transportation co., &
  community services available
• Inter-departmental, patient and family
  conferencing
• Transport requirements and standard weight limit
  of equipment
• Return rental equipment immediately after
  discharge


                         .
.
 Establish Bariatric Task Force
Goal:
    -Provide a safe environment of care for
 both the bariatric patient and healthcare
 worker.




                     .
    Bariatric Task Force Members
•   Administration
•   Nursing (licensed & unlicensed)
•   Rehabilitation PT/OT
•   Plant Operations/ Bio-Medical department
•   Laundry
•   Purchasing



                       .
       Emergency vs. Elective
        Bariatric Admission

• Design a pathway flow chart
• Include patient, environment, staff,
  equipment, & transport guidelines
• Pathway ends with safe discharge




                        .
Questions




    .
    Thank you


rguest@kaleidahealth.org




           .

				
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