Specialized staff and equipment for weight loss surgery patients: best practice guidelines.
OBJECTIVE
To provide evidence-based guidelines on the specialized personnel, equipment, and physical plant required for safe and effective care of severely obese weight loss surgery (WLS) patients.


METHODS
We examined MEDLINE (Ovid and PubMed) and the Cumulative Index of Nursing and Allied Health Literature for articles on facilities resources for care of WLS patients published in English between January 1980 and March 2004. We queried several web sites for appropriate references; these included the Agency for Healthcare Research and Quality and the American College of Surgeons. The majority of reference material was descriptive and not specific to facilities resources for WLS patients. We identified a substantial body of literature on the general subject of patient safety; three of these articles were used to develop recommendations on the use of technology for medical error reduction. All other recommendations are based on 11 expert opinion reports.


RESULTS
We recommended adequate training and credentialing for all medical staff; dedicated support and administrative personnel; and specialized interventional, diagnostic, operating room, and transport equipment. We specified needed adaptations to the physical plant and developed evidence-based guidelines for medical error reduction and systems improvements.


CONCLUSIONS
Specialized resources and dedicated staff are needed to protect the health of WLS surgery patients and staff. Adaptations include preoperative preparation for safe means of patient transport; techniques of anesthesia and intraoperative exposure; provisions for postoperative recovery; and measures to assure postoperative patient safety, hygiene, and comfort.
Whittemore
Anthony D
AD
Division of Vascular Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston MA 02115, USA. awhittemore@partners.org
Kelly
John
J
Shikora
Scott
S
Cella
Robert J
RJ
Clark
Thom
T
Selbovitz
Leslie
L
Flint
Loring
L
D003406:Credentialing; D013505:Digestive System Surgical Procedures / Q000193:education / Q000295:instrumentation / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D016239:MEDLINE; D019300:Medical Errors / Q000517:prevention & control; D008503:Medical Staff / Q000193:education; D017410:Practice Guidelines as Topic; D013043:Specialties, Surgical / Q000193:education / Q000295:instrumentation; D015431:Weight Loss