Transcript Obesity Prevention - Shellie Ray CRNP

Shellie Ray
Auburn University
• Obesity is one of the most challenging health crises
the country has ever faced.
• Second only to cigarette smoking, obesity is a
leading cause of preventable death in the U.S.
• Associated with HTN, DM, CAD, hyperlipidemia,
obstructive sleep apnea & cancers of the breast,
uterus, prostate & colon.
• Sixty-eight % of the American population are
overweight or obese.
• > 110,000 deaths yearly associated with obesity.
• Alabama is second only to Mississippi as the fattest
state in the nation.
• Americans spend more than $150 billion on health care related
to obesity. Considerable health risks associated with obesity so
prevention should be a high priority for health care providers
but is often not addressed.
• An objective of Healthy People 2020 is to increase the number
of health care providers who regularly assess BMI in their adult
patients.
• In a large national study of adults with BMI >30, only 42%
reported that their health care provider advised them to lose
weight.
• Routine screening with BMI and WC could detect a large
percent of adults who are overweight or obese.
• In primary care patients 18 years and older, will Body Mass
Index (BMI) and waist circumference measurements at every visit
reduce the incidence of obesity?
• Small test of change
• In a small group of approximately 15 adult patients will the
implementation of BMI and WC measurements increase the
awareness of their weight status thus helping them to achieve a
normal BMI?
• Many patients who are overweight or obese either don’t realize it or are in
denial and too few doctors are addressing the issue with their patients.
• Patients at the Wound Healing Center are treated for chronic, non-healing
wounds.
• Large number of patients are overweight or obese.
• The only time weight is addressed is on the admission paperwork that the
patient fills out. They enter their height and weight. BMI is not calculated
and WC not measured.
• Weight is not assessed at return visits.
• Patients: Healthier, more active, possibly decrease some
medications (HTN, diabetes, cholesterol meds)
• Medical Staff: physicians, nurses
• National Wound Healing Center: Obesity can impact wound
healing. Obtaining normal BMI can help wound healing times
thus increasing their wound healing time rates.
• Insurance companies: $150 billion in healthcare related
expenses related to obesity is spent by Americans yearly.
• Site: Northeast Alabama Regional Medical Center
Wound Healing Clinic. Outpatient clinic where
patients return to clinic for weekly or bi-weekly followup appointments.
• Week 1
• Patients will be given an information letter regarding
the project. Only patients who give consent will be a
part of the project. Approximately 15 patients will be
chosen for this small test of change.
• Patients BMI and WC will be measured during the vital
sign assessment. BMI will be charted on a graph as
normal, overweight or obese. WC will also be
charted.
• Overweight & obese patients will be given a Patient Readiness
Assessment to assess their readiness to make lifestyle changes in
order to lose weight.
• Patients who are ready and willing to make lifestyle changes
will be provided with education regarding changes to
incorporate in order to decrease their weight thus decreasing
BMI and WC. ( exercise, proper nutrition)
• Weeks 2-6
• When patients return to clinic BMI and WC will be measured
and charted on graph. Each patient should have at least 3
measurements
• Week 7
• All measurements should be obtained by this point.
• BMI and WC will be analyzed to see if there was a decrease in
BMI and WC.
• Final paper will be prepared.
• Week 8
• Results will be presented to stakeholders with a poster
presentation.
• Anticipated budget needs are small. The only tools needed are scales and a
tape measure which I will provide. I will develop a learning tool which will
provide information for proper nutrition and exercising tips. The WHC has a
copier which will be available to me for copies of the info tool and the
charts.
• Barriers:
• Weight is a sensitive issue which may cause emotional discomfort.
• Patient’s willingness to participate
• Bedridden patients unable to stand on scale and lift scales not available.