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Research says improved recording methods needed to reduce nurse injury rates when caring for obese patients

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Better recording protocols may help minimise nurse injury rates and enhance quality of care whilst treating obese patients, according to new research out of Edith Cowan University in Perth.

The research was conducted in response to the alarming statistic that 46 per cent of nurses have reported some form of musculoskeletal injury due to lifting, moving or helping an obese patient.

And aged care workers are particularly at risk for such injury, with Australian Bureau of Statistics data suggesting that about 41 per cent of adults aged 65–74 qualify as either overweight or obese.

“We’re going to get a lot more people in aged care and then if you combine that with the increasing obesity rate – this is a significant issue for our carers,” Kim McClean, lead author of the study, says.

Beverley Ewens, registered nurse and associate professor of nursing and midwifery at Edith Cowan University, tells Aged Care News that lack of proper equipment and training has made caring for obese patients a ‘big challenge’.

“If you haven’t got the education and training, you’re really going to lack confidence in giving the best care that you can to these patients,” she says.

To address this, McClean and her team observed the impact of a 12 month education and training program, emphasising consistent recording of height and weight measurements.

“One of the major findings around the height recording was that there was a lack of education and bit of confusion around how to record height in bedridden patients,” McClean says.

The researchers introduced nursing staff to a range of strategies to measure height with the patients remaining lying flat, minimising the need for lifting.

After the trial, patient BMI recording rose from 6 per cent to 33 per cent, while height measurements increased from 12 per cent to 33 per cent.

Whilst not a perfect outcome, McClean says that the move towards electronic health records could improve uptake of these procedures.

“User-friendly improvements should be considered, such as compulsory recording of patient weight and height, embedded and automatic BMI calculators and ‘check boxes’ for obesity conditions which may affect treatment,” she says.

Although the immediate focus of the study was the recording of obesity, McClean says that underweight patients can benefit from better measuring protocols, too.

“The weight-height BMI can also be used to look at malnutrition… which you see often in aged care.”

Wherever a person sits on the BMI scale, McClean says greater recording of data is the foundation of comprehensive care.  

“The data should be used to proactively assist the patients to treat their condition,” she says.

“Dieticians can then come in to play… or physiotherapists or other allied health where movement difficulties are identified.”

Ewens emphasises that further work should be done to consider the patients’ perspective, stressing that obesity is a complex issue.

“Nurses have said they do have some concerns about the specifics of things like wound management, how to mobilise these patients whilst maintaining their dignity, comfort and safety,” Ewens says

“The patient’s voice is very important in all of this, the patient’s experience, because it’s about a collaborative approach to care.

“It’s a partnership in care.”

The research also aims to ensure hospitals are receiving adequate funding for specialist care equipment and any extra-staffing requirements.

McClean tells Aged Care News that her research has uncovered that in Western Australia alone, underreporting accounted for a loss of $2.3 million dollars per year in unclaimed funding.

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