Introduction
This guidance relates to the safe and effective care provision of bariatric patients within both our inpatient and community settings.
A bariatric patient (larger person) can be defined as anyone regardless of age, who has limitations in health and social care due to their weight, physical size, shape, width, health, mobility (WHO 2000).
They either have a body mass index (BMI) greater than 40kg/m2 or are 40kg above ideal weight for height (NICE 2014).
Their size may exceed the safe working load (SWL) and dimensions of the support surface such as a bed, chair, wheelchair, couch, trolley, toilet, or mattress.
If a patient’s weight is unknown, the hip circumference of the patient needs to be measured for the patient to be able to sit or lie or use mobility equipment.
Patients may present with different body shapes. Patients of short stature for example, shorter than 146cm with a hip width of more than 40cm would also be considered to be bariatric.
Some people may not completely fit the above definition due to individual variations but have similar problems and needs that will require a similar approach to their care.
It is of importance, that all colleagues caring for such patients remain sensitive to their specific needs, are inclusive in their practice and always seek to preserve their dignity.
Local organisations need to work together and communicate manual handling risk assessment and care needs effectively in order to safely meet the needs of the bariatric patient, particularly where their care involves a transition between hospital and community services.
The purpose of this guidance is to minimise any associated risks to both the bariatric patient and clinical colleagues.
Five key points
Quality care
All patient’s should receive quality care regardless of their individual needs. The bariatric patient is no exception to this. This guide aims to address some of the additional challenges bariatric patients present with to ensure safe and effective care is delivered.
Safe working load (SWL)
The safe working load (SWL) of any equipment which is to be used with bariatric patients must be checked before care is delivered.
Manual handling
Any manual handling which is required in during the care of the bariatric patient must be provided by suitably trained colleagues. MAST compliance in manual handling is mandatory and must be kept up to date.
Risk assessments and care planning
Thorough risk assessments and care planning will ensure safe and effective care delivery for bariatric patients. This must be reviewed and updated regularly to ensure both colleagues and patient safety is optimised.
Support from subject-matter experts
Seek support from subject-matter experts when caring for a bariatric patient to ensure their needs can be safely and effectively met.
Quick guides
These quick guides will provide clinical colleagues with the necessary information to make arrangements that will ensure safe systems of work are in place, and to ensure high quality care can be delivered to the bariatric patient through means of thorough risk assessment, care planning and specialist equipment.
- Admission of the bariatric patient
- Emergency evacuation
- Environmental risks
- Manual handling
- Nutrition and hydration
- Resuscitation of the bariatric patient
- Reduced restrictive interventions (RRI) handling
- Specialised equipment
- Care of the bariatric patient skin management
Supporting documents
Links to associated documents
- Safer manual handling policy
- Hoist and sling for safer patient use policy
- Tissue viability and wound care manual
- Fire safety policy
- Medical device management policy
- Health and safety policy
- Reducing restrictive interventions (RRI) policy (formerly PMVA policy)
- Nutrition and hydration policy
Governance
The governance page details:
- training implications
- responsibilities, accountabilities and duties
- monitoring arrangements
- references
- equality impact assessment screening
Page last reviewed: September 24, 2024
Next review due: September 24, 2025
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