Date of Graduation

2013

Document Type

Dissertation/Thesis

Abstract

Many adults are unaware of their actual body weight, and those who are aware have a tendency to inaccurately report. Anesthetic drugs, like many other drugs, are weight based, some on ideal and some on actual body weight, depending upon the drug. There is a risk of inaccurately dosing medications during the anesthetic event if the medications are dosed based upon an inaccurate body weight. Literature indicates that self-reported patient weights are inaccurate for many reasons. Additionally, estimates of patient weight by healthcare providers are inaccurate. The majority of drugs used in anesthesia are weight based. It is very clear that patient safety is at risk when anesthesia drug dosages are based on an inaccurate patient weight. The first objective of this study was to increase knowledge of the validity of self-reporting of preoperative weight by clinicians in the pre-operative area. The second objective was to identify the number of patients who would have been given an incorrect dosage of medication based upon their self-reported weights. The third objective was to change the anesthesia policy to require the measurement of patient weight for persons requiring anesthesia. The final objective was to incorporate the new policy as part of the new nurse orientation to provide continuity of care among all new providers. This was a descriptive study with a convenience sample of all adult patients undergoing an elective surgical procedure in a one week period in three hospitals. The sample included 134 patients and was drawn from the population of adult patients requiring anesthesia services at three facilities in Ohio, California, and Wisconsin. Data analysis results were shared with all healthcare providers at the three hospitals. A deviation of plus or minus five pounds was applied to the data and analysis revealed that 59% (N=79) of the patients reported their weights inaccurately. Over reporting of weight came at a rate of 14.2% (N=19) with a mean discrepancy of ten pounds. Under reporting of weight came at a rate of 44.8% (N=60) with a mean discrepancy of 16.3 pounds. Data analysis for the group of participants (N=19) who over reported their weight revealed no statistically significant difference by gender. White patients over reported by a mean of 11.25 pounds while Black/African American patients over reported by 7.86 pounds. The average age of the participants who over reported their weight was 52.11 years. Data analysis for the group of participants (N=60) who under reported their weight revealed no significant difference by gender or race. The average age of the participants who under reported their weight was 38.22 years. A policy was written and incorporated into the routine pre-assessment process at the three hospitals in which the study was conducted requiring measured weights on all preoperative adult surgical patients. In addition, the new change in policy was incorporated into the nursing orientation. Follow up observation confirmed 100% compliance at all three hospitals. Patient safety is at the forefront of healthcare. It is imperative that healthcare providers obtain an accurate weight. The findings of this study verify the need for a weight measurement. There is a need for additional research related to validity of self-reported weights in the field of anesthesia where weight based medications play such an important role in the success of the anesthetic and safety of the patient.

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