The number of surgical weight-loss procedures performed on adolescents with morbid obesity continues to increase. The adolescent presenting for surgical weight-loss services offers unique challenges for the healthcare team. A developmental approach is necessary to provide effective care and will assist the young person to integrate the lifestyle changes necessary for achieving and maintaining maximum weight loss.
{"title":"Meeting the Unique Needs of Adolescents in Surgical Weight-Loss Programs","authors":"L. Kollar","doi":"10.1089/BAR.2012.9965","DOIUrl":"https://doi.org/10.1089/BAR.2012.9965","url":null,"abstract":"The number of surgical weight-loss procedures performed on adolescents with morbid obesity continues to increase. The adolescent presenting for surgical weight-loss services offers unique challenges for the healthcare team. A developmental approach is necessary to provide effective care and will assist the young person to integrate the lifestyle changes necessary for achieving and maintaining maximum weight loss.","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"136-139"},"PeriodicalIF":0.0,"publicationDate":"2012-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9965","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60818838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Why Is Treating the Kids So Difficult","authors":"E. Nadler","doi":"10.1089/BAR.2012.9975","DOIUrl":"https://doi.org/10.1089/BAR.2012.9975","url":null,"abstract":"","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"99-100"},"PeriodicalIF":0.0,"publicationDate":"2012-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9975","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epidemic levels of obesity in the United States have created a ripple effect throughout healthcare. Healthcare organizations have taken great strides to address obesity-related issues such as sensitivity training and adjustments to the environment of care. Studies suggest, however, that nurses, physicians, and their respective students need additional obesity education and training in the care of the obese patient. To date, there are no national guidelines regarding the specific education of obesity to be included in advanced practice nursing curricula. Obesity is incorporated within other disease state content guidelines rather than as a unique medical condition. Additionally, obesity content is seldom incorporated into core coursework, making it more challenging for students to consider in subsequent diagnostic and management courses. A review of the current obesity literature and of the primary and acute care adult/gerontology nurse practitioner (AGNP) competencies provides rationale for incorporation ...
{"title":"Incorporating Obesity Education into Adult Primary and Acute Care Nurse Practitioner Programs","authors":"V. Sabol, Margaret Hammersla, Shannon Idzik","doi":"10.1089/BAR.2012.9979","DOIUrl":"https://doi.org/10.1089/BAR.2012.9979","url":null,"abstract":"Epidemic levels of obesity in the United States have created a ripple effect throughout healthcare. Healthcare organizations have taken great strides to address obesity-related issues such as sensitivity training and adjustments to the environment of care. Studies suggest, however, that nurses, physicians, and their respective students need additional obesity education and training in the care of the obese patient. To date, there are no national guidelines regarding the specific education of obesity to be included in advanced practice nursing curricula. Obesity is incorporated within other disease state content guidelines rather than as a unique medical condition. Additionally, obesity content is seldom incorporated into core coursework, making it more challenging for students to consider in subsequent diagnostic and management courses. A review of the current obesity literature and of the primary and acute care adult/gerontology nurse practitioner (AGNP) competencies provides rationale for incorporation ...","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"62-69"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9979","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the last 20 years, the rate of obesity in the United States has climbed to more than 33%. Obesity has been linked with comorbidities such as diabetes, hypertension, sleep apnea, hyperlipidemia, certain cancers, gastroesophageal reflux disease, arthritis, stoke, and heart disease. Bariatric surgery has proven to be an effective option to treat the disease of obesity and decrease, or even resolve, the patient's comorbid problems. Current surgical options include: laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and the biliopancreatic diversion with duodenal switch. While it may be the least known and utilized, the biliopancreatic diversion with duodenal switch (BPD/DS) is proving to be an effective surgical option for the super morbidly obese (body mass index greater than 50). Research is now showing that patients in this category benefit from the BPD/DS due to superior weight loss, greater metabolic disease resolution, and lowest weight regain rate when ...
{"title":"The Increasing Incidence of the Biliopancreatic Diversion with Duodenal Switch as a Surgical Weight Loss Option: Implications for Nursing Care","authors":"M. Dunham","doi":"10.1089/BAR.2012.9981","DOIUrl":"https://doi.org/10.1089/BAR.2012.9981","url":null,"abstract":"Over the last 20 years, the rate of obesity in the United States has climbed to more than 33%. Obesity has been linked with comorbidities such as diabetes, hypertension, sleep apnea, hyperlipidemia, certain cancers, gastroesophageal reflux disease, arthritis, stoke, and heart disease. Bariatric surgery has proven to be an effective option to treat the disease of obesity and decrease, or even resolve, the patient's comorbid problems. Current surgical options include: laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and the biliopancreatic diversion with duodenal switch. While it may be the least known and utilized, the biliopancreatic diversion with duodenal switch (BPD/DS) is proving to be an effective surgical option for the super morbidly obese (body mass index greater than 50). Research is now showing that patients in this category benefit from the BPD/DS due to superior weight loss, greater metabolic disease resolution, and lowest weight regain rate when ...","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9981","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social Media and HIPAA Compliance","authors":"Trish Walters-Salas","doi":"10.1089/BAR.2012.9984","DOIUrl":"https://doi.org/10.1089/BAR.2012.9984","url":null,"abstract":"","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"85-86"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Specialty nursing organizations, such as the National Association of Bariatric Nurses (NABN), provide a venue for the genesis of standardized practice, expectations of care and the dissemination of new knowledge. However, fostering involvement closer to the point-of-care is critical to ensuring successful outcomes for both patients and the nurses caring for them. State chapters of the National Association of Bariatric Nurses are a natural segue way to providing local resources and support to those caring for the unique needs of bariatric patients and their families. As with many types of care, local and regional differences can provide distinct opportunities and challenges for nurses and the patient care team. This article will describe the development of the first state chapter of the National Association of Bariatric Nurses and offer strategies and insight for further state chapter development.
{"title":"North Carolina First in Bariatric Nursing: Development of the First State Chapter of the National Association of Bariatric Nurses in North Carolina","authors":"Elizabeth Rochin, K. Ross","doi":"10.1089/BAR.2012.9985","DOIUrl":"https://doi.org/10.1089/BAR.2012.9985","url":null,"abstract":"Specialty nursing organizations, such as the National Association of Bariatric Nurses (NABN), provide a venue for the genesis of standardized practice, expectations of care and the dissemination of new knowledge. However, fostering involvement closer to the point-of-care is critical to ensuring successful outcomes for both patients and the nurses caring for them. State chapters of the National Association of Bariatric Nurses are a natural segue way to providing local resources and support to those caring for the unique needs of bariatric patients and their families. As with many types of care, local and regional differences can provide distinct opportunities and challenges for nurses and the patient care team. This article will describe the development of the first state chapter of the National Association of Bariatric Nurses and offer strategies and insight for further state chapter development.","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"48-50"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Registered Dietitian (RD) has an important role in the care of the bariatric patient by providing preoperative and postoperative medical nutrition therapy. The purpose of this case study was to demonstrate the RD's role in working with a non-compliant preoperative patient as she prepared for weight loss surgery (WLS). The patient was not motivated to make changes in the quality of her diet or modify her eating behaviors, and was unwilling to stop smoking. The process to qualify for WLS extended to two years when a medical emergency prompted her to make necessary changes to qualify for surgery. Her non-compliance with dietary interventions prior to surgery did not result in poor outcome or non-compliance following dietary guidelines after surgery. This case study revealed non-compliance preoperatively was not predictive of postoperative WLS outcome. The results may prompt others to further investigate predictors of success for WLS.
{"title":"My Greatest Nutritional Challenge","authors":"R. Wright","doi":"10.1089/BAR.2012.9982","DOIUrl":"https://doi.org/10.1089/BAR.2012.9982","url":null,"abstract":"The Registered Dietitian (RD) has an important role in the care of the bariatric patient by providing preoperative and postoperative medical nutrition therapy. The purpose of this case study was to demonstrate the RD's role in working with a non-compliant preoperative patient as she prepared for weight loss surgery (WLS). The patient was not motivated to make changes in the quality of her diet or modify her eating behaviors, and was unwilling to stop smoking. The process to qualify for WLS extended to two years when a medical emergency prompted her to make necessary changes to qualify for surgery. Her non-compliance with dietary interventions prior to surgery did not result in poor outcome or non-compliance following dietary guidelines after surgery. This case study revealed non-compliance preoperatively was not predictive of postoperative WLS outcome. The results may prompt others to further investigate predictors of success for WLS.","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"51-54"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To enhance the vitamin and mineral supplementation knowledge base of all bariatric surgery care providers. Significance: Bariatric surgery patients require ongoing nutritional counseling during their weight loss surgery experience. It is not the sole responsibility of the dietician. A multidisciplinary approach is paramount. This article will discuss the common bariatric procedures performed in the U.S. and their respective vitamin and mineral deficiencies based on the surgical physiology. In addition, basic vitamin and mineral charts are provided that list basic information (why, what, when, and how) all bariatric care providers must be familiar in order to assure optimal preoperative and postoperative care.
{"title":"Vitamin and Mineral Supplementation for the Bariatric Patient: Why, What, When, and How?","authors":"K. Joyner","doi":"10.1089/BAR.2012.9980","DOIUrl":"https://doi.org/10.1089/BAR.2012.9980","url":null,"abstract":"Purpose: To enhance the vitamin and mineral supplementation knowledge base of all bariatric surgery care providers. Significance: Bariatric surgery patients require ongoing nutritional counseling during their weight loss surgery experience. It is not the sole responsibility of the dietician. A multidisciplinary approach is paramount. This article will discuss the common bariatric procedures performed in the U.S. and their respective vitamin and mineral deficiencies based on the surgical physiology. In addition, basic vitamin and mineral charts are provided that list basic information (why, what, when, and how) all bariatric care providers must be familiar in order to assure optimal preoperative and postoperative care.","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"12 1","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The question of consent presents certain ethical and legal concerns for subjects, investigators, publishers, and end-users of research. In this context, consent in a broad sense is the process that allows a human subject to make decisions with respect to participation in an investigational study. The decision may impact a subject emotionally, physically, or both. As bariatric nursing emerges as an evidenced-based science, nurses have been increasingly active in building this body of evidence. However, distinctions between quality improvement (QI) measures and human subjects research (HSR) can be confusing. Regardless, the underlying theme seeks to recognize the universal requirement to protect subjects from harm. This article examines issues pertaining to consent and a special and vulnerable population. Further, strategies to differentiate between the two categories of investigation are described. Specific examples of QI opportunities are included.
{"title":"Ethical Considerations of Quality Improvement and Human Subjects Research: Is There a Slippery Slope?","authors":"S. Gallagher","doi":"10.1089/BAR.2012.9987","DOIUrl":"https://doi.org/10.1089/BAR.2012.9987","url":null,"abstract":"The question of consent presents certain ethical and legal concerns for subjects, investigators, publishers, and end-users of research. In this context, consent in a broad sense is the process that allows a human subject to make decisions with respect to participation in an investigational study. The decision may impact a subject emotionally, physically, or both. As bariatric nursing emerges as an evidenced-based science, nurses have been increasingly active in building this body of evidence. However, distinctions between quality improvement (QI) measures and human subjects research (HSR) can be confusing. Regardless, the underlying theme seeks to recognize the universal requirement to protect subjects from harm. This article examines issues pertaining to consent and a special and vulnerable population. Further, strategies to differentiate between the two categories of investigation are described. Specific examples of QI opportunities are included.","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"55-57"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: According to the Centers for Disease Control, nearly 34% of adults in the United States are obese, and one treatment used is bariatric surgery. However, often these patients require large doses of opioids during the perioperative period, which can result in significant side effects. One agent that can be used as a supplement or in place of opioids is the alpha 2 agonist dexmedetomidine. However, research regarding the use of dexmedetomidine in bariatric surgery is limited. Therefore, the purpose of this evidenced-based review was to examine the effect of dexmedetomidine on anesthetic requirements during bariatric surgery and opioid requirements and recovery in the postoperative period. Methods: An evidenced-based review was completed using MEDLINE with a search of articles published after 2005. The terms obesity and bariatric surgery were linked with dexmedetomidine and scored for research quality. Results: A total of 182 subjects from three randomized controlled trials, one case review, and t...
{"title":"Dexmedetomidine in Bariatric Surgery: A Useful Opioid Adjunct? An Evidence-Based Review","authors":"E. Brown, K. Oswald, J. Pellegrini","doi":"10.1089/BAR.2012.9978","DOIUrl":"https://doi.org/10.1089/BAR.2012.9978","url":null,"abstract":"Background: According to the Centers for Disease Control, nearly 34% of adults in the United States are obese, and one treatment used is bariatric surgery. However, often these patients require large doses of opioids during the perioperative period, which can result in significant side effects. One agent that can be used as a supplement or in place of opioids is the alpha 2 agonist dexmedetomidine. However, research regarding the use of dexmedetomidine in bariatric surgery is limited. Therefore, the purpose of this evidenced-based review was to examine the effect of dexmedetomidine on anesthetic requirements during bariatric surgery and opioid requirements and recovery in the postoperative period. Methods: An evidenced-based review was completed using MEDLINE with a search of articles published after 2005. The terms obesity and bariatric surgery were linked with dexmedetomidine and scored for research quality. Results: A total of 182 subjects from three randomized controlled trials, one case review, and t...","PeriodicalId":55589,"journal":{"name":"Bariatric Nursing and Surgical Patient Care","volume":"7 1","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2012-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/BAR.2012.9978","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60820328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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