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his issue of ECPN will focus on a disease that can affect people of practically all age groups, economic backgrounds, and ethnicities—obesity. In our cover story, “The Challenges of Bariatric Care,” Susan Gallagher, RN, CWOCN, MSN, MA, PhD, provides a comprehensive overview of the state of this disease. Dr. Gallagher emphasizes the importance of specially designed equipment, a comprehensive bariatric care plan, and strategies to implement changes to better accommodate this patient population. Dr. Gallagher begins with a review of the most recent interpretation of obesity and provides tips for developing a comprehensive bariatric care plan that includes a multidisciplinary bariatric task force. Dr. Gallagher also points out the need for caregivers to select specialized equipment, taking into consideration not only weight limits for the equipment but also width of the equipment. Specialty frames and support surfaces, wide front-wheeled walkers, wide wheelchairs, wide room chairs, patient lifts, abdominal binders, and scales are all examples of equipment that may be purchased to enhance patient safety and prevent caregiver injury.
       In another article on the topic of obesity, “‘Please Don’t Feed the Fatties’ and Other Body Composition Myths,” Nancy Collins, PhD, RD, LD/N, examines obesity from the dietitian’s perspective. Dr. Collins points out an important fact that may be overlooked in the long-term care setting—while a resident may appear overweight, he or she may be inadequately nourished. Dr. Collins provides an overview of body composition and explores ways to measure body composition, including bioelectrical impedance analysis and hydrostatic weighing. Dr. Collins stresses that clinicians need to be aware that regardless of weight, many residents are losing lean mass, which affects immune function, wound healing, balance and mobility, and overall independent functioning.
       Both articles raise awareness of the special needs of this patient population. The title of the article by Dr. Collins illustrates 1 misconception related to obesity, and Dr. Gallagher notes that clinicians best serve their patients when they recognize obesity as the chronic condition that it is. It is important for caregivers to treat this population—as well as all patients—with dignity, respect, understanding, and sensitivity. Dr. Gallagher aptly points out, “Obese Americans neither chose to be overweight nor chose to experience widespread prejudice and discrimination.”
       In addition to the editorial focused on care of the bariatric population, this issue of ECPN features a continuing education (CE) article on urinary incontinence and indwelling catheters. In “Urinary Incontinence and Indwelling Catheters: CMS Guidance for Long-Term Care,” Diane K. Newman, RNC, MSN, CRNP, FAAN, discusses the new surveyor guidance from the Centers for Medicare and Medicaid Services (CMS) on Federal Tags 315 and 316, which will combine and become Tag 315. Turn to page 50 for the opportunity to receive 1 free CE contact hour.
       As always, I hope you enjoy this issue of ECPN. Feedback is always welcome at rolszewski@hmpcommunications.com.