Increased Patient Obesity Moves Perioperative Team to Evaluate Surgical Care Process

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New report notes patient's BMI, not just weight,helps prevent surgery-related complications.

Denver, CO, October 6, 2011 - As obesity rates climb in the U.S., perioperative professionals must be prepared to care for patients with a high body mass index (BMI) and to prevent the surgery-related complications seen in this patient population. High-BMI protocols, including strategies centered on interdepartmental communication, respiratory care, equipment, and staff education can reduce the risk of surgical complications for obese patients according to a report in the October issue of AORN Journal.

The effects of a high BMI on perioperative safety were brought to the forefront at an acute care, 313-bed community hospital in northern California when two sentinel events occurred during a six-month period in 2007. According to background in the article, at the time these sentinel events occurred, perioperative administrators did not have a mechanism in place for advance notification when elective, nonbariatric surgical procedures were scheduled for patients who were obese. For these patients, additional preparations for respiratory support and positioning needs were required on short notice.

In the Journal’s Preventing Perioperative Complications in the Patient with a High Body Mass Index, Diane Graham, MS, RN, CNS, CNOR and colleagues at John Muir Medical Center in Concord, California describe the work of a High BMI Task Force to create and implement a system that would improve surgical results for obese patients. Chart audit results confirmed the quality improvement project which included revised checklists noting the patient’s BMI, was successful; 92% of 50 charts showed inclusion of the BMI on the surgery schedule, and 94% showed inclusion of the BMI on the preoperative checklist. No positioning incidents or intubation emergencies have occurred in patients with a high BMI since January 1, 2009.

The AORN Journal is peer reviewed and provides registered nurses in the operating room and related services with information based on scientific evidence and principle. Articles cover the nurse’s roles before, during, and after surgery and include patient teaching and preparation, use and care of surgical instruments and supplies, asepsis, sterilization, anesthesia, and related topics.

About AORN
The Association of periOperative Registered Nurses (AORN) represents the interests of more than 160,000 perioperative nurses by providing nursing education, standards, and practice resources—including the peer-reviewed, monthly publication AORN Journal—to enable optimal outcomes for patients undergoing operative and other invasive procedures. AORN’s 40,000 registered nurse members manage, teach, and practice perioperative nursing, are enrolled in nursing education or are engaged in perioperative research.

Editor's Note:Please see the article for additional information, including other authors, author contributions, affiliations and disclosures. Some articles in AORN Journal can be downloaded for a fee; articles with CEs are free online at

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