Abstract
In response to escalating obesity in Manitoba, Canada, the Winnipeg Regional Health Authority (WRHA) formed a Bariatric Care Committee to address the issue of providing safe, efficient, and effective care for this population. The WRHA proposed that Deer Lodge Centre (DLC) be designated as the site for the management and care of bariatric patients requiring long-term chronic care. As a result, a DLC Bariatric Committee with several working groups was formed. The working groups were to provide plans for clinical program, communication, research and education, staffing, capital planning, and equipment. The Research and Education Working Group conducted literature reviews for each of the working groups. A selection of the most pertinent resources found for the DLC Bariatric Committee Working Groups are highlighted here. It is anticipated that this resource will provide assistance for others wishing to establish bariatric programs within their facility. Citations are categorized under the headings: clinical care (activities of daily living, airway management, and skin care), comprehensive knowledge, staff education, equipment/capital planning, excellence, respect, geriatrics, and safe handling. This resource guide will be of interest for nurses caring for bariatric patients and for organizations providing long-term care of bariatric patients.
Introduction
With the noticeable need for further development in this area of speciality and the increased number of bariatric or morbidly obese clients presenting at various healthcare sites within the region, the Winnipeg Regional Health Authority (WRHA) Bariatric Care Committee was formed with the purpose of addressing the issue of providing safe, efficient, and effective care to these clients. As a result, a decision was made to assign the responsibility for the management and care of bariatric patients requiring long-term chronic care to be consolidated at Deer Lodge Centre, Winnipeg, Manitoba, Canada. Deer Lodge Centre (DLC) (www.deerlodge.mb.ca) is a progressive 431-bed long-term care and rehabilitation facility providing a variety of inpatient, outpatient, and outreach programs to the community. DLC serves adults with complex needs who require rehabilitation and specialized care for long-term health concerns.
A DLC Bariatric Committee was assembled to devise a project plan for the proposed development of the DLC Chronic Care Bariatric Program. This Committee further defined the program proposed by developing a program philosophy, identifying program goals and objectives, and creating an operational plan. With the guidance of the committee, several working groups were established to address the areas identified in the operational plan, including clinical program, communication, research and education, staffing, capital, and equipment. One of the goals for the DLC Bariatric Committee was to incorporate evidence-based research, literature, and program components into the practice to continue the growth of knowledge development and best-practice protocols established within the interdisciplinary care team. As a result, one of the objectives for the Research and Education Bariatric Working Group was to conduct literature reviews for each of the working groups.
The Librarian from the J.W. Crane Memorial Library was invited by the Project Co-ordinator to be part of the Research and Education Bariatric Working Group in order to provide expert mediated searching and bibliographic management services. The J.W. Crane Memorial Library of Geriatrics and Gerontology (Crane Library) is a branch library of the University of Manitoba Health Sciences Libraries and is located at DLC. The Crane Library (www.umanitoba.ca/libraries/health/deerlodge) is Canada's largest and best-known library on geriatrics, gerontology, aging, and long-term care.
A selection of a number of pertinent resources found for the DLC Bariatric Committee Working Groups are highlighted in this article, and will provide assistance to others wishing to establish bariatric programs, with additional information for long-term care.
Materials and Methods
The following bibliographic databases were used to locate quantitative or qualitative research: PubMed, CINAHL, Scopus, AgeLine, Embase, and PsychINFO. Multiple words and phrases relating to the care of bariatric or morbidly obese patients in nursing homes were combined to maximize search results (see Appendix). Boolean and proximity operators, truncation symbols, keywords, and thesaurus terms were utilized in each database to develop a comprehensive search strategy. Results were limited to the English language, and the scope of the search was from 1990 to 2010. The best search strategy for each topic was saved as an alert in PubMed, CINAHL, and Embase. Relevant articles were also identified by hand searching references and bibliographies. The journal Bariatric Nursing and Surgical Patient Care was also systematically reviewed for selection purposes. All citations from the searches were exported and saved to RefWorks, a bibliographic management database. RefShare was used to share the files with the Project Co-ordinator who reviewed the findings and then identified key articles for the various working groups. The Librarian continues to monitor the search results from the alerts and distributes the findings to the working groups.
This bibliographic review is not considered an exhaustive list of the body of knowledge available about caring for a bariatric patient. Further literature searches highlighting different search strategies may supplement this resource guide.
Bibliographic Findings
The bibliographic findings in this article were selected due to the contribution and assistance they provide in establishing a bariatric program, with specific knowledge on caring for bariatric patients in long-term care facilities. Primarily excluded from the selection were brief articles (e.g. editorials, letters, opinions) and bariatric surgery literature (surgery will not be performed at DLC). Citations are categorized under the headings: Comprehensive Knowledge, Clinical Care (activities of daily living, airway management, and skin care), Equipment/Capital Planning, Excellence, Geriatrics, Respect, Safe Handling, and Staff Education. Although some articles could be listed under several headings, they were categorized in sections that reflect their major focus.
Comprehensive Knowledge
Arzouman J., Lacovara, J. E., Blackett, A., McDonald, P. K., Traver, G., & Bartholomeaux, F. (2006). Developing a comprehensive bariatric protocol: A template for improving patient care. MEDSURG Nursing, 15(1), 21–26.
Bennet, J. (2008). Don's corner. The obesity epidemic: Treating bariatric patients. Long-Term Living: For the Continuing Care Professional, 57(4), 42–44.
McAtee, M., & Personett, R. J. (2009). Obesity-related risks and prevention strategies for critically ill adults. Critical Care Nursing Clinics of North America, 21(3), 391–401.
Muir, M., Heese, G. A., McLean, D., Bodnar, S., & Rock, B. L. (2007). Handling of the bariatric patient in critical care: A case study of lessons learned. Critical Care Nursing Clinics of North America, 19(2), 223–240.
Risk Assessment and Process Planning for Bariatric Patient Handling Pathways (2007). Health and Safety Executive, (HSE research report RR 573), 104pp.
Swann, J. (2010). Breaking down barriers to bariatric care. Nursing and Residential Care, 12(7), 330–336.
Tizer, K. (2007). Extremely obese patients in the healthcare setting: Patient and staff safety. The Journal of Ambulatory Care Management, 30(2), 134–141.
Wignall, D. (2008). Design as a critical tool in bariatric patient care. Journal of Diabetes Science and Technology, 2(2), 263–267.
Clinical Care
Astle, S. M. (2009). Pain management in critically ill obese patients. Critical Care Nursing Clinics of North America, 21(3), 323–339.
Camden, S. G. (2009). Ethical realities of bariatric nursing: A case study approach to real-world dilemmas. Part 2: Paternalism-recognizing the tension between beneficence and autonomy. Bariatric Nursing and Surgical Patient Care, 4(3), 185–190.
Camden, S. G. (2009). Ethical realities of bariatric nursing: A case study approach to real-world dilemmas. Part 3: Religion, spirituality, health, and healing. Bariatric Nursing and Surgical Patient Care, 4(4), 277–280.
De Senarclens, O., Feihl, F., Giusti, V., Engelberger, R. P., Rodieux, F., Gomez, P., et al. (2008). Brachial or wrist blood pressure in obese patients: Which is the best? Blood Pressure Monitoring, 13(3), 149–151.
Elsner, J. J., & Gefen, A. (2008). Is obesity a risk factor for deep tissue injury in patients with spinal cord injury? Journal of Biomechanics, 41(16), 3322–3331.
Fife, C. E., & Carter, M. J. (2008). Lymph edema in the morbidly obese patient: Unique challenges in a unique population. Ostomy Wound Management, 54(1), 44–56.
Fitzgerald, S. G., & Kelleher, A. R. (2007). Mobility challenges in individuals with a spinal cord injury with increased body weight. Topics in Spinal Cord Injury Rehabilitation, 12(4), 54–63.
Gallagher, S., Arzouman, J., Lacovara, J., Blackett, A., McDonald, P. K., Traver, G., et al. (2004). Criteria-based protocols and the obese patient: Planning care for a high-risk population. Ostomy Wound Management, 50(5), 32–34, 36, 38.
Grossman, V. (2009). Imaging tips for large patients. RN, 72(4), 26–29.
Nonas, C. A. (1998). A model for chronic care of obesity through dietary treatment. Journal of the American Dietetic Association, 98(10), S16–S22.
Siddique, M. I., Mahmud, I., & Siddique, R. M. (2010). Obesity and sleep disorders: Implications for bariatric patients. Bariatric Nursing and Surgical Patient Care, 5(1), 75–79.
Thomas, S. A., & Rickabaugh, B. (2008). Bariatric nurse coordinator: Carving out a new role in bariatrics. Bariatric Nursing and Surgical Patient Care, 3(1), 63–72.
Todd, M. (2009). Managing chronic edema in the morbidly obese patient. British Journal of Nursing (Mark Allen Publishing), 18(18), 1120–1124.
Wills, M. (2006). Obesity and rehabilitation. Critical Reviews in Physical and Rehabilitation Medicine, 18(2), 133–172.
Activities of daily living
Pokorny, M. E., Scott, E., Rose, M. A., Baker, G., Swanson, M., Waters, W., et al. (2009). Challenges in caring for morbidly obese patients. Home Healthcare Nurse, 27(1), 43–54.
Simoes, E. J., Kobau, R., Kapp, J., Waterman, B., Mokdad, A., & Anderson, L. (2006). Associations of physical activity and body mass index with activities of daily living in older adults. Journal of Community Health, 31(6), 453–467.
Airway management
Antrim, K. J. (2008). Intubation of the obese patient. International Student Journal of Nurse Anesthesia, 7(1), 20–24.
Benedik, P. S., Baun, M. M., Keus, L., Jimenez, C., Morice, R., Bidani, A., et al. (2009). Effects of body position on resting lung volume in overweight and mildly to moderately obese subjects. Respiratory Care, 54(3), 334–339.
El Solh, A. A. (2009). Airway management in the obese patient. Clinics in Chest Medicine, 30(3), 555–568.
Harris, A. T., Morell, D., Bajaj, Y., & Martin-Hirsch, D. (2010). A discussion of airway and respiratory complications along with general considerations in obese patients. International Journal of Clinical Practice, 64(6), 802–806.
Siela, D. (2009). Pulmonary aspects of obesity in critical care. Critical Care Nursing Clinics of North America, 21(3), 301–310.
Wald, D. A. (2009). Airway management and the challenge presented by obese patients. RT: The Journal for Respiratory Care Practitioners, 22(10), 12–14.
Skin care
Davis, J. M., & Crawford, P. S. (2002). Persistent leg ulcers in an obese patient with venous insufficiency and elephantiasis. Journal of Wound, Ostomy, and Continence Nursing, 29(1), 55–60.
Fife, C. E., & Carter, M. J. (2008). Lymph edema in the morbidly obese patient: Unique challenges in a unique population. Ostomy Wound Management, 54(1), 44–56.
Gallagher, S., Langlois, C., Spacht, D. W., Blackett, A., & Henns, T. (2004). Preplanning with protocols for skin and wound care in obese patients. Advances in Skin and Wound Care, 17(8), 436–441; quiz 442–443.
Gallagher, S., Shaver, J., & Cole, K. (2007). 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, 2(1), 77–82.
George, B., & Malkenson, G. (2008). Pressure ulcers, a clinical review: Prevention and treatment of pressure sores are discussed. Rehab Management: The Interdisciplinary Journal of Rehabilitation, 21(10), 16–19.
Guida, B., Nino, M., Perrino, N. R., Laccetti, R., Trio, R., Labella, S., et al. (2010). The impact of obesity on skin disease and epidermal permeability barrier status. Journal of the European Academy of Dermatology and Venereology, 24(2), 191–195.
Hahler, B. (2006). An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Management, 52(6), 34–47.
Lowe, J. R. (2009). Skin integrity in critically ill obese patients. Critical Care Nursing Clinics of North America, 21(3), 311–322.
Mathison, C. J. (2003). Skin and wound care challenges in the hospitalized morbidly obese patient. Journal of Wound, Ostomy, and Continence Nursing, 30(2), 78–83.
Mimura, M., Ohura, T., Takahashi, M., Kajiwara, R., & Ohura, N., J. (2009). Mechanism leading to the development of pressure ulcers based on shear force and pressures during a bed operation: Influence of body types, body positions, and knee positions. Wound Repair and Regeneration, 17(6), 789–796.
Pokorny, M. E. (2008). Best practices lead in: Skin physiology and diseases in the obese patient. Bariatric Nursing and Surgical Patient Care, 3(2), 125–128.
Rose, M. A., & Drake, D. J. (2008). Best practices for skin care of the morbidly obese. Bariatric Nursing and Surgical Patient Care, 3(2), 129–134.
Rose, M. A., Pokorny, M., & Drake, D. J. (2009). Preventing pressure ulcers in the morbidly obese: In search of an evidence base. Bariatric Nursing and Surgical Patient Care, 4(3), 221–226.
Wilson, J. A., & Clark, J. J. (2003). Obesity: Impediment to wound healing. Critical Care Nursing Quarterly, 26(2), 119–132.
Yosipovitch, G., DeVore, A., & Dawn, A. (2007). Obesity and the skin: Skin physiology and skin manifestations of obesity. Journal of the American Academy of Dermatology, 56(6), 901–916.
Equipment/Capital Planning
Andrade, S. D. (2004). Planning and design guidelines for bariatric healthcare facilities. Retrieved October 5, 2010, from http://info.aia.org/nwsltr_print.cfm?pagename=aah_jrnl_20061018_award_winner
Bakewell, J. (2007). Equipment bariatric furniture: Considerations for use. International Journal of Therapy and Rehabilitation, 14(7), 329.
Barista, D. (n.d.). Designing for the obese. Retrieved October 5, 2010, from www.bdcnetwork.com/article/designing-obese
Equipping your facility for bariatric patients. (2008). Health Devices, 37(3), 69–75.
Facility design and safety issues for staff and obese patients. (2005). Healthcare Hazard Management Monitor (HHMM): The Newsletter of the Center for Healthcare Environmental Management, 18(7), 1–7.
Hunt, D. G. (2007). Evaluating equipment and techniques for safe perioperative positioning for the morbidly obese patient. Bariatric Nursing and Surgical Patient Care, 2(1), 57–63.
Kramer, K. L. (2004). WOC nurses as advocates for patients who are morbidly obese: A case study promoting the use of bariatric beds. Journal of Wound, Ostomy, and Continence Nursing, 31(6), 379–384; discussion 384–387.
Kramer-Jackman, K., & Kramer, D. (2010). Bariatric hospital bed safety and selection. Bariatric Nursing and Surgical Patient Care, 5(1), 45–55.
Lipperman, G., & Preira, G. (2002). Accommodating the bariatric resident. Nursing Homes Long-Term Care Management, 51(10), 82.
Muir, M., & Haney, L. L. (2004). Designing space for the bariatric resident: Providing ample space for larger residents isn't just a matter of comfort—Quality of care and staff safety depend on it. Nursing Homes: Long-Term Care Management, 53(11), 25.
Muir, M., & Haney, L. L. (2004). Ergonomics and the bariatric patient. Director (Cincinnati, Ohio), 12(3), 143–146.
Thrall, T. H. (2005). Design with dignity: Either by building from scratch or retrofitting existing space, hospitals learn to accommodate obese patients. H&HN: Hospitals and Health Networks, 79(11), 48.
Tizer, K. (2007). Extremely obese patients in the healthcare setting: Patient and staff safety. The Journal of Ambulatory Care Management, 30(2), 134–141.
Wagner, S. K. (2007). Dignity and style: Bariatric furniture designs hit their stride. Health Facilities Management, 20(4), 21–25.
Excellence
Annis, T. D. (2002). The synergy model in practice: The interdisciplinary team across the continuum of care. Critical Care Nurse, 22(5), 76–79.
Arzouman, J., Lacovara, J. E., Blackett, A., McDonald, P. K., Traver, G., & Bartholomeaux, F. (2006). Developing a comprehensive bariatric protocol: A template for improving patient care. MEDSURG Nursing, 15(1), 21–26.
Kirkpatrick, M. K., Esterhuizen, P., & Drake, D. (2009). An optimal caring/healing environment for obese clients. Bariatric Nursing and Surgical Patient Care, 4(2), 123–132.
Larkin, H. (2004). Capital and candor. To meet the needs of obese patients, hospitals change processes, equipment and attitudes. Hospitals and Health Networks/AHA, 78(2), 2, 58–62.
Wright, K., & Bauer, C. (2005). Meeting bariatric patient care needs: Procedures and protocol development. Journal of Wound, Ostomy, and Continence Nursing, 32(6), 402–406.
Geriatrics
Bales, C. W., & Buhr, G. (2008). Is obesity bad for older persons? A systematic review of the pros and cons of weight reduction in later life. Journal of the American Medical Directors Association, 9(5), 302–312.
Bradway, C., DiResta, J., Fleshner, I., & Polomano, R. C. (2008). Obesity in nursing homes: A critical review. Journal of the American Geriatrics Society, 56(8), 1528–1535.
Bradway, C., DiResta, J., Miller, E., Edmiston, M., Fleshner, I., & Polomano, R. C. (2009). Caring for obese individuals in the long-term care setting. Annals of Long-Term Care, 17(7), 17–21.
Bradway, C., Miller, E., Heivly, A., & Fleshner, I. (2010). Continence care for obese nursing home residents. Urologic Nursing, 30(2), 121–129.
Dimant, J. (2005). Bariatric programs in nursing homes. Clinics in Geriatric Medicine, 21(4), 767–792.
Felix, H. C. (2008). Obesity, disability, and nursing home admission. Annals of Long-Term Care, 16(7), 33–36.
Felix, H. C. (2008). Personal care assistance needs of obese elders entering nursing homes. Journal of the American Medical Directors Association, 9(5), 319–326.
Jarosz, P. A., & Bellar, A. (2009). Sarcopenic obesity: An emerging cause of frailty in older adults. Geriatric Nursing, 30(1), 64–70.
Jensen, G. L. (2005). Obesity and functional decline: Epidemiology and geriatric consequences. Clinics in Geriatric Medicine, 21(4), 677–687.
Kaiser R., et al. (2010). Functionality and mortality in obese nursing home residents: An example of “risk factor paradox”? Journal of the American Medical Directors Association, 11(6), 428–435.
Lang, I. A., Llewellyn, D. J., Alexander, K., & Melzer, D. (2008). Obesity, physical function, and mortality in older adults. Journal of the American Geriatrics Society, 56(8), 1474–1478.
Lapane, K. L., & Resnik, L. (2006). Weighing the relevant issues: Obesity in nursing homes. Journal of Aging and Social Policy, 18(2), 1–9.
Mathys, M. L., & Lefevre-Wilson, S. (2003). The treatment of obesity in LTC. Long-Term Care Interface, 4(12), 46–52.
Muir, M., & Haney, L. L. (2004). Designing space for the bariatric resident: Providing ample space for larger residents isn't just a matter of comfort—Quality of care and staff safety depend on it. Nursing Homes: Long-Term Care Management, 53(11), 25.
Salihu, H. M., Bonnema, S. M., & Alio, A. P. (2009). Obesity: What is an elderly population growing into? Maturitas, 63(1), 7–12.
Swann, J. (2010). Breaking down barriers to bariatric care. Nursing and Residential Care, 12(7), 330–336.
Respect
Awotidebe, A., & Phillips, J. S. (2009). Knowledge and attitudes of physiotherapy students towards obesity. South African Journal of Physiotherapy, 65(3), 27–31.
Bejciy-Spring, S. (2008). R-E-S-P-E-C-T: A model for the sensitive treatment of the bariatric patient. Bariatric Nursing and Surgical Patient Care, 3(1), 47–56.
Camden, S. G., Brannan, S., & Davis, P. (2008). Best practices for sensitive care and the obese patient. Bariatric Nursing and Surgical Patient Care, 3(3), 189–196.
Holland, D. E., Krulish, Y. A., Reich, H. K., & Roche, J. D. (2000). Expanding the care plan for a morbidly obese patient. Nursing, 30(12), 32hn1–32hn4.
Lansing, R., McGuire, J., Palmersheim, P., & Baird, G. (2009). Providing holistic care to bariatric patients. Journal of Continuing Education in Nursing, 40(10), 438–439.
Poon, M., & Tarrant, M. (2009). Obesity: Attitudes of undergraduate student nurses and registered nurses. Journal of Clinical Nursing, 18(16), 2355–2365.
Safe Handling
Bunke, J. F. (2008). Safe strategies for lifting large patients. Nursing, 38 Suppl Therapy, 4–6.
Cookson, K. (2007). Large but unseen: Bariatric patients and manual handling. Cardiometabolic Risk and Weight Management, 2(1), 14–16.
Cowley, S. P., & Leggett, S. (2010). Manual handling risks associated with the care, treatment and transportation of bariatric patients and clients in Australia. International Journal of Nursing Practice, 16(3), 262–267.
Darragh, A. R., Campo, M., & Olson, D. (2009). Therapy practice within a minimal lift environment: Perceptions of therapy staff. Work, 33(3), 241–253.
Department of Veteran Affairs. (2006). Safe bariatric patient handling toolkit. Retrieved October 5, 2010, from www.visn8.va.gov/patientsafetycenter/safePtHandling/BariatricsToolkit.pdf
Gallagher, S. (2005). Obesity and the aging adult: Ideas for promoting patient safety and preventing caregiver injury. Clinics in Geriatric Medicine, 21(4), 757–765, vii–viii.
Hignet, S., & Griffiths, P. (2009). Manual handling risks in the bariatric (obese) patient pathway in acute sector, community and ambulance care and treatment. Work, 33(2), 175–180.
Hignett, S., & Griffiths, P. (2009). Risk factors for moving and handling bariatric patients. Nursing Standard, 24(11), 40–48.
Humphreys, S. L. (2007). Obesity in patients and nurses increases the nurse's risk of injury lifting patients. Bariatric Nursing and Surgical Patient Care, 2(1), 3–6.
McGinley, L. D., & Bunke, J. (2008). Best practices for safe handling of the morbidly obese patient. Bariatric Nursing and Surgical Patient Care, 3(4), 255–260.
Mclaren, S. (2007). Opinion: It is fair to assume a link between back injury in nurses and patient obesity. Nursing Times, 103(17), 12–12.
Muir, M., & Archer-Heese, G. (2009). Essentials of a bariatric patient handling program. Online Journal of Issues in Nursing, 14(1), 1.
Muir, M., & Gerlach, S. (2003). Reducing the risks in bariatric patient handling. The Canadian Nurse, 99(8), 29–33.
Muir, M., & Heese, G. A. (2008). Safe patient handling of the bariatric patient: Sharing of experiences and practical tips when using bariatric algorithms. Bariatric Nursing and Surgical Patient Care, 3(2), 147–158.
Occupational health and safety issues associated with management bariatric (severely obese) patients. (2005). Retrieved October 5, 2010, from www.health.nsw.gov.au/policies/gl/2005/pdf/GL2005_070.pdf
Roland, D., Howes, C., Stickles, M., & Johnson, K. (2010). Safe intrahospital transport of critically ill obese patients. Bariatric Nursing and Surgical Patient Care, 5(1), 65–70.
Rose, M. A., Drake, D. J., Baker, G., Watkins Jr., F. R., Waters, W., & Pokorny, M. (2008). Caring for morbidly obese patients: Safety considerations for nurse administrators. Nursing Management, 39(11), 47–50.
Safe bariatric patient handling toolkit. (2007). Bariatric Nursing and Surgical Patient Care, 2(1), 17–45.
Scott, E. S., Pokorny, M. E., Rose, M. A., & Watkins, F. (2010). Safe “handoffs” for the morbidly obese. Bariatric Nursing and Surgical Patient Care, 5(1), 71–74.
Thompson, S., & Jevon, P. (2009). Manual handling 4—Using a sling hoist. Nursing Times, 105(3), 12–13.
Tideiksaar, R. (2008). Part II: Organizational components of a safe resident handling program. Director (Cincinnati, Ohio), 16(3), 22–25.
Whipple, K. L. (2008). Maximizing healthcare provider safety while rehabilitating the bariatric patient. Bariatric Nursing and Surgical Patient Care, 3(1), 41–45.
Staff Education
Barr, J., & Cunneen, J. (2001). Understanding the bariatric client and providing a safe hospital environment. Clinical Nurse Specialist CNS, 15(5), 219–223.
Chang, V. W., Asch, D. A., & Werner, R. M. (2010). Quality of care among obese patients. JAMA: Journal of the American Medical Association, 303(13), 1274–1281.
Green, S. M., & Gillett, A. (1998). Clinical caring for patients with morbid obesity in hospital. British Journal of Nursing (BJN), 7(13), 785–792.
Harris, H. (2008). Nursing care of the morbidly obese patient. Nursing Made Incredibly Easy, 6(3), 34.
Holland, D. E., Krulish, Y. A., Reich, H. K., & Roche, J. D. (2001). How to creatively meet care needs of the morbidly obese. Nursing Management, 32(6), 39–41.
McAtee, M., & Personett, R. J. (2009). Obesity-related risks and prevention strategies for critically ill adults. Critical Care Nursing Clinics of North America, 21(3), 391–401.
Nowicki, T., Burns, C., Fulbrook, P., & Jones, J. (2009). Changing the mindset: An inter-disciplinary approach to management of the bariatric patient. Collegian (Royal College of Nursing, Australia), 16(4), 171–175.
Price, B. (2010). Continuing professional development: The older woman's body image. Nursing Older People, 22(1), 31–37.
Rotkoff, N. (1999). Care of the morbidly obese patient in a long-term care facility. Geriatric Nursing (New York), 20(6), 309–313.
Scarano, E. M. (2009). A big lesson for nurse educators. Bariatric Nursing and Surgical Patient Care, 4(4), 259–262.
Silverstein, B. A. (2010). Lessons from a morbidly obese nurse patient. Bariatric Nursing and Surgical Patient Care, 5(2), 109–112.
Walker, M. L., & Gantt, L. T. (2010). Creation of a bariatric “patient” and simulation scenario for use with student nurses. Bariatric Nursing and Surgical Patient Care, 5(2), 127–136.
Whitfield, P. J., & Grassley, J. (2008). Nurses' experiences of caring for postoperative bariatric patients. Bariatric Nursing and Surgical Patient Care, 3(4), 291–298.
Winkelman, C., & Maloney, B. (2005). Obese ICU patients: Resource utilization and outcomes … including commentary by Watson LA. Clinical Nursing Research, 14(4), 303–326.
Conclusion
This selection of resources will help incorporate evidence-based knowledge into care of the bariatric population. Even though a significant body of knowledge is available on bariatric patients, more research is needed for caring for bariatric patients in long-term care facilities. 3 Because bariatric individuals represent unique challenges, further research is also needed so that nurses and interdisciplinary teams know how to face these challenges and develop bariatric programs within their facility. Other areas that require more research include patient care, staff education programs, interdisciplinary team roles, equipment, and the role patients/families have in treatment planning.
Footnotes
Acknowledgments
The authors are indebted to the ongoing support received from the J.W. Crane Memorial Library and the healthcare team members at Deer Lodge Centre committed to the development of a quality bariatric program.
Disclosure Statement
No competing financial interests exist.
Appendix
Search terms used: capitalized terms are subject headings from various databases; lowercase are keywords used.
| Nursing Homes | Seating |
| Long Term Care | Lifting |
| Chronic Care | Mattresses |
| Continuing Care | Blood Pressure Cuffs |
| Home for Aged | wheelchairs |
| Residential Care | commodes |
| Extended Care | chair |
| Rehabilitation Centre | capital planning |
| Complex Continuing Care | facilities |
| Chronic Care | Sensitive Care |
| Morbidly Obese | Respect |
| Morbid Obesity | Stigma |
| Bariatric | Empathy |
| Clinical Care | Social discrimination |
| skin care | Attitude of health personnel |
| Ulcers | Professional–patient relations |
| Wound Care | Nurse–patient relations |
| toileting | compassion |
| Activities of Daily Living | dignity |
| feeding | Safe Patient Handling |
| dressing | safe patient handling |
| bathing | lifts & transfers |
| grooming | Ergonomics |
| hygiene | injuries |
| Pain | transport |
| Wounds and Injuries | Lifting |
| Equipment and Supplies | Lifting and Transfer Equipment |
| Beds and Mattresses | Occupational Safety |
| Interior Design and Furnishings | Patient Positioning |
| Beds | Patient Safety |
| Toilet Facilities | Moving and Lifting Patients |