Background. There is documented evidence of the increased global prevalence of obesity. The Central Statistics Office indicates that 53% of adults in Ireland are overweight with 18% classified as being obese (CSO, 2016). It has also been established that persons who are obese are more likely to be admitted to hospital and more likely to be in ICU than those of normal weight (Galinsky et al. 2010). In keeping with this changing patient demographic, there is a need to develop the care and moving and handling needs of this patient group. However, little is known about the proportion of bariatric patients in Irish hospitals or the strategies used to provide for this population’s specific needs and requirements within the hospital setting. Nursing staff are consistently at the interface of a patient’s hospital admission and subsequent care, and physiotherapists are frequently the providers of moving and handling training to other healthcare personnel. The aim of this study was to explore the frequency and process of providing moving and handling care for bariatric patients in acute Irish hospital settings.
Method. A cross-sectional study design using an anonymous 24-item questionnaire was used to survey all Clinical Nurse Managers (Grade I, II and III) in the participating hospital. A gatekeeper alerted potential participants by email of the study and provided information on participation in the study. Questionnaires were distributed to each CNM office and placed in an area for easy access by all CNMs. The CNMs were requested to complete the questionnaire and return it by internal post in the self-addressed envelope provided. Descriptive statistics of frequencies and percentages were used and associations were tested using Chi-square analysis in SPSS v23.
Results. A total of 35/94 CNMs responded, giving a response rate of 37.2%. The majority of respondents (85.7%) had provided care for bariatric patients; 47.1% stating that they provided care for up to 3 bariatric patients in the past month. Seventy seven percent (77.1%) stated that there were barriers to establishing bariatric patients’ weight, and only 23.5% reported that they ‘always’ or ‘usually’ have access to bariatric equipment. In the opinion of 50% of the CNMs there was no clear system for ordering bariatric equipment, and 93.9% stated that they did not have guidelines to inform their practice when caring for bariatric patients. Only 11.8% had undertaken education or training in the management of the bariatric patient and 97.1% stated that they would like additional education or training.
Conclusion. To our knowledge, this is the first study of bariatric moving and handling in an Irish hospital. Despite the relatively poor response rate and acknowledging the potential self-selecting bias in respondents, the results of this study highlight the need for greater clarification of roles for addressing the needs of bariatric patients in acute hospital settings. Additionally the barriers to establishing a patient’s weight and the subsequent procurement or rental of bariatric equipment were identified, and this requires further investigation. The limited clinical guidance is a concern but the enthusiasm for specific bariatric training is a positive finding that can be acted upon by physiotherapists involved in moving and handling education and training.
References
Central Statistics Office [CSO], (2016) http://www.cso.ie/en/index.html accessed 17.10.2016.
Galinsky T, Hudock S, Streit J. (2010) Addressing the need for research on bariatric patient handling. Rehabilitation Nursing, 35: 242-247.
Ethics Approval. This study was approved by the School of Medicine Research Ethics Committee, Trinity College Dublin and had permission from the Nurse Research Access Committee of the participating hospital.
