Executive Summary

Establishing a culture of safety pertaining to patient care is challenging in any setting; however, special challenges arise in the presence of obesity because excess weight and weight distribution often interfere with the caregiver’s ability to provide the most basic care. This is especially true when considering patient handling and mobility. The risks associated with bariatric patient handling and mobility are complex, and each patient must be considered individually.

The purpose of this Bariatric Safe Patient Handling and Mobility (SPHM) Guidebook is to provide best practice guidance to address the needs of bariatric patients, their families, and those who care for them. It presents emerging science, practical information, and a collection of tools and information that enable members of the greater health care community to: assess their current organizational capacity; plan and implement safe care of bariatric patients throughout the continuum of health care; and evaluate both patient and program outcomes. It includes space and design recommendations, guidance for selection of appropriately-sized technology (equipment and devices), communication tools, and other essential information; along with a comprehensive list of references and links.

This guidebook is designed as a first step to safely accommodate the physical, emotional, and spiritual needs of our patients of size; however, it is not a prescription for care. Readers are encouraged to seek new and emerging science as a way to continue the journey toward further improving patient care and promoting caregiver safety, irrespective of patient size.

Acknowledgements

This guidebook was possible because of the devoted attention of the personnel and management of the Center for Engineering & Occupational Safety and Health (CEOSH), St. Louis, Missouri.

A special thank you is extended to the Bariatric Safe Patient Handling and Mobility Guidebook Professional Advisory Group (PAG) who developed this guidebook and to management at their respective Veterans Integrated Service Networks (VISNs) and medical centers for their support.

Peggy Bone, MSN, RN, CSPHP, CIC, Safe Patient Handling and Mobility Coordinator, Birmingham VA Medical Center, Birmingham, AL

Tim Buchanan, RN-BC, MSN, Safe Patient Handling and Mobility Facility Coordinator, VA St Louis Health Care System, St. Louis, MO

Judee Gozzard, RN, MSN, CSPHP, Former Safe Patient Handling Coordinator, C.W. Bill Young VA Medical Center, Bay Pines, FL

Tony Hilton, DrPH, MSN, FNP, CRRN, RN, Safe Patient Handling Coordinator, VA Loma Linda Healthcare System, Loma Linda, CA

Valerie Kelleher, Visual Information Specialist, VISN 8 Patient Safety Center of Inquiry, Tampa, FL

Nancy Kirchner, MA, RN, Safe Patient Handling Coordinator/VISN 23 Safe Patient Handling Point of Contact, Minneapolis VA Health Care System, Minneapolis, MN

*Charlotte Lynch, MS, CNS, CSPHP, Safe Patient Handling Coordinator, Dayton VA Medical Center, Dayton, OH

Marie Martin, Ph.D., Acting National Program Manager, Patient Care Ergonomics (10P3D) and Industrial Hygienist/Safe Patient Handling Facility Coordinator, VA North Texas Health Care System, Dallas, TX

Mary W. Matz, MSPH, CPE, CSPHP, former VHA Safe Patient Handling National Program Manager, James A. Haley Veterans’ Hospital, Tampa, FL

Lisa Milstead, RN, MSN-ED, MHA, CHPN, Nurse Manager Special Programs/Medical Specialty, Huntington VA Medical Center, Huntington, WV

Mary Lou Muir, RN, COHN, Former Bariatric Patient Handling Consultant, Winnipeg, MB

Lynne Olson, ARNP, Bariatric Coordinator/Bariatric Nurse Practitioner, Bay Pines Health Care System, Bay Pines, FL

Val Posa, MSN, RN, Special Projects Clinical Coordinator, VA Pittsburgh Healthcare Center, Pittsburgh PA

Frank Rossi, Physical Therapist, C.W. Bill Young VA Medical Center, Bay Pines, FL

A special thanks is extended to the following individuals for their contributions to this guidebook and to management at their respective VISNs and VA/VHA facilities for their support.

Sylvia Baack, PhD, RN, Chief, Nursing Education, VA North Texas Health Care System, Dallas, TX

Lois Barkman-Soloman, RN, Fargo VA Health Care System, Fargo, ND

Roberta Capewell, PhD, RN, Quality Assurance & Program Integrity Dept., Visiting Nurse Association of Greater Philadelphia, Philadelphia, PA

Lena Deter, RN, MPH, CSPHP, DELHEC, LLC. Educational Services & Consulting, Hermitage, TN

Michelle Franklin, RN, BSN, Safe Patient Handling Coordinator, Captain James A Lovell Federal Health Care Center, Chicago, IL

Traci Galinsky, Ph.D., Captain, U.S. Public Health Service, Research Psychologist, NIOSH, Cincinnati, OH

Susan Gallagher, PhD, MSN, MA, RN, CBN, CSPHP, Founder, Celebration Institute, Inc., Sierra Madre, CA

Kimberly A. Hudson, MSN, RN, CCRN, SPHM-Fall Prevention Coordinator, Marion VA Medical Center, Marion, IL

Christina McCullough, R.T.(R)(M)(CT), Radiology Technologist, C.W. Bill Young VA Medical Center, Bay Pines, FL

Roberta Oeser, RN, Former Safe Patient Handling Coordinator, Jack C Montgomery VA Medical Center, Muskogee, OK

Lynn Salazar, MSN, RN, Safe Patient Handling/Falls Prevention Coordinator, South Texas Veterans Health Care System, San Antonio, TX

Susan Wyatt, BSN, RN, Safe Patient Handling Coordinator, Phoenix VA Health Care System, Phoenix, AZ

CEOSH Publishing Staff

Tina Beckner, Lead Technical Information Specialist, St. Louis, MO

Lesley Luscri, Technical Information Specialist, St. Louis, MO

Melody Watts, Technical Information Specialist, St. Louis, MO

Connie Young, Chief, Publishing Services, St. Louis, MO

Copyright Acknowledgements

Copyrighted documents used in this guidebook were reproduced with permission for VA use only.

Alpha Modalities, LLC

3110 Judson Street, Suite 149 Gig Harbor, WA 98335 http://alphamodalities.com/

HumanFit, LLC

15401 S. Len Avenue Oregon City, OR 97045

Hignett, et al. Loughborough University

LiftSeat Corporation, Inc. 2001 Midwest Road Suite 204 Oak Brook, IL 60523 http://www.liftseat.com/

MedCare Products

151 East Cliff Road Burnsville, MN 55337 www.medcarelifts.com http://www.patran.net/index.html

Patran/Jamar Health Products, Inc.

Stryker Medical 3800 East Centre Ave.

Portage, Michigan 49002 http://www.stryker.com/en-us/index.htm

How to Use This Guidebook

Veterans Health Administration (VHA) Center for Engineering & Occupational Safety and Health (CEOSH) guidebooks are “BEST PRACTICE” resources designed to assist health care facilities with the implementation and enhancement of programs and to more effectively comply with current Department of Veterans Affairs (VA)/VHA policy and external regulatory standards. Each guidebook has three sections:

 Preface: Disclaimers, Executive Summary (summary of how this book supports each program), Acknowledgements, How to Use This Guidebook, Update Listing (list of any online updates made to the guidebook prior to a new publication), and Acronyms and Abbreviations, (list of acronyms and abbreviations used in the guidebook).

 Chapter Contents: Each chapter contains a general discussion that provides VA-specific guidance on the topic.

 Additional Reference Materials: Enclosures and Appendices. (Enclosures are provided in a generic format, to be edited and used by individual facilities. Examples include templates, forms, samples, tools, and checklists.)

This guidebook is available in two formats:

Online Version: The online version toolbar includes the following features:

 Previous and Back Buttons – These buttons allow the user to page through the chapter contents.

 Contents – A hyperlinked table of contents that helps the user navigate the guidebook quickly. Click this icon to return to the full table of contents from the Search or Favorites tools discussed below.

 Search – This feature allows the user to type a specific word(s) to be found. Once the search is complete, a hyperlinked list of locations of the word(s) will be displayed.

 Favorites – The star icon lists saved favorite guidebook sections.

 Save Favorites – The star icon with the green plus sign allows the user to customize the favorites list for their needs by saving favorite sections. When the user is in a location that he/she wants to save as a favorite, clicking on the star with the green plus sign will save it in the user’s favorites.

PDF Version (Printer-Friendly): This version allows the user to print locally on a network printer at his/her workplace or save to a disk for printing at a reproduction facility. Each enclosure is a separate document and must be printed separately.

References and Web site links within each chapter and enclosure/attachment were current at the time of publication.

Update Listing

The following listing identifies online updates since the initial publication of the July 2015 edition of this guidebook. It is designed to assist the reader in verifying the most current information available.