What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed

 What Bed Size Does a Patient Need? The Relationship Between Body Mass Index and Space Required to Turn in Bed

Wiggermann, Neal; Smith, Kathryn; Kampar, Dee

Over one-third of the U.S. population is now obese with a body mass index (BMI) greater than 30 kg/m2 (Ogden, Carroll, Fryar, & Flegal, 2015). As the general population has increased in body size, so too has the hospital population. From 2006 to 2015, the mean patient weight in acute care increased from 80.5 to 83.7 kg (177.5–184.5 lbs; Vangilder, Lachenbruch, Algrim-Boyle, & Meyer, 2017). Over the same period, the mean BMI increased from 29.0 to 29.7 kg/m2 (Vangilder et al., 2017), which is very near the definition of obese. A particular challenge for caregivers is that, although the mean body weight of the population is increasing, the heaviest patients are increasing at an even faster rate. For example, in 2006, 2.5% of patients weighed more than 136 kg (300 lbs), compared with 4.0% in 2015 (unpublished data from Vangilder et al., 2017). To properly care for a patient of size, caregivers require specialized equipment that can accommodate the dimensions, weight, and specific mobility needs of such patients (Camden, 2006). Matching the patient with the proper size of hospital bed is particularly important for the recovery of the patient and the safety and effectiveness of the care team. The hospital bed is typically the piece of equipment with which the patient has the most contact and is central to most aspects of nursing care. The standard width of a hospital bed is 91 cm (36 in.), although 102-cm (40-in.) and 127-cm (50-in.) widths are also available. Currently, there is no data to support guidance on what size of bed should be selected for a particular patient.There is little mention in the literature of how to select a bed size for a patient, and none of these recommendations appear to be supported by empirical evidence on patient space requirements. In many cases, the lowest weight capacity of standard equipment appears to drive bariatric protocols, such as using awider bed for patients weighing greater than 159 kg (350 lbs; Muir & Archer-Heese, 2009). Another source suggests assigning specialized “bariatric” beds for patients heavier than 147 kg (325 lb) or with a BMI greater than 55 kg/m2 , although it is unclear how this threshold was determined (Gourash, Rogula, & Schauer, 2007).turn and laterally slide the patient simultaneously, which is physically demanding and requires additional staff. Although there are many consequences to having a bed that is too narrow, there may also be drawbacks to using beds that are unnecessarily wide. Wider beds tend to cost more, and using a bed that is needlessly wide may incur unnecessary costs for the healthcare institution. Moreover, an unnecessarily wide bed will require caregivers to reach farther as they extend their arms from the edge of the bed to the patient, which could increase the risk of back injury (Waters, 2007).