Problem/Purpose: Caring for obese patients in intensive care units (ICU) is challenging. There are limited data about how nurses care for this vulnerable population. This study describes the nursing resources and patient outcomes in obese, critically ill patients. Methods: Patients with a body mass index (BMI)over 30 kg/m2 were identified by advanced practice nurses (APN) in four facilities to provide cross-sectional data about equipment/personnel resources and patient outcomes. Results: Our patient sample (n=47) had a mean BMI of 47 kg/m2 and was typically female (65%), Caucasian (79%), aged 56 (range 23-83), admitted with a cardio/pulmonary diagnosis (63%) and APACHE II score of 13; they averaged 4 days in the ICU. Use of specialized equipment was associated with patients with a BMI greater than 40kg/m2. Most participants (63%) required 2 or more staff to assist with positioning. One-third of the participants required 2 or more attempts to obtain intravenous/arterial access. Ten patients (23%) received special skin care, although the incidence of pressure ulcer occurrence was low (5%). 24 patients (56%) required mechanical ventilation; 5 (12%) were ventilated for 3 or more days. Respiratory complications occurred in 21% of the sample. Other complications included new cardiac problems (13%), DVT (2%) and line dislodgement (9%). Nearly all patients survived (98%). Graphically, complications were more likely to be associated with increasing BMI rather than resource use. Conclusions: In general, this sample is younger, female, and less severely ill on admission than the typical ICU patient. Additional staff/staff time and specialized equipment were more likely to be used for patients with a BMI of more than 40 kg/m2. Outcomes were better than expected from reports in the literature; this may be due to the involvement of APNs involved in the care of obese patients in this study. Funding: Frances Payne Bolton School of Nursing.
Session #1077 - Acute Care Research: Impacting Patient Care Outcomes
The 29th Annual MNRS Research Conference (April 1-4, 2005)