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Safety and Transfer Training for the Bariatric Population

Safety and Transfer Training for the Bariatric Population. Objectives. Recognize risks of potential patient/ caregiver injury Identify when to use special bariatric patient-handling equipment/technology. Obesity Rates in the US 2010.

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Safety and Transfer Training for the Bariatric Population

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  1. Safety and Transfer Trainingfor theBariatric Population

  2. Objectives • Recognize risks of potential patient/ caregiver injury • Identify when to use special bariatric patient-handling equipment/technology Charlene J. Anderson, Bariatric Nurse Care Coordinator

  3. Obesity Rates in the US 2010 Charlene J. Anderson, Bariatric Nurse Care Coordinator

  4. We have the responsibility to stay safe by using the appropriate equipment and patient transfer techniques. Charlene J. Anderson, Bariatric Nurse Care Coordinator

  5. Employee Dangers • Caregiver fatigue • Muscle strain and injury • Lost time from work • Lost income Charlene J. Anderson, Bariatric Nurse Care Coordinator

  6. ASSESS the Situation BEFORE You Lift • Right equipment? • NIOSH recommends the use of assistive devices when the weight to be lifted exceeds 35 lbs. • Right number of helpers? • Right position to help? Charlene J. Anderson, Bariatric Nurse Care Coordinator

  7. Right Equipment? • Most standard hospital equipment is rated to accommodate 250-350 lbs. • Bariatric equipment in GSMC is rated to accommodate 400-1000 lbs. KNOW the limit for the item you select! Charlene J. Anderson, Bariatric Nurse Care Coordinator

  8. Right Number of Helpers? • Don’t attempt to lift or reposition the bariatric patient alone! • Minimum of 2-3 caregivers Charlene J. Anderson, Bariatric Nurse Care Coordinator

  9. Right Position to Help? The Key to Lifting Safely • NEVER use your back • Keep your back straight or slightly arched • Allow your legs to do the work • Never twist your body while lifting or placing the object down Charlene J. Anderson, Bariatric Nurse Care Coordinator

  10. Body Mechanics and the Bariatric Patient Think Ahead!!! • How heavy or awkward is the load? • How should I position myself to lift this load safely? • Do I need help from others? Charlene J. Anderson, Bariatric Nurse Care Coordinator

  11. Transporting • Use the appropriate transport vehicle • Wheelchair • Bed/stretcher (manual or power-controlled) • Get help when needed • Push…don’t pull Charlene J. Anderson, Bariatric Nurse Care Coordinator

  12. Repositioning Safety • Involve the patient when possible • Provide assist devices as needed Charlene J. Anderson, Bariatric Nurse Care Coordinator

  13. Patient Injury: Friction or Shear Charlene J. Anderson, Bariatric Nurse Care Coordinator

  14. Bariatric Skin Challenges • Reaching certain areas of the body (esp. underneath the pannus) • Compromised circulation (less blood flow through fatty tissue, possibly diabetes) • Tissue breakdown from skin rubbing together • Large, deep skin folds • Physical mobility issues Charlene J. Anderson, Bariatric Nurse Care Coordinator

  15. Resulting Skin Problems Most Common are: • Friction and shear injuries • Conditions related to poor toileting hygiene and incontinence • Pressure ulcers Charlene J. Anderson, Bariatric Nurse Care Coordinator

  16. Nursing Management to Prevent Skin Problems • Select roomy clothing • Use corn-starch based powders, cotton, fabric, gauze or other materials to separate skin surfaces from one another • Reposition patient q2h (further manual repositioning of arms, legs, breasts, and pannus is often required) • Minimize high-Fowler’s and semi-Fowler’s position • Provide bariatric equipment that is wide enough to accommodate the patient. Side rails and arm rests can rub against skin causing breakdown. • Schedule toileting programs • Use wipes or spray no-rinse washes regularly after urination and defecation Charlene J. Anderson, Bariatric Nurse Care Coordinator

  17. Nursing Management to Prevent Skin Problems….Continued…. • Provide access to appropriately sized commodes (either patient room toilets or bariatric bedside commodes) • Apply a skin protectant product at the first sign of skin breakdown • Assess pressure points for skin integrity or signs of breakdown • Heels • Sacrum • Occiput (higher risk in obese population) • Between skin folds (thighs, rolls of skin) • Penis • Check placement of lines and tubes (to prevent falling between skin folds • Educate patient and S.O. caregivers regarding skin assessment and protection strategies Charlene J. Anderson, Bariatric Nurse Care Coordinator

  18. Be Familiar With Equipment • Beds • Stretchers • Wheelchairs • Lifts and slings • Shower seats • Bedside commodes • Other Charlene J. Anderson, Bariatric Nurse Care Coordinator

  19. Bariatric Equipment for the Nursing Unit • Extra large blood pressure cuffs – disposable vs. reusable • Wheelchairs • Beds • Chairs • Stretchers • Bed scales, step-on scales • Lifts • Bedside commodes • Shower seats Charlene J. Anderson, Bariatric Nurse Care Coordinator

  20. Bariatric Equipment for the OR • Specialty OR tables • Side extenders • Foot boards • Positioning devices • Stirrups • Bean bags, vac packs • Bariatric length safety straps • Longer length instruments • Reusable instruments in trays • Disposable stapler/cutter units (lots of reloads!) • Other • Bougies, EGD tower (therapeutic scope for sleeves, diagnostic for bypass), etc. Charlene J. Anderson, Bariatric Nurse Care Coordinator

  21. Bariatric Gowns Charlene J. Anderson, Bariatric Nurse Care Coordinator

  22. Bariatric patients have unique emotional and physical needs that we must meet. Each staff member should provide care that is safe for both the patient and the caregiver. Charlene J. Anderson, Bariatric Nurse Care Coordinator

  23. References • US Obesity Trends by State, 1985-2010, U.S. Centers for Disease Control, http://www.cdc.gov/obesity/data/trends.html • Waters TR. When is it safe to manually lift a patient? Am J Nurs. 2007;107(8):53-58. • Cohen MH, Nelson GG, Green DA, et al. Patient handling and movement assessments: a white paper. Dallas, TX: The Facility Guidelines Institute; 2010. • Camden SG, Shaver J, Cole K. Promoting the patient’s dignity and preventing caregiver injury while caring for a morbidly obese woman with skin tears and a pressure ulcer. Bariatric Nursing and Surgical Patient Care. 2007;2(1):77-82. • 2 Krasner DL, Kennedy-Evans KL, Henn T. Infection control perspective - Bariatric skin care: Common problems and management strategies. Bariatric Times. 2006;3(2):16-17. Charlene J. Anderson, Bariatric Nurse Care Coordinator

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