Manual handling risks in the bariatric (obese) patient pathway in acute sector, community and ambulance care and treatment.

As part of a larger research project the patient pathway was mapped for an emergency admission to identify the manual handling major risks. Focus group interviews were held with 25 key stakeholders from the acute, community and ambulance healthcare sectors and social services at 3 venues across the United Kingdom (UK). A detailed qualitative iterative analysis used 'cause and effect' or fishbone (Ishikawa) diagrams to identify key issues. Five themes emerged as generic risks throughout the bariatric patient pathway, these were: patient factors including body shape, mobility, pain, co-operation, privacy, comfort and dignity; building (or vehicle) space and design, including space, clearance, floor surface, and safe working load of floor; equipment (manual handling and clinical) and furniture, including fit, maximum weight capacity, availability, suitability, compatibility, size, and effort to move; communication both within and between organisations; and organisational and staff issues, including policies, culture and staff availability and training. It was concluded that buildings, vehicles and equipment need to be designed to 'fit' a range of bariatric shapes and sizes so that bariatric patients could be accommodated in safety and comfort, and with minimal loss of dignity.