Bariatric Times - December 2008 - (Page 13)

Bariatric Times • December 2008 Patient Management Perspective 13 RISK ASSESSMENT, RECOGNIZING ATYPICAL PRESSURE ULCERS, REPOSITIONING, nutrition, and the plan of care may need to be adapted to meet the patient’s needs. mandate to transform acute care pressure ulcer prevention and timely appropriate intervention. The stakes are high in that this mandate affects the top two concerns facing hospitals today: patient outcomes and reimbursement. The bariatric, wound, and risk management teams are in key positions to make significant contributions to outcomes pertaining to care of the obese patient at risk for pressure ulcers in the acute care setting. The lack of evidence makes it difficult to affirm even what we think about wound care in general, much less consider the numerous complexities of the person of size. Many factors influence the development and healing of pressure ulcers. Clinicians of every discipline play a pivotal role in this challenging and complex process, using a comprehensive approach involving skin care, attention to pressure, nutritional support, and patient and family education. An interdisciplinary approach that addresses the unique needs of the obese patient is the essence of preventing development of pressure ulcers in this evolving environment. REFERENCES 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Pressure ulcers. Accessed August 1, 2008 at: http://www.merck.com/mmpe/sec10/ch126/ch126a.html Pressure ulcer staging. Accessed August 1, 2008 at: http://www.npuap.org/pr2.htm Braden Scale for Prediction of Pressure Ulcer Score. Accessed August 1, 2008 at: www.bradenscale.com/bradescale.htm Camden S. Nursing care of the bariatric patient. Bariatric Nursing and Surgical Patient Care. 2006;1(1):21–30. Gallagher SM. Obesity and the skin care in the critical care area. Critical Care Nursing Quarterly. 2002;25(1):69–75. Camden SG & Shaver J. Promoting dignity and preventing caregiver injury while caring for a morbidly obese woman with skin care challenges. Bariatric Nursing and Surgical Patient Care. 2007;2(1):77–82. Kramer K, Gallagher S. WOC nurses as advocates for patients who are morbidly obese: A case study promoting use of bariatric beds. JWOCN. 2004;31(1):276–281. Gallagher S. The challenges of obesity and skin integrity. Nurs Clin N Am. 2005;40(2):325–335. Gallagher S, Langlois C, Spacht D, et al. Preplanning protocols for skin and wound care in obese patients. Advances in Skin and Wound Care: J Prevention and Healing. 2004;17(8):436–443. Shea JD. Pressure ulcers. Clin Orthopedic Related Research. 1975;112:89–110. AUTHOR CORRESPONDENCE Contact Susan Gallagher at the Celebration Institute, Inc., susan@celebrationinstitute.com susangallagher@hotmail.com http://www.merck.com/mmpe/sec10/ch126/ch126a.html http://www.npuap.org/pr2.htm http://www.bradenscale.com/bradenscale.htm http://www.carecredit.com http://www.carecredit.com

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Bariatric Times - December 2008 Table of Contents Patient Management Perspective Diabetes Perspective Interview: ASMBS’s Georgeann Mallory Editorial Message Editorial Board Body Contouring Perspective Meeting Perspective Journal Watch Advertiser Index News & Trends

Bariatric Times - December 2008

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