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Care of the bariatric patient governance

Contents

  1. Training implications
  2. Responsibilities, accountabilities and duties
  3. Monitoring arrangements
  4. References
  5. Equality impact assessment screening

1 Training implications

1.1 Mandatory and statutory training (MAST) facilitators

In addition to manual handling training, up-to-date guidance and advice on supporting the bariatric patient whilst in our care will be cascaded through mandatory and statutory training sessions. This includes fire, health, safety and security, reducing restrictive interventions and resuscitation training.

As part of their training the key trainers will cover the following:

  • how to deliver training to colleagues in the use of the specialist equipment.
  • handling the bariatric patient
  • the origins and history of the study of bariatrics and the psychological aspects of bariatric care

2 Responsibilities, accountabilities and duties

2.1 Senior managers

They are responsible for:

  • providing inclusive leadership to ensure resources are in place to meet the needs of bariatric patients
  • ensuring that colleagues receive the appropriate training and resources via the training needs analysis and risk assessments

2.2 Matrons and service managers

They are responsible for the safety of both colleagues and patients within their clinical area. To fulfil this responsibility in relation to this guidance they will:

  • identify the environment within which the patient should receive care
  • identify funding for the hire of specialist equipment and transport if required
  • organise the hiring of any identified equipment
  • make any clinical colleagues they manage aware of this guidance
  • release colleagues to attend any training, which is provided in relation to this guidance
  • identify any additional training needs in relation to this guidance to the trust Manual Handling team.

2.3 Ward or department managers

They will liaise with the modern matron or service manager regarding the following:

  • identify any specialist equipment or transport, which is required and may need to be hired
  • make any clinical colleagues they manage aware of this guidance
  • where required, identify and allow time for colleagues to be trained on the safe use of equipment in relation to this guidance
  • report any non-compliance with the contents of this guidance document by writing to the Manual Handling team (by emailing rdash.manualhandlingteam@nhs.net)
  • monitor that all the necessary risk assessments are completed in line with this guidance
  • allocate an appropriate environment which meets the needs of the individual whilst still promoting their privacy and dignity
  • ensure any loaned equipment is decontaminated prior to use

2.4 Care co-ordinators

They will:

  • advise inpatient colleagues of any specific weight and measurement issues for patients, prior to admission to hospital if possible
  • complete manual handling risk assessment documentation which can be found under questionnaire’s on SystmOne

2.5 Ward colleagues or named nurse

They will:

  • complete assessment documentation
  • obtain the functional independence measure score (FIM) and weight of the patient or waist circumference (documented in the manual handling risk assessment form)
  • liaise with the ward manager over the obtaining of any specialist equipment
  • contact specialist advisors for advice and support
  • initiate admission and discharge procedures in conjunction with the care co-ordinator

2.6 Manual Handling team

They will:

  • advise on equipment including any associated risks or considerations
  • where required advise on and deliver or facilitate training
  • in conjunction with the health and safety lead, risk assess the patients transport from trust premises to other premises
  • incident and trend analysis relating to bariatric patients

2.7 Patient manual handling key trainers

Each ward has a trained patient manual handling key trainer who will be responsible for:

  • the colleagues in their area working to safe manual handling procedures
  • providing manual handling training to the colleagues within their area of work
  • liaising with the Manual Handling team in relation to any colleagues training needs they are unable to meet

2.8 Dietitian

Colleagues within dietetic services play a significant role in advising on the nutritional needs of patients, which includes bariatric patients. The team can be contacted on rdash.dietetics@nhs.net for any enquiries or patient referrals.

3 Monitoring arrangements

3.1 Compliance with the following having been completed at, or as soon as possible following admission of the patient

  • Documented weight on admission.
  • A completed manual handling assessment, including a falls risk assessment.
  • Formulation of a manual handling care plan.
  • Also documented evidence that:
    • regular reassessment of the manual handling care plan
    • provision of any suitable specialist equipment
  • How: Review through ongoing referral information.
  • Who by: Manual Handling team.
  • Reported to: Health, safety and security forum.
  • Frequency: Annually.

3.2 Colleagues’ awareness and adherence to this guidance with respect to care of the bariatric patient

  • How: Review of any complaints or concerns received which relate to the care of a bariatric patient.
  • Who by: PALS, matrons and service managers.
  • Reported to: Patient Safety and Investigations team.
  • Frequency: As and when they arise.

4 References

5 Equality impact assessment screening

The completed equality impact assessment for this policy has been published on this policy’s webpage on the trust policy library or archive website.

5.1 Privacy, dignity and respect

5.1.2 Requirements

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, “not just clinically but in terms of dignity and respect”.

Consequently, the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity, and respect, (when appropriate this should also include how same sex accommodation is provided).

5.1.2 Indicate how this will be met

Privacy, dignity and respect of the patient will be considered at all times. Sensitivity to the patient’s needs will also be addressed.

5.2 Mental Capacity Act

5.2.1 Requirements

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individual’s capacity to participate in the decision-making process.  Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all employees working with individuals who use our service are familiar with the provisions within the Mental Capacity Act.  For this reason, all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act 2005 to ensure that the rights of individual are protected, and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

5.2.2 Indicate how this will be achieved

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act 2005 (section 1).

Page last reviewed: September 06, 2024
Next review due: September 06, 2025

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