Infrastructure Design: A Critical Element in the Care of the Patient With Obesity.

ABSTRACT: The worldwide rate of obesity continues to rise, causing healthcare systems to morph to meet the demands posed by the concomitant increase in comorbidities associated with this condition. Increasing patient weight imposes its own constraints on the safety of patients and providers; therefore, a sound healthcare facility infrastructure is required to properly address the medical needs of patients with obesity. Currently, most healthcare systems-in their attitudes, equipment, and facility design-are ill equipped to meet the needs of this epidemic. In this article, we discuss the facilities and equipment design considerations in providing medical care to patients with obesity. Extending beyond the physical plant, we also touch on organizational elements that enable the healthcare provider to safely care for this challenging patient population. The rising prevalence and disease burden of excess adiposity highlight the obligation to recognize that the design needs common to all of our patients must include the particular needs of the patient with obesity.

Patient handling in the veterans health administration: facilitating change in the health care industry.

OBJECTIVE: To describe a 15-year process creating an industry standard of practice without regulatory support through organizational leadership. METHODS: Description of the development and rollout of a safe patient-handling program, including the initial scientific development, a cultural history, and agency data. RESULTS: Patient-handling injuries represent more than 20% of injuries to nurses. These declined by more than 40% throughout the program. In parallel, program scope and implementation evolved through collaboration across facility program managers in one organization, among various organizations, and between users and equipment manufacturers. Program success required a shift from a technology focus to culture change and behaviors. CONCLUSION: Program evolution arises from collaborative practice and interactions between individual practitioners, organizational needs and interests, and manufacturers. Creation of a public forum was critical to changes in a meanwhile internationally accepted standard.

AORN Ergonomic Tool 4: Solutions for Prolonged Standing in Perioperative Settings.

Prolonged standing during surgical procedures poses a high risk of causing musculoskeletal disorders, including back, leg, and foot pain, which can be chronic or acute in nature. Ergonomic Tool 4: Solutions for Prolonged Standing in Perioperative Settings provides recommendations for relieving the strain of prolonged standing, including the use of antifatigue mats, supportive footwear, and sit/stand stools, that are based on well-accepted ergonomic safety concepts, current research, and access to new and emerging technology.