I was just wondering what are your tips in turning a patient (eg. Q4 turning or pads change) who has a leg pain and is a morbidly obese? My patient is too big that I am ordering a big bariatic bed for him.
He helps a little to nothing when changing his pad. He came from a LTC with a long term IDC (with yellowish discharge and foul smell) so I decided to give him a pad change and wash. I asked for 4 people in the ward to help him get changed. Any tips?
He is q4 turn since he is now on bariatic bed.
Nope. A bariatric bed can structurally handle more weight, and it’s wider to accommodate the extra width of the patient.... it does NOTHING to alleviate gravity. The pt’s skin is experiencing all of the same pressure as it was prior to the new bed and needs to be repositioned q2 hrs
OP, I am assuming that the bed that has been ordered has an air mattress and turn assist functions on the bed.
I would also look at hiring a hover matt system and speak to the rep of the company of the hoist that you have, you could buy or rent a leg lifter sling attachment.
Contact your OHS person for advice and assistance with risk assessment. Also get the PT and OT involved.
Many health services have a bariatric / manual handling consultant. It is often the person who manages the equipment library. There are a few companies and people I could give you contacts for if you are in Australia. Shoot me a PM if you do.
Sometimes an overhead trapeze can help. Even if the pt has only very minimal ability to assist, any little bit helps! And he can begin to improve using it, esp if PT/OT can offer him some advice.
Hello thank you for all your nice inputs! My patient was just got admitted in our ward when I looked after him. The urinary catheter was just recently inserted and ofcourse we took a sample for urinalysis and culture (we replaced his old one).
He is q4 turn since he is now on bariatic bed. The urologist was aware of the BPH and deemed that it is vital for him to have the foley in. I just find it challenging to turn and do cares for this heavy patient who cannot turn himself and was in pain with the slight movement. I have asked for help for other nurses on the floor.
The reason I posted this is for me to get an idea on how to safely turn him and improve my practice on taking care of this kind of patient.
It still doesn’t matter if they are on a bariatric bed. It’s q2 turning. These people are at a much higher risk of skin breakdown and infection. Even on a bari bed.
OP, I am assuming that the bed that has been ordered has an air mattress and turn assist functions on the bed.
I would also look at hiring a hover matt system and speak to the rep of the company of the hoist that you have, you could buy or rent a leg lifter sling attachment.
Contact your OHS person for advice and assistance with risk assessment. Also get the PT and OT involved.
Many health services have a bariatric / manual handling consultant. It is often the person who manages the equipment library. There are a few companies and people I could give you contacts for if you are in Australia. Shoot me a PM if you do.
Good luck.
Even on those beds you still need q2 turning. My facility gets those beds. They are low air loss bariatric mattresses. You still have to turn. There are heavy bars right down the middle that can cause issues. Especially if the flow in the bed is off on the slightest.
Get a long flat sheet fold in half place it so it is centered under the heaviest parts of the torso. For positioning the patient to the center or a side of the bed. lay the bed flat then raise the bed so it is above you waist and do a slow steady pull.
For turning to side or back lay the bed flat then lower the bed so you have really good leverage and take edge of sheet and do a faster pull upward while pulling towards you for full side line position If you want more of an angle not fully on the back or side do a slower pull with pillows ready for an angle.
If the bead has a tilt function. To slide up tilt the bed so the foot of the bed as high as possible with head as low as it will go and pull both sides of the sheet until the patients head is at the headboard.
Just a reminder - please, raise the HOB ASAP! A large pt will be struggling to breathe; work quickly, do what you have to, and then get him more upright.
.thumb.png.e0f6c8cde7dc7bfee14de32046ff02b0.png){kind=small}
NRSKarenRN, BSN, RN
10 Articles; 19,198 Posts
Good article:
Turning and repositioning patients who are morbidly obese
https://www.myamericannurse.com/turning-and-repositioning-patients-who-are-morbidly-obese/