Early ID of Morbidly Obese Improves Surgical Care

Improves perioperative care and postoperative outcomes for patients with BMI of 35 or more

THURSDAY, Oct. 6 (HealthDay News) -- Early identification of patients with a body mass index (BMI) of 35 kg/m² or more improves perioperative care and outcomes, according to a study published in the October issue of the AORN Journal.

Diane Graham, R.N., from the John Muir Medical Center in Concord, Calif., and colleagues investigated the issues pertaining to the care of morbidly obese patients in order to develop and apply policies and procedures to decrease the risk of adverse outcomes for these patients. A task force was created with the aim of improving identification of patients with high BMIs undergoing elective or emergent surgery.

The investigators identified four areas for improvement during surgical care: communication, respiratory care, equipment, and education. A key risk-reduction strategy was identification of patients with a BMI of 35 kg/m² or higher and notification of the surgical department. Evidence-based guidelines were established including preoperative, intraoperative, and postoperative patient care recommendations. Suitable equipment was identified and purchased, where necessary. An education plan for caring for obese patients was developed and implemented. By November 2009, BMI was included on the surgery schedule and on the preoperative checklist of 92 and 94 percent of 50 audited charts, respectively. Since January 2009, there have been no positioning incidents or intubation emergencies in patients with a high BMI.

"Early identification of patients with high BMIs resulted in improved perioperative care and postoperative outcomes," the authors write. "The project heightened staff member awareness of the specialized needs of the patients with a high BMI."

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