1. Johnson, Anastasia (Stacy Smith) BSN, RN, CNOR
  2. Dohlin, Ella MA, RN
  3. Severson, Kristy

Article Content


This project addressed the role of the clinical nurse specialist (CNS) in the development of a Bariatric Surgery Program across the continuum of care at St. Mary's Duluth Clinic Health System (SMDC) in Duluth, Minnesota.



Alleviating symptoms of medical co-morbidities experienced by obese patients is evidenced in both direct and indirect healthcare costs. Improving quality of life, along with co-morbidities resolution, is the goal of weight loss surgery.



Weight loss surgery (bariatric surgery) is one of the most effective treatment choices for morbid obesity. Collaboration began among CNSs working in the ambulatory clinic, peri-operative services and the post-op general surgery unit in the hospital to ensure preparation for a new specialty group of patients.



Staff development was initiated using a comprehensive, multidisciplinary approach. Education included sensitivity training, pre-operative and post-operative care of bariatric surgery patients. Bariatric furniture and transfer devices were procured, along with application of grant monies to purchase portable lifting equipment. Training for safe patient handling was provided. Order sets and pathways were developed for system wide use.



Patients and families were better prepared for the pre- and post-operative experience. Cost savings to patients occurred with decreased length of stay in the hospital. Nursing personnel had improved knowledge and enhanced ability to meet the special needs of bariatric patients. Safe handling and equipment training provided for fewer staff injuries. Impact to the organization was evidenced in decreased length of stay from 3.6 to 2.4 days, with an annual cost savings of $131,000. Center of Excellence designation for the health system was achieved.



CNS collaboration across the health system has been instrumental to successfully providing safe care and effective follow-up. Development of shared pathways ensures the specialized plan of care is followed and alerts the team to additional individualized needs.


Implications for Practice:

Spiritual and emotional care was integrated into the physical aspects of health maintenance and achieved through collaborative partnership among all members of the weight management team. Working together, CNSs practicing in different areas of a health system improved the care for a specialty group of patients.


Section Description

The journal is proud to share the student abstracts accepted for poster presentation at the 2009 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.