Bariatric Practice, Australia

Zero Hunger, Improved Nutrition
Case Study Submitted by: Shirley Lockie, Managing Director, Perioperative Services
Country: Australia
Nurse-led programme of individualized patient care lead to a tighter control on clinical assessment and enhanced clinical outcomes.

Sixty-six percent the Australian population is overweight or obese but only two percent attend for bariatric surgery services. The current waiting time for bariatric surgery in the public system is more than three years. Without health insurance, there is no alternative but to wait while your health deteriorates.

Shirley Lockie, a Perioperative Nurse Surgical Assistant in a bariatric and general surgical practice in Australia has developed a comprehensive bariatric programme to respond to patients’ needs and guide them through the procedure. The core team consists of surgeon, dietitian, psychologist and perioperative coordinator. Continuity of care, continual assessment, and communication and planning, ensures the best for each individual having a bariatric procedure.

As a typical example of the patients cared for in this programme, one woman who came to the clinic was in the super obese category and had Type II diabetes, hyperlipidaemia, hyperparathyroidism and hypothyroidism. She was bipolar, had gastro-oesophageal reflux disease and obstructive sleep apnoea. She was attending a tertiary centre for medical management of obesity and had no private health fund.

Shirley worked with the woman’s GP, endocrinologist, anaesthetist, surgeon, dietitian and psychologist, liaising to establish a clear pathway, identifying risks such as lithium and post-operative nausea, and diabetes management. Protocols were established of when she should see the endocrinologist and GP to monitor diabetic control and hypertension.

One year after surgery, the patient’s weight has dropped 72kg; her diabetes and hypertension have resolved; an macronutrient management is ongoing. She has sold her wheelchair and is undertaking a course in medical reception/healthcare.

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