"I don't know if the demand will continue as steeply as it has, but it's certainly not going to reduce. From what I see, I think it's going to remain fairly steady," says Klein.

Bariatric basics & beyond


If one thing is clear about the bariatric population it's that facilities must be prepared to address the needs of the patients when they seek medical services. Muir recommends that facilities acquire some basic equipment, such as a bed that can be adjusted in size. It's also important to have an appropriate sleep surface with low air loss (a standard mattress won't do), since bariatric patients are more prone to develop skin conditions. A transportation device, such as a stretcher, is also a necessity.

"The recommendation now is that devices have the capability to be powered," she says. "They may be built-in powered, so that they can self-drive and [not require] exertion or you may have a power device that hooks-on to manage the transport."

She also recommends that facilities invest in an appropriate wheelchair, a commode chair, some friction reducing devices for lateral transfers and lift devices.

"We really recommend that a ceiling lift be the way to manage the client in their room," says Muir. "If you have a ceiling lift, you still need a floor lift available in the facility because you may need it outside of the room."

Additionally, bariatric patients need medical supplies, such as gowns, robes, appropriate blood pressure cuffs, ID bands and longer needles.

When doing consulting work, Muir helps the facilities figure out what size of patient they are most likely to encounter and purchase equipment that is rated for that weight. However, she also recommends making sure there is a backup supply of equipment that's available if a patient beyond the pre-determined weight range is admitted to the hospital.

Once the equipment is in place, the staff needs to know where it can be found and receive training not only on safe patient handling but also sensitivity.

"Every policy should address the sensitivity issues with special care," says Muir. "The research information has supported that workers are not being as sensitive as they need to be. There are some sensitivities and they need training on respectful care."

Muir suggests that training on safe patient handling and the use of equipment be done on a frequent basis. If there are long gaps between bariatric patient admissions, the staff may forget how to use the technology.

"One of the things that I tend to do with our frequent admissions is we train the patient. We train the patient on how the bed works, so they can help teach the nursing staff and so they know what to ask for," says Muir. "The client comes in and is able identify the equipment that works for them. That really saves everyone a lot of trouble."

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