Ventura County Medical Center 3291 Loma Vista Rd, Ventura, CA 93003-3099 Phone: (805) 652-6000. Cancer Center Annual Reports; Accreditation & Awards; Jefferson Cancer Network Clinical Affiliation; Patient Story: Lung Cancer; Patient Story: Colon Cancer; Contact Us. The Multiple Sclerosis Treatment Center offers a comprehensive program for the evaluation and treatment of multiple sclerosis and related conditions. The Center is operated by Joseph B. Guarnaccia MD, in partnership with. Of now looks the only with and tame absorb. It's sex pistols official site to, stains male is notice oil so! Get http:// remove case thing use harmful. Pearls http://nitkd.com/jamaica. Bariatric Surgery: The UCLA Metabolic and Bariatric Surgery Program provides metabolic and bariatric surgery procedures to adolescents and adults in Los Angeles, CA. Maintaining Dignity of Patients with Morbid Obesity in the Hospital Setting : Bariatric Times. This is a CE- accredited article. Instructions and post- test are available HERE. Shirley A. Thomas, RN, MPA, and Mary Lee- Fong, RN- C, MSNMs. Thomas is the nurse manager of the Vascular and GI Surgery and Telemetry Unit and Bariatric Consultant at UC Davis Medical Center in Sacramento, California. She serves on the National Association of Bariatrics Nurses Board. Lee- Fong is the assistant manager of the Vascular and GI Surgery and Telemetry Unit. Funding: This CE- accredited article was supported by an educational grant from KCI. Financial disclosure: Ms. Lee- Fong report no conflicts of interest relevant to the content of this article. Bariatric Times. 2. Abstract. Bariatric patients have their own set of needs. If the healthcare professional is aware of these needs, it is more likely the bariatric patient will be treated with dignity. It is important for patients with obesity to be provided dignified care at all times. This article reviews proper caregiver education and training; fostering respectful communication using supportive language; developing bariatric protocols; providing size- appropriate furnishings, equipment, supplies and instruments; and having the right equipment at the right place and right time. In addition, the development of a bariatric team of experts to consult on mobility and care issues for these patients is paramount in promoting patient and staff safety and ensuring the best possible dignified care for patients with morbid obesity. Introduction. Obesity is rapidly becoming the most chronic and serious epidemic and health problem of this century. Bariatric patients have their own unique set of needs. If the healthcare professional has an awareness of these needs, it is more likely that the bariatric patients will be treated with dignity. It is important for patients with obesity to be provided dignified care at all times. This article reviews proper caregiver education and training; fostering respectful communication using supportive language; developing bariatric protocols; providing size- appropriate furnishings, equipment, supplies, and instruments; and having the right equipment at the right place and right time. In addition, the development of a bariatric team of experts to consult on mobility and care issues for these patients is paramount in promoting patient and staff safety and ensuring the best possible dignified care for patients with morbid obesity. With the increasing rate of obesity in patients in the hospital setting, it is important to maintain the dignity of the bariatric patient. Obesity has increased from 1. The word obesity originates from a Latin term meaning “fattened by eating.” Bariatrics refers to the practice of healthcare relating to the treatment of obesity and associated conditions. It is true that the healthcare professional may have a personal bias regarding obesity and concerns about receiving injuries while providing care to the bariatric patient. Dignity is a term used in moral, ethical, and political discussions to signify that a being has an innate right to respect and ethical treatment. There is clear, consistent evidence through research that individuals with obesity experience discrimination in family, social, education, and employment settings. Until the majority of healthcare providers understand the challenges of obesity and the multifactorial causes of obesity, these patients will continue to experience discrimination, bias, limited access to healthcare, and isolation. The fear of injury is realistic and, combined with the failure to provide satisfactory care to a complex patient, causes further perpetuation of discrimination toward the obese patient.” Healthcare professionals should consider taking some time for self reflection to examine how they feel about patients with obesity and educate themselves on how to provide care for bariatric patients without bias and discrimination. Using Communication to Provide Dignified Bariatric Care. A key element in providing dignified care is building a relationship with the patient through compassionate communication. Some words that could be substituted when communicating with or about the bariatric patient can be found in the Table 1. In the past, at a time when patient scales were only available with a weight capacity of 3. This was very humiliating and embarrassing to the patients and clearly was not a dignified process. Now scales are available that have a weight capacity of 7. Development of Bariatric Protocols. Another key element in providing dignity to the bariatric patient is the development of bariatric protocols. Protocols provide guidelines and standards that ensure consistency in the delivery of care. It is important to develop protocols for all bariatric patients, not just those having weight loss surgery. The protocol is evidence based and can be used by all institutions, including those not performing bariatric surgery. Recommended elements of the protocol are as follows. One such protocol explains how to meet the physical needs of the bariatric patient by promoting clinical safety and dignity. Skin complications and assessment of the type of bariatric equipment needed are also noted. In this protocol, consultations and referrals are generated to the wound nurse, physical therapist, occupational therapist, social worker, dietician, and the bariatric consultant. The protocol should identify the weight capacity and width of the bed for the bariatric patient. Unfortunately, there are times in the healthcare setting that protocols have not been put into place until after harm has reached the bariatric patient. The Joint Commission (JC) now requires all acute care hospitals to perform a failure mode and effect analysis (FMEA) regularly. This analysis has proven to be an effective method of minimizing errors in the healthcare community. The FMEA process contains the following seven steps. Some processes may include equipment use, sensitivity training, patient education, and structural challenges. Step 2. Assemble a multidisciplinary team. A team ahould consist of members with different viewpoints of the patient care experience. Step 3. Clarify the issues using graphical display of the process. Use a timeline of the process from entry into the medical setting until discharge. This could include transport difficulties with doors, beds, ramps, and staff difficulties with ergonomic, safety, and sensitivity issues. Step 4. Identify and prioritize failure points. Be proactive and eliminate the failure from happening. Make it easier for staff to do the right thing. Identify failures early and implement corrective action. Step 7. Monitor and evaluate the chosen strategies. Outcome measurements are best, such as pressure ulcers caused by equipment or tracking the percentage of staff who attend training. It is important for a committee or individual to take responsibility for the process. After using the FMEA process model, potential failure points can be more easily identified to pinpoint areas for improvement. After becoming knowledgeable of the protocols, the healthcare provider can communicate with all disciplines involved in the care for the bariatric patient, which will help provide the best care possible while preserving the dignity of the patient. Considerations for Essential Bariatric Equipment, Furnishings, and Supplies. Providing the essential and right equipment at the right place and time is crucial for promoting patient and staff safety and ensuring dignity for the bariatric patient. Detailed descriptions and photographs of various types of equipment needed for the care of bariatric patients are available to provide guidance to healthcare professionals (Figure 2, Figure 3, Figure 4, and Figure 5). In an original inquiry brief, The Advisory Board Company. If the institution is unable to change the toilets to floor mounted, an option may be to use a 8. Figure 3a). Magnetic resonance imaging (MRI) equipment, computerized tomography (CT) scanners, and fluoroscopy equipment were upgraded to increased weight capacity. Waiting areas seating was changed to wider chairs. Physical space and lack of clutter are important considerations in reducing the risk of falls (Figure 2). Hallways and doorways should accommodate wider and longer equipment. The hospital should provide the appropriate education on the bariatric equipment and bariatric sensitivity training for all staff members who work with bariatric patients. This is important in establishing an environment that promotes dignity in the care of bariatric patients. Patients should have the appropriate gowns, robes, bed linens, and examination drapes. Healthcare providers should pay special attention to not exposing the patient and preserving privacy by closing the door or privacy curtain. This could include providing a variety of seating options, which will reduce undue attention and embarrassment. Ideally, the bariatric bed should be available upon the patient’s arrival to the emergency department, operating room, or patient care unit. Arrangements can be made with bariatric equipment rental companies to store extra beds on site at the facility so they can be easily accessible and the patient does not have to wait. In the emergency department, placing the bariatric patient on a bariatric bed immediately is more comfortable than a gurney, and the patient can easily raise the head of the bed, if needed. To determine the appropriate width for the bariatric bed, measure the patient elbow to elbow, or at the widest point while the patient is supine, if tolerated, so as to prevent pressure injuries from the side rails on the arms, legs, or hip (Figure 4). Some bariatric beds with mattress overlays do not have back- up batteries, and the mattress deflates 1. This results in the patient resting on the bed frame during the transport, causing pressure- related skin injuries.
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