(PI-015) Exploring Equitable Skin Care for the Patient Who Weighs 500 to 1200 Pounds
Thursday, May 16, 2024
2:15 PM – 3:15 PM East Coast USA Time
Introduction: Little evidence exists that guides care for patients whose weight ranges between 500 and 1200 pounds. This quality improvement project explored care challenges associated with this specific patient population.
Methods: A multi-phased mixed method design was put in place for this quality improvement project. The first phase included brief interviews (N = 34) to identify the major issues associated with care. Ten areas of care were identified. Phase two of this quality improvement project was: craft 10 questions based on the findings in phase one, create a survey using Survey Monkey technology with consent language, distribute the 10-item survey to 1719 healthcare professionals within and outside the US, report data using standard graphics (descriptive statistics) Phase three of this project was to validate the data with seasoned healthcare professionals (N = 10) for purposes of creating the 2023 enclosure to the VA Bariatric SPHM Guidebook
Results: Based on interviews, surveys and focus groups the top ten challenges/opportunities associated with caring for the person whose weight ranged 500 to 1200 pounds were identified as follows: diagnostic studies, emotional exhaustion, inadequate technology/equipment, post-mortem care, occupational injury, environmental barriers, lack of coordinated planning, limited post-acute resources, atypical clinical care. Of these 10 areas, all but one directly or indirectly relate (post-mortem care) to skin health, and the challenges associated with a high degree of adiposity and inadequate diagnostic studies, equipment/technology, resources and clinical intervention. Massive lower leg lymphedema, lipedema, vascular injury, intertriginous dermatitis, incontinence and incontinence associated dermatitis are just a few of the skin challenges identified.
Discussion: The promise of future technological development is, in this case, often driven by subject matter experts and clinicians rising to the challenge of caring for today's patients of size with skin concerns. This points to the need for close partnerships between clinicians and suppliers of resources (academic, industry, material, etc) to be sure promising solutions are efficiently developed and distributed to better serve individuals of size with consistent standards of equitable, safe skin care.