In 2021, a study was published in the Journal of Research in Nursing, about moving and handling care of bariatric patients. 322 clinical nurse managers were surveyed on the biggest barriers they faced when it came to caring for persons of size within their clinical area. The top 3 barriers that were identified are 1. lack of equipment at 75%, 2. lack of staff 65.2%, and lack of training and education 57.6%. This study highlights the challenges healthcare professionals face in establishing a culture of safety in caring for the bariatric population. Excess weight and weight distribution can be a barrier for a caregiver to provide even the most basic care. These patients require special equipment, techniques, and sensitivity to ensure the safety of patients of their caregivers. Here, we will explore six risks with moving and handling bariatric patients.

  • Musculoskeletal Injuries Among Healthcare Staff: The physical demands associated with caring for bariatric patients significantly increase the risk of musculoskeletal injuries among healthcare staff. Tasks such as repositioning, bathing, lifting, or transferring individuals of size put excessive strain on the muscles and joints, potentially leading to injuries if not managed correctly. In fact, persons of size represent less than 10% of all patients, however 30% of caregiver injuries are due to bariatric patient handling.
  • Increased Risk of Falls and Injury: Patients of size often have reduced mobility and balance issues, making them more susceptible to falls during transfers. These falls can result in serious injury for the patient and the caregiver.
  • Increased Likelihood of Pressure Injuries: The combination of increased weight, immobility, and the comorbidities often associated with these patients, puts them at a significant risk for pressure injury development. These can be slow to heal and very painful which can lead to life-threatening complications. Bariatric patients often require more regular repositioning, pressure relieving mattresses and microclimate management to minimize the risk of skin breakdown. 
  • Lack of Specialized Bariatric Equipment: Standard hospital equipment may not be designed to accommodate the size, body shape, and weight of bariatric patients. According to the 2021 study, 75% of nurse managers state their unit has a lack of specialized equipment designed for bariatric use.  Proper equipment can increase the risk of accidents and injury during patient transfers and compromise the effectiveness of care. 
  • Staff Shortages: Healthcare staffing shortages can lead to poor patient outcomes such as falls and hospital-acquired infections. Inadequate staffing levels can also exacerbate the risks associated with moving and handling bariatric patients. According to the 2021 study, 65% of nurse managers state they are short staffed. Staff shortages lead to injuries when staff may resort to unsafe practices or attempt transfers without proper assistance.
  • Limited Training and Education: According to the 2021 study, 58% of nurse managers state their unit lacks proper training on how to care for bariatric patients. Comprehensive training programs is a necessity to help educate staff properly about safe patient handling, especially in the bariatric population. Insufficient training on proper techniques and best practices for moving and handling bariatric patients is a significant risk factor for injuries in patients and staff.

Safe patient handling is critical in bariatric care, where patients require specialized attention and equipment. Healthcare personnel must conduct patient assessment, use appropriate equipment, and receive proper training and education to ensure their safety and the safety of patients during movement. By addressing these risks, quality of care for these patients can be enhanced while fostering a safe workplace for healthcare providers.

Amber Slay, BSN, RN Clinical Director, Savaria Patient Care Academy

Amber Slay, BSN, RN

Clinical Director, Patient Care Academy

References

Dockrell, S., & Hurley, G. (2021). Moving and handling care of bariatric patients: a survey of clinical nurse managers. Journal of research in nursing : JRN, 26(3), 194–204. https://doi.org/10.1177/1744987120970623

McClean, K., Cross, M., & Reed, S. (2021). Risks to Healthcare Organizations and Staff Who manage Obese (Bariatric) Patients and Use of Obesity Data to Mitigate Risks: A Literature review. Journal of multidisciplinary healthcare, 14, 577–588.