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Mobilization of the Obese Patient and Prevention of Injury
Christine M Walden*1, Herbert R Garrison*2, Michael Rotondo1, Linda D Holfer*3, William B Floyd*1, Walter J Pories3
1Vidant Medical Center and Brody School of Medicine, East Carolina University, Greenville, NC;2Vidant Medical Center andBrody School of Medicine, East Carolina University, Greenville, NC;3Brody School of Medicine, East Carolina University, Greenville, NC

OBJECTIVE(S):
Obese patients are difficult to transport between emergency departments, imaging facilities, operating rooms, ICU’s, acute care and rehabilitation resources. Each move, along with turning, bathing and access to bathrooms, poses risks of injury to personnel and patients. Similarly, inadequate mobilization raises the risks of pressure ulcers. The costs can be prohibitive.
METHODS:
In six pilot units, mobilization of patients was delegated to trained lift teams that covered the units 24 hrs/day for patients >200 pounds, Braden Score ≤ 18 and/or pressure ulcers.
RESULTS:
In fiscal year 2012 hospital acquired pressure ulcers on pilot units decreased from 5.1 to 3; non-pilot units remained constant. Patient handling employee injury on pilot units dropped from .097 to .037/1000 patient days, a 62% decrease, while rates on non-pilot units remained at .029/1000 patient days. Employee satisfaction rates were 100%, 99% and 95% in response to three separate queries.
PROGRAM COST: Net program cost was $156,031 vs. losses of $5 million in the previous three years from employee injuries alone. Reduction in hospital acquired pressure ulcers saved $754,604 retained revenue and $433,888 in ancillary costs. The 62% reduction in Worker's Compensation on pilot units produced $240,000 cost savings plus avoiding $93,000 due to absentee coverage, total gain of $1.52 million.
CONCLUSIONS:Lift teams on nursing units produce sharp improvements in care and prevent patient handling employee injuries. Since surgeons manage many of the obese in hospitals, lift teams offer savings and an important improvement in surgical care


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