Obesity and Progressive Care

Aug 01, 2016

Added to Collection

Obesity epidemic adds potential complications for ICU patients

Article in Critical Care Nurse provides overview of obesity-related complications, nursing assessments and clinical interventions

 — August 1, 2016 — The U.S. obesity epidemic means more critically ill patients have weight-associated conditions affecting their illness or are at greater risk of specific complications during their hospital stay.

Hospitalized critically ill obese patients present unique challenges to the nurses who provide care for them in critical and progressive care units, and an article in the August issue of Critical Care Nurse (CCN) offers guidance on providing optimal care to obese patients.

Diabetes, high blood pressure, heart disease, gastroesophageal reflux, incontinence, sleep apnea, joint disease and pressure ulcers are among the various conditions and diseases associated with obesity. During a hospital stay, critically ill patients with weight-associated conditions may need more frequent nursing assessments and increased monitoring.

The article “Progressive Care of Obese Patients” provides specific information about obesity-related complications, assessments and interventions and discusses specific nursing competencies integral to providing care to obese patients. A sample plan of care details each body system and lists interventions and resources needed to implement each activity.

Lead author Lori A. Dambaugh, RN, DNP, CNS, PCCN, ACCNS-AG, is an assistant professor of nursing and clinical nurse specialist track coordinator at Wegmans School of Nursing, St. John Fisher College in Rochester, New York.

“With up to a quarter of critically ill patients classified as obese, nurses must be aware of how obesity may change how their patients respond to their illness,” Dambaugh said.

According to the article, obese patients who have been in an intensive care unit (ICU) may benefit from a stay in a progressive care unit before being transferred to a general care unit or discharged to home. Progressive care may also be appropriate for hospitalized obese patients with unstable clinical conditions.

Co-author Margaret M. Ecklund, RN, MS, CCRN, ACNP-BC, is an advanced practice nurse working as a clinical nurse specialist with the wound, ostomy and skin care team for Legacy Health, Portland, Oregon. She is also the contributing editor of the journal’s Progressive Care column.

“Progressive care is the unifying term for the increased level of care and nursing vigilance needed by patients who are not in the ICU but have complex healthcare needs,” Ecklund said. “Progressive care units may be an excellent setting for obese patients who require increased monitoring and may have unstable clinical conditions.”

Other common terms for progressive care settings include stepdown, intermediate, telemetry, transitional, high acuity, direct observation or medical-surgical progressive care units.

As the American Association of Critical-Care Nurses’ bimonthly clinical practice journal for high acuity, progressive and critical care nurses, CCN is a trusted source for information related to the bedside care of critically and acutely ill patients.

AACN offers progressive care nurses a multitude of clinical and educational resources, including a clinical guide of essentials for progressive care nursing, the core curriculum for this growing practice area and PCCN certification — AACN Certification Corporation’s fastest-growing credential.

Access the article abstract and full-text PDF by visiting the CCN website at http://ccn.aacnjournals.org.

About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The award-winning journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high acuity, progressive and critical care settings. CCN enjoys a circulation of more than 107,000 and can be accessed at http://ccn.aacnjournals.org/.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.