Nurses' Perceptions of Safety Concerns When Caring for Morbidly Obese Patients

The nursing care of people with class III obesity in an acute care setting: a scoping review

BACKGROUND

Patients with Class III obesity pose unique challenges to health care staff and organisations. Care requirements of this population are unique and require specialised equipment and knowledge to meet these needs, maintain the quality of care, as well as the safety of patients and staff.

AIM

To synthesise the evidence on the nursing care of Class III obese patients in acute care settings.

METHODS

A scoping review informed by JBI. CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase were searched for primary research articles about the nursing management of people classified as Class III obese in acute care. Methodological quality of included studies was assessed; data extracted and synthesised into themes.

RESULTS

Fourteen studies were included in the review. The synthesis generated three themes: Access to equipment, knowledge and training, patient care, and opportunities to improve care.

CONCLUSIONS

A paucity of high-quality evidence informs the nursing care of people with Class III obesity in acute care. Access to appropriate equipment dominated the findings of this review. Adequate provision of equipment and education on its use are required. Education to promote engagement with patients, adapting clinical practice and promotion of self-care could improve care and outcomes.

The relationship between patient obesity and nursing workload: An integrative review

AIMS AND OBJECTIVES

To explore the relationship between patient obesity and nursing workload, and discuss the nursing activities most affected by patient obesity.

BACKGROUND

The increasing number of patients with obesity, and the severity of obesity, impacts the healthcare workforce, particularly to nurses who provide most direct care to patients. There is growing evidence to suggest that patient obesity may increase nursing workload and time taken for clinical care.

DESIGN

Integrative review.

METHODS

A comprehensive search of academic databases for primary research related to patient obesity and nursing workload, published since 2000, was conducted. References of relevant articles were hand-searched.

RESULTS

27 articles were analysed. Analysis was undertaken at the levels of patient characteristics, nursing work and the healthcare system. The increasing number of patients with obesity, and the severity of patient obesity, increases nursing workload by affecting nursing time needed to deliver care. An increased number of nurses, particularly with increased clinical skill, are needed to deliver care meeting these increased needs. Organisational change is required to provide infrastructure and bariatric equipment that enables effective nursing care of patients with obesity. Organisations must consider additional time and staff needs when delivering care for patients with obesity.

CONCLUSIONS

The current health system is not established to address the challenge of providing nursing care to the increasing numbers of patients with obesity. Further research on accurately and objectively quantifying the impact and severity of patient obesity on nursing clinical activities is required.

RELEVANCE TO CLINICAL PRACTICE

When determining staffing, healthcare organisations must consider the increased nursing staff, time and clinical skill required to provide care for patients with obesity. Healthcare organisations should implement policies that ensure sufficient staffing in areas where care of patients with obesity is prevalent, and provide training for and workplace availability of bariatric equipment.

[The care of obese persons from the perspective of executives of inpatient care facilities. Results of qualitative expert interviews]

BACKGROUND

Although nursing home residents are increasingly suffering from obesity, little research has been done on the appropriate care for them. The present study examines how executives of long-term care facilities perceive obese residents, which meaning does obesity have for them, and whether they associate the care of the obese with additional expenditures.

MATERIALS AND METHODS

In all, 15 guideline-based interviews were conducted with executive managers of nursing homes in Berlin, Saxony and Bavaria. The analysis of the interviews was based on the method of Meuser and Nagel.

RESULTS

The results demonstrate that obese nursing home residents are hardly noticed by executives. This results from the fact that they attribute only minor significance to obesity as a nutritional and health problem. The care of obese residents is associated with additional instrumental and personnel-related expenditures. However, facilities do not have sufficient resources to provide them. Obesity is a serious, but unrecognized problem in long-term care.

CONCLUSION

To improve the awareness of obesity, intense professional discussions are required. The provision of additional instrumental and human resources becomes necessary to ensure appropriate care of obese nursing home residents.