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A Patient Safety Dilemma: Obesity in the Surgical Patient

Goode, Victoria
Thesis/Dissertation; Online
Goode, Victoria
Merwin, Elizabeth
Bullock, Linda
The obese surgical population is a vulnerable population in need of further research. The prevalence of obesity in the surgical setting exceeds the estimates of the general population. Thus, healthcare workers, specifically surgical staff, can expect to encounter this population frequently in practice. The associated health risks, hospital costs, and potential for adverse events associated with obesity make it imperative to continue to examine the care delivered to this vulnerable population. The purpose of this dissertation was to quantify the prevalence of obesity in the surgical population, to examine the degree to which undesirable outcomes occur in the obese surgical patient population. These manuscripts, reported in Chapters 3, 4, and 5, include Alice Magaw: A model for Evidence-Based Practice, A Patient Safety Dilemma: Obesity In the Surgical Patient, and Are ICD Codes in Electronic Health Records Useful in Identifying Obesity as a Risk Factor When Evaluating Surgical Outcomes provide information that will influence decisions regarding patient safety outcomes. In Manuscript 1, the historical background on patient safety, describes the importance of vigilance as being important to patient safety outcomes and validates the importance of recognizing vulnerable populations when establishing protocols for patients. Magaw’s contribution to patient safety helps practitioners recognize the potential for adverse events, and the necessity of the practice of anesthesia to seek to identify populations prone to adverse events and to examine alternative methods to prevent them. In Manuscript 2, confirmed that a patient safety dilemma exists for healthcare systems and healthcare providers regarding caring for the obese patient population. In the examination of three AHRQ patient safety indicators (PSIs), for the inpatient population, obesity was found to increase the likelihood of adverse outcomes in two of three PSIs examined. In Manuscript 3, clinical data was used to calculate the patient’s BMI, which was then used to categorize the patients into BMI. The findings of this research confirm that ICD-9 codes for the obese surgical populations were under-utilized. This was an alarming finding for patient safety as it was determined in this research that obesity is a predictor of adverse events in the inpatient surgical obese population.
University of Virginia, School of Nursing, PHD, 2015
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