The nursing care of people with class III obesity in an acute care setting: a scoping review

Abstract

Background Patients with Class III obesity pose unique challenges to health care staff and organisations. Care requirements of this population are unique and require specialised equipment and knowledge to meet these needs, maintain the quality of care, as well as the safety of patients and staff. Aim To synthesise the evidence on the nursing care of Class III obese patients in acute care settings. Methods A scoping review informed by JBI. CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase were searched for primary research articles about the nursing management of people classified as Class III obese in acute care. Methodological quality of included studies was assessed; data extracted and synthesised into themes. Results Fourteen studies were included in the review. The synthesis generated three themes: Access to equipment, knowledge and training, patient care, and opportunities to improve care. Conclusions A paucity of high-quality evidence informs the nursing care of people with Class III obesity in acute care. Access to appropriate equipment dominated the findings of this review. Adequate provision of equipment and education on its use are required. Education to promote engagement with patients, adapting clinical practice and promotion of self-care could improve care and outcomes.

Impact of Obesity on Outcomes of Emergency Department Visits for Cardiac Chest Pain: Insights From a Nationwide Emergency Department Study

“…These settings lack the dedicated equipment required to cater to the special needs of these patients. In fact, most facilities have been retrofitted to make do, rather than being specifically designed for this purpose, resulting in inadequate care provision [ 17 , 18 ].…”

Good Things Don't Always Come in Small Packages

“…Caring for patients with Class 3 obesity requires attention to multiple components such as physical assessment, identification of risk factors including ACEs, safe patient handling, use of correct equipment, skin protection, and attention to interpersonal relationships. A recent scoping review noted a paucity of high-quality evidence informing care of these individuals 39. Existing research tends to focus on selection and use of appropriate equipment along with caregiver education regarding aspects of patient care.…”

“…More than 40 comorbidities have been linked to Class 3 obesity. 7,[38][39][40][41] They include metabolic syndrome, type 2 diabetes mellitus, hypertension, dyslipidemia, coronary heart disease, osteoarthritis, stroke, gastroesophageal reflux disease, depression, nonalcoholic fatty liver disease, infertility in females, erectile dysfunction, gallbladder disease, obstructive sleep apnea, and asthma. Of particular interest to WOC nurses, obesity is associated with pelvic floor dysfunction resulting in constipation, and fecal and urinary incontinence.…”

“…A recent scoping review noted a paucity of high-quality evidence informing care of these individuals. 39 Existing research tends to focus on selection and use of appropriate equipment along with caregiver education regarding aspects of patient care. We located a second scoping review that found that safe and effective care of patients with Class 3 obesity substantially increases nursing and challenging nurses' safety if training or staffing needs are not met.…”

Healthcare Professionals’ Perspectives of Nonsurgical Care of Older Inpatients with Class II or III Obesity and Comorbidities: A Qualitative Study

“…Older people with Class II or III obesity (defined as body mass index (BMI) ≥35 kilogram divided by height in meters squared (kg/m 2 ) or body mass index ≥40 kg/m 2 , respectively) have age and weight related comorbidities needing complex care and frequent hospital admissions. [1][2][3][4] In 2017-18 Australian data reported 31% of adults were living with obesity (BMI ≥ 30 kg/m 2 ). 5 In 2019/20 the National Health Service in England reported a 17% increase in hospital admissions of patients with obesity compared to the 2018/19 period.…”