Hal Robertson Dip Physio (NZ), Dip OHS, MAPA Ergonomist, Workforce Health, Workforce Division, South Australia Health (P01, Thursday, NZI 6 Room, 12-12.30)

1. Hal Robertson. Manual Task Services, Workforce
Health, SA Health
Jo Bills. Physiolink

2. Person fits two or more of the following criteria:
 Weighs 120Kg+
 BMI 40+
 Hip width >20” (51cm)

3. The Project
•Sponsored by Employers Mutual Member
Benefit Program, 2010
•SA Aged Care Consultative Committee
project
•Hosted by Elanora SYP Homes Inc

4.  To reduce the risk of injury to employees
by identifying future risk management
strategies for bariatric care in the
residential and community aged care
sector
 To develop resources for management of
the bariatric resident/client (Fact Sheets)

5. Working Party (4)
Literature Review
Workshops -December 2010
(1 metro- Adelaide; 2 country-Mt Gambier and Kadina )
Collation of feedback (questionnaires)
Development of Fact Sheets x 6

6.  Determine participants knowledge and
readiness of organisations to manage obese
and bariatric clients
 Provide basic information on bariatric client
management and bariatric issues
 Identify AC funding model’s limitations with
funding care of B clients

7. Participant input
Small group discussions to identify
the needs of
◦ The obese client
◦ The worker
◦ The Aged Care industry
To safely manage larger clients and the current
barriers in achieving this

9. Does your organisation …
 Have guidelines on managing bariatric clients?
 Hire in bariatric equipment?
 Have bariatric specific manual handling training?
 Roster additional staff to manage bariatric client
transfers and hygiene care?

10.  Beds SWL>200kg
 Pressure care mattresses>150kg
 Shower chairs and commodes>150kg
 Wheelchairs>100kg
 Walking aids>100kg
 Lifting machines>150kg
 Weighing scales>150kg

11. Prompts
 Access to bariatric resources
 Improved knowledge about B equipment
 Improving worker safety with handling larger clients
 Resources to develop organisational B guidelines
 Resources to promote sensitivity and dignified care
 Other reasons
Post workshop questionnaire
 What they had gained using same prompts

12. Organisations with bariatric policies or Guidelines
50%
percentage of responses
40%
30% Adelaide
20% Country (2)
10%
0%
Yes No DK N/A DNR
2008 WA Hospital audit-79% of hospital surveyed had B
Guidelines. (Paterson)

13. Organisations that Hire Bariatric Equipment
Percentage of responces
50%
40%
30% Adelaide
20% Country (2)
10%
0%
Yes No DK N/A DNR

14. Organisations that provide Bariatric Specific MHT
Percentage of responses
70%
60%
50%
40% Adelaide
30% Country (2)
20%
10%
0%
Yes No DK N/A DNR
Bariatric patients are involved in between 14%, and 21% of body
stressing incidents associated with acute patient care hospitals
across metropolitan Adelaide, but make up less than 2% of all
inpatients.

15. Organisations that provide additional staff for Bariatric Client
transfers/hygiene tasks
Percentage of responses
50%
40%
30% Adelaide
20% Country (2)
10%
0%
Yes No DK N/A DNR
Felix (2010) reported a 42% increase in cost (paid time to
complete the task) to perform hygiene care on an obese client
compared to bathing normal sized clients in USA Nursing Homes

16. Equipment for bariatric patients present in workplace
Percentage of responses
80%
70%
60%
50% Adelaide
40%
30% Country
20%
10%
0%
50
0
00
50
00
50
0
0
15
15
20
>1
>1
>1
>1
>1
s>
t>
L>
es
ds
rs
es
rs
at
ne
SW
ai
od
ai
ai
al
M
hi
ch
ch
sc
PC
m
ng
ac
ds
Sh
m
w/
ng
lki
m
be
Co
wa
hi
g
ig
in
we
lift
2008 WA Hospital audit-Beds (66% had enough), transfer and hygiene aids
(58% had enough). Wheelchairs (57% had enough) (Paterson)

17. Pre workshop expectations and post workshop satisfaction.
Adelaide.
95%
90%
85% Pre Adelaide
80% Post Adelaide
75%
70%
Resources B equipment Improve Devt. B Dignified
about B care knowledge worker safety Guidelines care

18. Pre workshop expectations and post workshop satifaction.
Country
Percentage of responses
102%
100%
98%
96% Pre country
94% Post country
92%
90%
88%
Resources B Improve Devt. B Dignified
about B care equipment worker Guidelines care
knowledge safety

19. Bariatric Fact Sheets
1. Needs & Considerations of Bariatric People in Aged
Care (definition; stats; BMI; general info)
2. Designing a Safe Environment (design guidelines)
3. Weight Bias
4. Needs of Staff (tools, algorithms, wellness)
5. Needs of the AC Industry (lobbying for
funding, planning)
6. Equipment (options, purchasing checklists)
All have references and resources.
https://www.employersmutual.com.au/south-
australia/member_incentives_program/index.htm

20.  ACFI does not adequately fund for additional
workers, specialised equipment and in some cases
increased space required to safely manage bariatric
clients
 Few ACFs are resourced to manage dependant clients
who weigh over 150kg
 Community organisations cannot provide more than 2
staff to transfer/provide hygiene care at home, therefore
struggle with dependant clients over 100kg
 Acute hospitals in Adelaide have difficulty D/Cing
dependant patients weighing over 120kg to ACFs

21. Not known
 Lack of shared weight and BMI data
Need
 Influence funding to support safe and dignified
care
 Industry guidelines
 E-data base of client weights/BMI

23. •Felix H C, Bradway C, Miller E, Powell L S. Obese Nursing Home
residents: a Call to Research Action. JAGS. 2010.58:6. 1196-1197
•Paterson, C. ASSC Survey results. Safe Steps. National Hospital
Intervention and Compliancy campaign. Work SafeWA. March 2009.
http://www.commerce.wa.gov.au/WorkSafe/Content/Industries/Health_a
nd_community_services/#Manual%20handling
•Link to bariatric fact sheets.
https://www.employersmutual.com.au/south-
australia/member_incentives_program/index.htm