BARIATRIC BUILDING

BLOCKS FOR SUCCESS

GOVERNANCE

Is care of the bariatric patient on your

organisations “risk radar”?

Have they invested in building capacity to

care for the bariatric patient Specialist equipment &/or care environments

Identifying a “go to” person/service to serve as

source of expertise

Supportive programs

RULES & PROCEDURES

Procedure to guide staff will vary depending

on care environment

What are key messages for staff

Needs to be person centred

Think about legislative requirements and

how they may impact

CAPABLE WORKFORCE

Don’t make assumptions that staff intuitively know

how to manage a bariatric patient

What other training might be required?

Have staff had appropriate manual handling

training and is competency re-evaluated?

Are staff competent with using available bariatric

equipment?

Do you need additional tools to support care

provision? E.g. Safe Work Practice guides for

mobilisation or other care activities

EQUIPMENT 101

What equipment is required? Not just acute in-patients

One size doesn’t fit all

Is equipment labelled with SWL?

How is equipment managed/accessed?

Where is the equipment stored?

Who are your allies?

WELL DESIGNED ENVIRONMENT

Early consultation with clinicians is essential

Sell it as not just bariatric patients we are

designing for

Design considerations- Access throughout the facility

SWL of fixtures

Circulation space

Bathroom design

MOCK ROOM SET UP

SKIN INJURY &

IMMOBILITY

AVOIDING “SOME” OF

THE PITFALLS

CONTIBUTING FACTORS COMMON SKIN AILMENTS

Sub-optimal nutritional

status

↓ blood supply to adipose

tissue

Immobility

Difficulty managing

hygiene

Difficult visualisation

Cellulitis

Oedema

Venous ulceration

Excoriation

Incontinence Associated

Dermatitis (IAD)

Intertrigo

Pressure injury

SKIN INTEGRITY INSULT

http://www.erworld.com/my_day1/lymph2.jpg

PRESSURE INJURIES

Increased moisture + immobility + sub-

optimal nutritional status + ↓ blood flow

to adipose tissue = ↑ risk

Difficult to manage

Difficult to heal

INTERTRIGO

True incidence & prevalence unknown

Inflammation resulting from moisture

trapped in skin fold subjected to friction

Risk factors = excessive sweating, obesity,

deep skin folds, immobility, diabetes mellitus

Can be aggravated by hot/humid conditions

SKIN SAVING STRATEGIES

Maximise nutritional status

Assist with hygiene as required

Minimise shear and friction

Manage moisture

Educate about risk factors and prevention and

management strategies

Regular skin inspection is essential

Can be physically challenging

Consider atypical areas of risk

Questioning = important part of identifying risk

YOU’VE GOT TO MOVE IT, MOVE IT

Environment and infrastructure considerations

Deconditioning is real and PROBLEMATIC

Need to aim to maximise mobility from the outset

in a safe manner

What about a mobility algorithm?

Understanding bariatric movement patterns

Essential to have equipment to support mobility

programs

Height adjustable beds, hoists, mobility aids (walkers,

crutches, etc), exercise equipment (arm bikes, etc),

slide boards, patient gowns…….

CEILING HOIST WALK