TABLE 3.
FROM:
Specialized Staff and Equipment for Weight Loss Surgery Patients: Best Practice Guidelines
Anthony D. Whittemore, John Kelly, Scott Shikora, Robert J. Cella, Thom Clark, Leslie Selbovitz and Loring Flint
BACK TO ARTICLETable 3.. Essential recommendations
| Patient safety |
| Personnel |
| Physician director of bariatric program |
| Designated hospital administrator |
| Critical care coverage 24 hours a day/ 7 days a week |
| Equipment |
| Inpatient units (floor, ICU, PACU) |
| Wide beds |
| Standard to 440 pounds |
| Automated/adjustable to full sitting position |
| Built-in scale |
| Low air-loss mattress |
| Lifting/transferring equipment |
| Wide commodes |
| Wide wheelchairs, stretchers, walkers |
| Monitoring devices |
| Wide BP Cuffs |
| Biphasic defibrillators |
| Sequential compression devices |
| Emergency airway equipment |
| Ambulatory facility |
| Wide examination tables, bolted to floor |
| Appropriately sized scales |
| Operating room |
| Automated wide operating table |
| Appropriate weight capacity |
| Lifting/transferring equipment |
| Instruments |
| Extra-long abdominal instrument sets |
| Appropriately sized retractors |
| 43- to 46-cm laparoscopes |
| Radiology |
| Automated wide tables with appropriate weight capacity |
| CT, MRI, and interventional capability within 60 minutes |
| Physical Plant |
| Dedicated floor, ICU, and PACU for bariatric patients |
| Wide entrance doors to room and bathroom |
| Floor-mounted toilets |
| Elevators with wide doors and adequate weight capacity |
| Medication error reduction |
| Executive walkrounds |
| Sentinel event reporting system |
| Medication error reduction (continued) |
| P&T committee to establish dosing guidelines |
| Computerized order entry |
| Automated medication administration system |
| Systems improvements |
| Mandatory statewide bariatric intervention registry |
| Critical pathway |
| Credentialing requirements |
| See surgery, anesthesia, and nursing task group reports |
| Establish criteria for credentialing in emerging technology |
| Future research |
| Collaborate with societies and payers to standardize outcome data registry |
| Develop simulator training programs |
| Collaborate with industry to develop appropriately sized equipment |
PACU, Post Anesthesia Care Unit; P&T, Pharmacy and Therapeutics.
